Vertebral Column

Question 1

Vertebral Column Articulations

Answer 1

1. Atlanto-occipital articulation
2. Atlanto-axial articulation
3. Vertebral Bodies
4. Zygapophysial (facet) joints
5. Costovertebral Articulation
6. Costotransverse Articulation
7. Lumbosacral articulation
8. Sacroiliac Articulation
9. Sacrococcygeal articulation

Question 2

Vertebral Column Bones

Answer 2

33 bones

• 7 cervical
• 12 thoracic
• 5 Lumbar
• 5 Sacral (Fused)
• 3-4 Coccygeal (Fused)

Question 3

Vertebra vs. Vertebrae

Answer 3

Vertebra - Singular

Vertebrae - Plural

Question 4

Primary Spinal curvatures

Answer 4

• Thoracic

- Sacral/coccygeal

Question 5

Secondary spinal Curvatures

Answer 5

• Cervical

- Lumbar

Question 6

Features of A Typical Vertebra

Answer 6

• Vertebral Body
• 2 pedicles
• 2 lamina
• 2 Transverse Process
• Spinous Process
• Superior Articulating facets
• Inferior Articulating facets
• Vertebral Canal
• Superior Vertebral Notches
• Inferior Vertebral Notches

Question 7

Typical Cervical Vertebrae

Answer 7

• 7 Cervical vertebrae
• Transverse foramina
• Anterior and Posterior Tubercles
• Bifid Spinous process
• Vertebral Foramen is large/triangular
• Superior Facets face Superior/Posterior
• Inferior Facets face Inferior/Anterior

Question 8

Foramen vs. Foramina

Answer 8

Foramen (Singular)

Foramina (Plural)

Question 9

Typical Lumbar Vertebrae

Answer 9

• 5 Lumbar Vertebrae
• Massive Bodies
• Vertebral Foramen is triangular
• Blunt processes
• Mammillary Process
• Superior facets face posterior/Medial
• Inferior Facets face anterior/lateral

Question 10

Typical Thoracic Vertebrae

Answer 10

• 12 thoracic Vertebrae
• Costal facets on body and transverse processes
• Vertebral Foramen is smaller and circular
• Superior facets face mainly posterior and slightly lateral
• Inferior facets face mainly anterior/ slightly medial

Question 11

Typical Sacrum and Coccyx

Answer 11

• 5 Sacral vertebrae
• 3-4 Coccygeal Vertebrae
• Decrease in size

Question 12

Atypical Vertebrae

Answer 12

• C1 (Atlas): No body (superior articulating facets with occipital bone
• C2 (Axis): Dens (Axis for turning the head side to side)
• C7: Vertebra Prominens (long spinous process - easy to palpate)
• T1: Complete superior costal facet and inferior demifacet
• T10-T12: Largest, wedge shaped body (taller Anteriorly)

Question 13

Atlanto-Occipital Articulation

Answer 13

Bones: Atlas and Occipital Bone

Classification: Synovial; Condyloid

Movements: Flexion/Extension (Nodding “yes”); Slight lateral flexion, tilting of the head

Question 14

Atlanto-Occipital Joint ligaments

Answer 14

Anterior Atlanto-Occipital Membrane: Runs from anterior arch of C1 to anterior margin of foramen magnum

Posterior Atlanto-Occipital Membrane: Runs from posterior arch of C1 to posterior margin of Foramen magnum

Question 15

Atlanto-Axial Articulation

Answer 15

Bones: Atlas (C1) and Axis (C2)

Classification: Synovial; Median Joint (dens with Atlas) - Pivot; Lateral joints (inferior Facets of C1 with superior facets of C2) - Gliding

Movements: Rotation; Shaking head “no”

Question 16

Atlanto-Axial Joint ligaments

Answer 16

• Alar Ligament: Runs from both sides of the dens to lateral margins of foramen magnum. Checks rotation.
• Tectorial Membrane: Continuation of posterior longitudinal ligament. Runs from body of C2 to internal surface of foramen magnum
• Cruciate Ligament: Transverse Ligament of Atlas: Between medial aspects of C1 lateral mass (holds Dens in place); Superior/inferior longitudinal bands: both extend from transverse ligament, superior band to occipital bone and inferior band to body of C2

Question 17

Vertebral Bodies (“joint”)

Answer 17

Bones/Structures involved: Vertebral bodies, intervertebral (IV) discs, layer of hyaline cartilage superior and inferior to IV Disc (No IV between C1 and C2)

Classification: Symphysis

Question 18

Intervertebral Discs

Answer 18

Annulus Fibrosus: Lamellae of fibrocartilage arranged for strength, thinner posteriorly

Nucleus Puplosus: Mainly water and gelatinous in nature; Avascular receiving nutrition via diffusion from blood vessels at periphery of annulus fibrosus; Absorbs compression forces between vertebrae

Question 19

Zygapophysial joints (Facet Joints)

Answer 19

Bones: Inferior articular processes of vertebra; Superior articular processes of adjacent vertebra

Classification: Synovial; Gliding

Movements: Based on orientation of facets

Question 20

Costovertebral Articulations

Answer 20

Bones: Head of ribs; costal facet or demifacet on vertebral bodies and IV Disc between them

Classification: Synovial; gliding

Question 21

Costotransverse Articulations

Answer 21

Bones: Tubercle of ribs; Transverse costal facets of same level vertebra (Ribs 11 and 12 don’t articulate with transverse processes)

Classification: Synovial; Gliding

Question 22

Lumbosacral Articulation

Answer 22

Bones: L5, Sacrum

Classification: Symphysis - IV Disc

Ligaments: Iliolumbar ligament and lumbosacral ligament

Question 23

Lumbosacral Articulation Ligaments

Answer 23

Iliolumbar ligament: from transverse process of L5 into two bands; Crest of ilium and anterior sacroiliac ligament

Lumbosacral ligament: from transverse process of L5 to sacrum and lower band of iliolumbar ligament

Question 24

Sacroiliac Articulation

Answer 24

Bones: Sacrum and Ilium

Classification: Synovial; Gliding

Question 25

Sacroiliac Articulation Ligaments

Answer 25

Anterior sacroiliac ligament: runs from sacrum to ilium in anterior/inferior direction Interosseous sacroiliac ligament: Posterior, connecting tuberosities of sacrum and ilium; Strongest of three ligaments Posterior sacroiliac ligament: Sacrum to Ilium tuberosity and posterior superior spine of ilium

Question 26

Sacrococcygeal articulation

Answer 26

Bones: Sacrom (apex) Coccyx (Base) Classification: Symphysis Ligaments: Anterior, posterior, and lateral sacrococcygeal ligaments. Intercornual sacrococcygeal ligament.

Question 27

Ligaments of the Vertebral Column

Answer 27

1. Anterior Longitudinal Ligament 2. Posterior longitudinal Ligament 3. Ligamenta Flava (Flavum) 4. Supraspinous Ligament 5. Ligamentum Nuchae 6. Interspnous Ligaments 7. Intertransverse Ligaments

Question 28

Anterior Longitudinal Ligament

Answer 28

Extends from sacrum to occipital bone (anterior to foramen magnum) Attached to anterior and lateral surfaces of vertebral bodies and IV Discs. Three layers. Helps to prevent hyperextension of vertebral column. Only Ligament that checks extension.

Question 29

Posterior Longitudinal Ligament

Answer 29

Extends from sacrum to C2 Runs through vertebral canal attached to posterior surface of vertebral bodies and IV discs. Multiple layers. Helps reinforce posterior border of IV Discs.

Question 30

Ligamenta Flava

Answer 30

Travels between lamina of vertebrae - posterior surface of one lamina to anterior surface of lamina above. Keeps flexion in check by resisting separation of the laminae in flexion.

Question 31

Supraspinous ligament

Answer 31

Runs along outer surface of spinous processes C7 to sacrum. Strong, Fibrous. Assists in limiting flexion.

Question 32

Ligamentum Nuchae

Answer 32

Extends from external occipital protuberance to C7 Spinous process. Also has attachment for posterior border of foramen magnum. Fans out due to shortness of cervical spinous processes. Helps to support the heads and check flexion; Serves as attachment for some muscles.

Question 33

Interspinous ligaments

Answer 33

Run between adjacent vertebra along the whole length of the spinous process. Blend with Ligamenta flava (anterior) and Supraspinous Ligament (posterior)

Question 34

Intertransverse LIgaments

Answer 34

Connect adjacent transverse processes

Question 35

Spinal Cord

Answer 35

Continuation of the medulla oblongata. Extends from foramen magnum to level L2. Conus medullaris-terminal end of the spinal cord. Cauda equina - "horses Tail" : remaining nerve roots after the conus medullaris Filum Terminale: Long strand of connective tissue (pia mater) anchoring spinal dural sac to dorsum of coccyx; Remnant of caudal part of spinal cord in embryological development.