KRS 353 - Lecture 12

Herniated disc

Damage to the annulus fibrosus that causes the nucleus pulposus to bulge is called?

Where the Atlas (C1) sits on Axis (C2). Most vervical rotation occurs here A pivot-type joint Most mobile joint of any two vertebrae

Describe the Atlantoaxial joint:

First joint. Formed by occipital condyles of skull sitting on articular fossa of the 1st vertebra. Allows flexion & extension int he saggital plane.

Describe the Atlantooccipital joint:

Contains a high proportion of elastic fibers. Important because it keep the spine in constant compression, enhancing spine's stability (AKA "Pre-stress")

Describe the function of the ligamentum flavum?

1. Cervical region 2. Transverse foramen 3. Superior articular facet 4. Spinous process

Give the region and the landmarks of the image:

1. Lumbar region 2. Mammillary process 3. Body 4. Vertebral foramen 5. Transverse process 6. Spinous process 7. Superior articular process 8. Superior vertebral notch 9. Body 10. Inferior vertebral notch 11. Inferior articular process

Give the region and the landmarks of the image:

1. Thoraic region 2. Costal Facet 3. Lamina 4. Pedicle 5. Superior articular process 6. Superior articular facet 7. Transverse process 8. Costal facet

Give the region and the landmarks of the image:

Cervical vertebrae. 1. Vertebral Foramen 2. Superior articular facet 3. Transverse foramen 4. Body 5. Spinous process 6. Spinous process 7. Superior articular facet 8. Transverse process 9. Body 10. Transverse foramen 11. Inferior articular facet

Give the type of vertebrae in the image, and identifiy all the landmarks:

1. 2nd Lumbar Vertebra: Superior view 2. Vertebral Body 3. Vertebral foramen 4. Pedicle 5. Transverse Process 6. Superior articular process 7. Mamillary process 8. Lamina 9. Spinous process 10. Accessory process

Give the vertebrae, view, and the landmarks of the image:

1. Axis (C2): posterosuperior view 2. Inferior articular process 3. Lateral mass 4. Superior articular facet for atlas 5. Dens 6. Posterior articular facet for transverse ligament 7. Transverse process 8. Spinous process

Give the vertebrae, view, and the landmarks of the image:

1. Transverse process 2. Transverse foramen 3. Inferior articular facet for axis 4. Anterior arch 5. Atlas (C1): Inferior view 6. Anterior tubercle 7. Vertebral foramen 8. Posterior arch 9. Posterior tubercle

Give the vertebrae, view, and the landmarks of the image:

Classified as Cartilagenous with fibrocartilage as binding tissue. (Eg., Intervetebral disks - fibrocartilage)

How are the articulations of the spine classified?

IV discs are avascular and rely on mechanical means for nutrition (Eg. intermittent changes in posture and body position alter internal disc pressure causing a "pumping action")

How do IV discs gain nutrition?

The ribs articulate with both the body and transverse processes They are synovial, non-axial, slight gliding movements

How do the ribs articulate with the spine?

33 Irregular bones: 7 Cervical 12 Thoracic 5 Lumbar 5 Sacral (fused) 4 Coccygeal (small, fused)

How many irregular bones make up the spine? Hint: Coffee at 7, Tea at 12, Lunch at 5, Supper at 9

4

How many normal curves does the spine have?

1. True ribs 2. False ribs 3. Floating Ribs 4. Sternal Angle 5. Sternal Notch 6. Thoracic vertebra 7. Clavicular notch 8. Sternum 9. Manubrium 10. Body 11. Xiphoid process 12. Ribs 13. Costal cartilage

Identify the landmarks in this image:

From Left to Right: Lordosis, Kyphosis, Scoliosis

Name the 3 common spinal misalignments shown in this picture:

Two anterior (forward): Cervical & Lumbar Two posterior (backward): Thoracic and Sacral

Name the curves of the spine in this image:

The facet joints

What anatomical structure(s) assist in sustaining loads on the spine, particularly in hyperextension?

Atlas & Axis.

What are the first 2 cervical vertebrae called?

1. Ant/Post Longitudinal Ligaments 2. Supraspinous Ligament (In the cervical region this ligament is enlarged, AKA Nuchal Ligament) 3. Interspinous Ligaments 4. Intertransverse Ligaments 5. LIgamentum Flavum

What are the five ligaments that are key to the vertebral column?

Atlanto-occipital joint. Atlanto-axial joint.

What are the joints of the first 2 cervical vertebrae?

Fibers of the nucleus pulposus bulge to the same side as the movement, the concave side.

What are the movements of the nucleus pulposus inside the disc ("other theory")?

1. Costotransverse joint 2. Costovertebral joint

What are these two joints?

Manubrio-sternal joint Joint between the sternum and xyphoid process

What are two joints in the sternum?

7 pairs of true ribs attach directly to sternum 5 pairs of false ribs 3 pairs attach indirectly to sternum 2 pairs of floating ribs - ends are free

What comprises 12 pairs of ribs?

A body, a bony ring called the neural arch, and bony processes which are attachment sites for ligaments and muscles.

What comprises a typical vertebra?

12 pairts of ribs and the sternum

What comprises the thorax?

An exaggerated thoracic curve that is often seen in elderly women with osteoporosis.

What is Kyphosis?

An exaggerated lumbar curve that results from a strength imbalance between the lower back muscles and weakened abdominal muscles. It is the most common cause of lower back pain (LBP).

What is Lordosis?

The development of wedge-shaped vertebrae because of abnormal epiphyseal plate behavior that results in a kyphotic spine.

What is Scheuermann's disease?

An exaggerated lateral deviation of the spine that can be caused by carrying books or a heavy purse on one side. Severe cases are characterized by extreme lateral deviations and localized rotation of the spine.

What is Scoliosis?

The fibers of the nucleus pulposus bulge to the opposite side as the movement.

What is the "balloon theory" of movement for the nucleus pulposus?

Thick outer band of disk made up of concentric rings of collagen.

What is the Annulus Fibrosus?

Gelatinous material that occupies the center of the disk. Gelatinous material is made up of mucopolysaccharide, with the risk of the NP consisting of water.

What is the Nucleus Pulposus?

Runs the length of the spinal column and attaches to each spinous process

What is the functino of the Supraspinous Ligament?

Extends from base of skull to sacrum to link vertebral bodies

What is the function of the Ant/Post Longitudinal LIgaments?

Compressed elastic material that allows for compression in all directions along with torsion. Becomes less resilient with age, injury, or improper use.

What is the function of the Nucleus Pulposus?

Enables the spine to absorb blows & shocks

What is the function of the spinal curves?

Functional units are called "motion segements", and they consist of two adjacent vertebrae and the soft tissue between them.

What is the functional unit of the spine called and what does it consist of?

Absorb shock and aid in movement of adjacent vertebrae

What is the purpose of the Intervetebral disks?

Facets are lined up to prevent twist movements (transverse plane)

What movement is prevented by lumbar vertebrae?

The facets prevent movement in the saggital plane (forward and backward movement)

What movement is prevented by thoracic vertebrae?

Rotation, transverse

What movement is the thoracic region most mobile in?

The shapes of the articulating surfaces of the facet joints of each vertebrae.

What physically limits the ranges of motion at different levels of the spine?

With age. Fluid loss increases around the second decade of life, and as the disc degenerates, compressive and shear forces on the spine increase.

When do we see a more permanent loss of fluid in the nucleus puposus?

Cervical and Lumbar, the secondary curves

Which spinal curves are due to gravity?

Primary: Thoracic & Sacral

Which spinal curves are the primary curves?

The lumbar region.

Which spinal region has the largest vertebrae?

Because each vertebrae must support the weight of the portion above it.

Why do vertebrae get larger from the top down?