FABS Quiz 11

What is the study of ligaments called?

Syndesmology

Main function of ligaments

Connect bone to bone, stabilize joints, resist motion, provide proprioception

What ligament runs along anterior vertebral bodies?

Anterior Longitudinal Ligament (ALL)

ALL attaches from where to where?

C0 → anterior sacrum

Function of ALL

Resists extension

What ligament runs along posterior vertebral bodies?

Posterior Longitudinal Ligament (PLL)

PLL attaches from where to where?

C2 → posterior sacrum

What does PLL become superiorly?

Tectorial membrane

PLL resists what motion?

Flexion

Which ligament connects spinous processes tips?

Supraspinous ligament

Supraspinous ligament becomes what in cervical spine?

Ligamentum nuchae

What ligament connects lamina to lamina?

Ligamentum flavum

Most elastic ligament in spine

Ligamentum flavum

What ligament connects articular processes?

Facet capsule

What ligament connects spinous process to spinous process?

Interspinous ligament

What ligament connects transverse processes?

Intertransverse ligament

Intertransverse ligament resists what motion?

Opposite lateral flexion

Anterior ligaments resist what motion?

Extension

Posterior ligaments resist what motion?

Flexion

Lateral ligaments resist what motion?

Opposite side bending

PLL is anatomically where?

Anterior

PLL is biomechanically where?

Posterior

ALL becomes what at sacrococcygeal joint?

Anterior sacrococcygeal ligament

PLL becomes what at sacrococcygeal joint?

Posterior deep sacrococcygeal ligament

Supraspinous becomes what at sacrococcygeal joint?

Posterior superficial sacrococcygeal ligament

Sacrotuberous ligament function

Resists nutation

Sacrospinous ligament function

Resists nutation

Iliolumbar ligament function

Resists nutation + side bending

Posterior SI ligament function

Resists counternutation

Anterior SI ligament function

Resists nutation

Strongest SI ligament

Interosseous ligament

3 components of IVD

Annulus fibrosus, nucleus pulposus, endplates

Annulus fibrosus structure

12–20 concentric layers

Annulus fibrosus collagen type

Type I

Function of annulus fibrosus

Resists tensile forces

Nucleus pulposus origin

Notochord

Nucleus pulposus water content

70–90%

Nucleus pulposus collagen type

Type II

Endplate function

Nutrient diffusion

Which part of IVD has nerve supply?

Outer 1/3 annulus

Outer 1/3 annulus

No

Flexion compresses which part of disc?

Anterior

Flexion causes tension where?

Posterior annulus

Nucleus moves which way in flexion?

Posterior

Extension compresses which part?

Posterior

Extension causes tension where?

Anterior

Nucleus moves which way in extension?

Anterior

Lateral flexion compresses which side?

Ipsilateral

Lateral flexion tension occurs on?

Contralateral

IVD resists what motion most?

Rotation

Weakest region of disc

Posterolateral

Most common disc herniation location

Posterolateral

4 types of disc pathology

Bulge, protrusion, extrusion, sequestration

Bulge definition

Symmetrical expansion

Protrusion definition

Contained nucleus

Extrusion definition

Nucleus breaks through annulus

Sequestration definition

Free fragment

Medial disc herniation → patient leans which way?

Toward pain

Lateral disc herniation → patient leans which way?

Away from pain

IVF superior boundary

Pedicle above

IVF inferior boundary

Pedicle below

IVF anterior boundary

Vertebral body + disc

Vertebral body + disc

Facet joint

Cervical IVF additional structure

Uncinate process

Thoracic IVF narrowed by what?

Ribs

Main structure passing through IVF

Spinal nerve

What sensory structure is in IVF?

Dorsal root ganglion

What nerve also passes through IVF?

Recurrent meningeal nerve

What vessels pass through IVF?

Arteries + veins

Arteries + veins

Lymphatics + fat

Cervical nerve position in IVF

Lower third

Thoracic nerve position in IVF

Middle third

Lumbar nerve position in IVF

Upper third

Flexion effect on IVF

Increases size (~19%)

Extension effect on IVF

Decreases size (~11%)

Ipsilateral side bending effect

Decreases IVF

Contralateral side bending effect

Increases IVF

Disc affects which nerve?

Nerve below

Example: L4–L5 disc affects which nerve?

L5

3 key things to determine in disc case

Nerve affected, disc level, medial vs lateral

What condition narrows IVF?

Foraminal stenosis

What condition is degeneration of spine?

Spondylosis