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Flashcards in Spinal Lecture 4 Deck (58)
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1
Q

where does the anterior longitudinal ligament extend from?

A

anterior surface of vertebral bodies

2
Q

can you stress the anterior longitudinal ligament?

A

No, taugt extension, can’t in reality stress it

3
Q

what aspects of the anterior longitudinal ligament are broader, thinner?

A

broader caudally and thinner cranially

4
Q

at about the level of C2 what is the anterior longitudinal ligament replaced by?

A

it is replaced by the anterior atlantooccipital membrane (different type of tissue)

5
Q

the anterior longitudinal ligament is thicker and narrower in the _spine than in the _ and _ spine

A

thicker and narrower in the T-spine than in the c and l-spine

6
Q

the anterior longitudinal ligament extends to the front of the ___

A

sacrum

7
Q

the longitudinal fibres of the anterior longitudinal ligament attach to what?

A

IVD

hyaline cartilage

anterior aspect of vertebral bodies

8
Q

the anterior longitudinal ligament fibres blend with what?

A

subadjacent periosteum, perichondrium and periphery of the annulus fibrosis

9
Q

describe the anterior longitudinal ligament superficial layer

A

longest, extend over 3 of 4 vertebrae (thinnest, weakest)

10
Q

How many vertebrae does the anterior longitudinal ligament intermediate layer run between?

A

between two or three vertebrae

11
Q

describe the anterior longitudinal ligament deep layer

A

one body to next (strongest)

12
Q

where does the posterior longitudinal ligament lay?

A

lies in the vertebral canal on the posterior surface of the vertebral bodies

13
Q

what is the posterior longitudinal ligament continuous with at about C1-C2?

A

membrane tectoria

14
Q

what does the posterior longitudinal ligament attach to?

A

IVD, hyaline cartilage and vertebral bodies

15
Q

in the lumbar spine and lower thoracis spine the posterior longitudinal ligment is ___, narrow over ___ and broad over ___

A

in lumbar spine and lower thoracic spine it is DENTICULATE, narrow over VERTEBRAL BODIES and broad over DISCS

16
Q

what is the posterior longitudinal ligament fused with and how does this reinforce the disc

A

fused with nulus fibrosis of the IVD therfore reinforces disc posteriorly

17
Q

when is the posterior longitduinal ligament taut?

A

in flexion

18
Q

T/F the posterior longitudinal ligament is affected by anything in the vertebral canal i.e. meningitis, disc herniation

A

TRUE

19
Q

describe the superficial layer of the posterior longitudinal ligament

A

longest, extend over 3 of 4 vertebrae

20
Q

describe the intermediate layer of the posterior longitudinal ligament

A

between two or three vertebrae

21
Q

describe the deep layer of the posterior longitudinal ligament

A

extends between adjacent vertebrae

22
Q

where is the ligamentum flavum found and what does it lie posterior to?

A

inside vertebral canal posterior to spinal cord

23
Q

what does the ligamentum flavum connect in the vertebral canal?

A

connects lamina to lamina

24
Q

what tissue properties does the ligamentum flavum have and what does this allow for?

A

yellow elastic tissue like the ligamentum nuchae to allow for mobility and recoil

25
Q

what does the ligamentum flavum restrict and what does it provide rebound tension for?

A

restricts flexion and lends rebound tension to go back into extension

26
Q

do the fibres of the ligamentum flavum run parallel or perpendicular?

A

almost perpendicular fibres

27
Q

what two points does the ligamentum flavum run between?

A

descend from inferior surface of one lamina to the superior surface of next lower lamina

28
Q

where is the ligamentum flavum thin, thick and thickest?

A

thin -broad and long in the neck

thicker - in the thoracic spine

thickest -in the lumbar spine

29
Q

what is the most superficial ligament in the spine?

A

surpraspinous ligament

30
Q

what points does the supraspinous ligament run between

A

from spinous process to spinous process - C7 to sacrum (becomes ligamentum nuchae above C7)

31
Q

what level may the supraspinous ligament cease at?

A

L5

32
Q

what portion of the spine has a thicker and broader supraspinous ligament

A

L-spine

33
Q

what does the supraspinous ligament intimately blend with

A

neighbouring fascia

34
Q

what does the supraspinous ligament provide attachment for

A

muscle, fascia and aponeurotic attachment

35
Q

how many segments does the superficial fibres of the supraspinous ligament extend over

A

3 to 4 segments

36
Q

how many segments does the intermediate fibres of the supraspinous ligament span between?

A

two to threee segments

37
Q

how many segments does the deep fibres of the supraspinous ligament span between

A

one segment

38
Q

what movement stresses the surpraspinous ligament

A

flexion

39
Q

what ligament fills the gap between SPs

A

interspinous ligament

40
Q

is the interspinous ligament thick or thin?

A

thin, almost membranous

41
Q

the __ ligament connects adjoining spine from root to apex of each

A

interspinous ligament

42
Q

what does the interspinous ligament meet with anteriorly and posteriorly

A

meet ligamentum flavum anteriorly and supraspinous ligament posteriorly

43
Q

where is the interspinous ligament narrow and where is it broad

A

-narrow and elongated in the thoracic spine -broader and thicker in the lumbar spine

44
Q

where is the interspinous ligament poorly developed and what is it replaced by in this area

A

poorly developed in the cervical spine where its replaced by and interspinous muscle

45
Q

When is the interspinous ligament taut?

A

in flexion

46
Q

what points does the intertransverse ligament travel between

A

between transverse processes, superior part of one below to inferior part of one above

47
Q

in which area does the intertransverse ligament have few, irregular fibres and what is it replaced by in this area

A

in C-spine and it is largely replaced by the intertransverse muscle

48
Q

in which area does the cords of the intertransverse ligament blend with surrounding muscles

A

t-spine

49
Q

in which area is the intertransverse ligament thin and membranous

A

l-spine

50
Q
A
51
Q

Whn running the psoas in contracting causing ____ and ____. If there is disfunction in the area (such as anterior longitudinal ligament not doing it’s job) the Psoas then needs to stabilize the spine too. This is not it’s intended job and now is sucepitble to ___.

A

Side bending and rotation. Injury

52
Q

What is a negative consequence of the ligamentum flavum becoming ossified?

A

Spinal stenosis. Not much you can do to fix but you can correct everything around it and get the patient mobile and moving as much as possible.

53
Q

Anterior Longitudinal Ligament

A1:

A2:

Fibre Direction:

Stress:

Function:

Relationships:

A

Anterior Longitudinal Ligament

A1: Front of Sacrum - Anterior surface of vertebral bodies, IVD, hyaline cartilage

A2: C2 (replaced by atlantooccipital membrane) - Anterior surface of vertebral bodies, IVD, hyaline cartilage

Fibres blend with subadjacent periosteum, perichondrium and peripher of the annulus fibrosis

3 layers: Superficial (3 to 4 vertebrae - weakest), intermediate (2 or 3 vertebrae), deep (one body to next - strongest)

Fibre Direction: Vertical (superior / inferior)

Stress: Taught in extension but can’t in reality stress it

Function: Resists extension, prevents anterior translation, force attenuation by transmitting force through the entire spine.

Relationships:

Continuous with anteromedial aspect of SIJ at the sacrum

Lateral borders of the ALL merge with attachment sites for Psoas - implication is a tight psoas can put stress on the anterior longitudinal ligament and thus the vertebrae. Vice versa if there is no movement or disfunction is present in the lumbar spine it can impact the psoas

Crura shares attachemnt - R. side L1-L3 L. side L1-L2. Every time you breath the crura is pulling on L1-L3

54
Q

Posterior Longitudinal Ligament

A1:

A2:

Fibre Direction:

Stress:

Function:

Relationships:

A

Posterior Longitudinal Ligament

A1: C1/C2 (replaced by membrane tectorium) - posterior surface of vertebral bodies, IVD, hyaline cartilage

A2: Sacrum - posterior surface of vertebral bodies, IVD, hyaline cartilage

3 layers: superficial (3 to 4 vertebrae), intermediate (2 to 3 vertebrae), deep (extends to adjacent vertebrae)

Fibre Direction: vertical (superior / inferior)

Stress: Taut in flexion

Function: resist posterior translation, flexion

Relationships:

Affected by anything in the vertebral canal such as meningitis or disc herniation

Strongest attachments to outer layer of annulus fibrosis weakest attachments to vertebral bodies

Attachment for the dura

55
Q

Ligamentum Flavum:

A1:

A2:

Fibre Direction:

Stress:

Function:

Relationships:

A

Ligamentum Flavum

A1: Inferior aspect of one lamina (inside vertebral canal posterior to spinal cord)

A2: Superior aspect of another (inside vertebral canal posterior to spinal cord)

Fibre Direction: Vertical (perpendicular fibres)

Stress: Side bend? Flexion?

Function: restrics flexion and lends rebound tension to go back into extension

Force attenuation - transmitted between supraspinous, interspinous as well as up and down the spine

Helps to protect the contents of the vertebral foramen by helping to form the roof over top

Relationships:

Lateral fibres attach to facet joint capsule

Medial fibres fuse with interspinous ligament

Made up of 80% elastin (yellow - unique to this ligament)

If buckes as it comes into neutral or extension it could push into the vertebral foramen and you could be in trouble - it merges with the interspinous ligament which pulls it back out disallowing it to buckle

56
Q

Supraspinous Ligament

A1:

A2:

Fibre Direction:

Stress:

Function:

Relationships:

A

Supraspinous Ligament

A1: C7 (replaced by ligamentum nuchae) - Spinous process

A2: Sacrum (may cease at L5) - Spinous process

Superficial fibres (3 to 4 segments), intemediate (2 to 3), deep (segment to segment)

Fibre Direction: Vertical (superior / inferior)

Stress: Flexion

Function:

Relationships:

Most superficial ligament in the spine

Thicker in L-spine

Binds to the interspinous ligament

Blends with neighbouring fascia - thus act as force transducer - transmitting force develpoed in the extremities and torso into the lumbar vertebral column

Area for muscle, fascia and aponerutoic attachment

57
Q

Interspinous Ligament

A1:

A2:

Fibre Direction:

Stress:

Function:

Relationships:

A

Interspinous Ligament

A1: Root of one spine

A2: Apex of another spine

Fibre Direction: Vertical - fan shaped allowing the ligament to expand without rupture

Stress: Flexion

Function: Resist flexion, force dispersal

Relationships:

Meet ligamentum flavum anteriorly

Meet supraspinous ligament posteriorly

  • Thus dispersed force between the two

The fibres run mostly anterior posterior to act as an anchor, transmitting the AP pull of the TLF, into which is attached the supraspinous ligament and ligamentum flavum, not allowing the later to buckle

58
Q

Intertransverse Ligament

A1:

A2:

Fibre Direction:

Stress:

Function:

Relationships:

A

Intertransverse Ligament

A1: Superior part of one TP

A2: Inferior part of another TP

Fibre Direction: Vertical

Stress: ?

Function: Prevents side bending a rotation (a little)

Relationships:

Replaced with intertransverse muscle in the c-spine