Palmer- Spinal- Exam 1 Learning Objectives

What are the primary and secondary curvatures

primary: thoracic and sacrococcygeal region, curve points posteriorly. AKA kyphotic, posterior curves

secondary: cervical and lumbar region, curve points anteriorly. AKA lordotic, anterior curves

Lordotic curve is formed by greater ______________ than ______________ IVD height in cervical and lumbar reigions

anterior; posterior

primary curvature is formed from the difference of

vertebral bodies

secondary curvature is formed from the difference of

IVD

what are the typical lateral curvatures of the spine

Upper thoracic and lumbar regions due to handedness, genetics and environmental factors

What causes lateral curvatures? (TQ)

deviations result from asymmetrical muscle tone

Describe the intervertebral disc (IVD) functions

Function:

-attach and separate vertebral bodies from each other

- help form the spine

-act as a powerful ligament

- forms anterior border of vertebral canal and IVF

-shock absorber

what are the components of the IVD

-nucleus pulposus (water, collagen, proteoglycans)

-annulus fibrosus (Type 1/2 collagen)

IVD height diminishes with...

age

What is the general anatomical features of a typical vertebrae? (12)

-Superior and inferior epiphyseal rim

-Pedicle

-Body

-Vertebral Arch

-Vertebral foramen

-Lamina

-Superior and inferior vertebral notches

-Transverse process

- Transverse tubercle

- Spinous process

- spinous tubercle

-Superior articular process AND facet

which somites give rise to the vertebral column

sclerotomes

what are perichordal discs and intrasclerotomal fissures? What do they give rise to?

perichordal discs: embryonic IVD that arise from intrasclerotomal fissures

intrasclerotomal fissures: between scleotomites or a perichordal blastema. Divides perichordal blastema (marshmellows) into two parts

How many pairs of chondrification centers of there on a typical vertebrae? Where are they located (TQ)

3 pairs (6 total)

1 pair in the neural arch

1 pair for L/R transverse processes

1 pair in the centrum (body)

TQ- What is the order of ossification for vertebrae

membranous-->Chondrification-->ossification (bone)

membranous vertebral blastema is the same thing as ?

perichordal blastema

how many primary center of ossification are there? Where are they?

3 total

1 in the centrum (body)

2 in the neural arch

primary centers grow toward each other and cartilage decreases until small ___________ _____________ joints remain

cartilage synchondrosis

synchondrosis (cartilaginous joint) formed between the centrum and neural arch is called

Neurocentral synchondrosis

how many secondary center of ossification are there? Where are they? (TQ)

5 total

2- superior/inferior epiphyseal plate

2 tips of transverse processes

1 tip of spinous process

C1 spinal nerve exits ____________C1 vertebrae

above

How many cervical vertebrae are there? Cervical spinal nerve?

7 vertebrae, 8 cervical spinal nerves

C8 spinal nerve exits______________ C7 vertebrae

below

T1 spinal nerve exits _____________ T1 vertebrae

below

Explain the arteries within the spinal canal (TQ) (6)

Segmental arteries- from aorta

Spinal Branch arteries- mixed spinal nerves

Medullary (Feeder Arteries) - supply Ant/Post spinal artery

Anterior spinal artery- only 1

Posterior spinal arteries- 2

radicular arteries- supply rootlets

Explain the veins within the spinal canal (TQ)

Internal vertebral venous plexus

anterior and posterior spinal veins

basivertebral venous foramina- provides venous return

Describe meninges of the spinal canal

Dura Mater- tough external layer

Arachnoid mater- web-like real space filled with CSF

Pia Mater- adheres to spinal cord

Describe the spaces of the spinal canal (TQ)

(know where CSF is flowing and what meninges they are between TQ)

Epidural space- external to the dura, filled with fat

Subdural space- potential space between dura and arachnoid

Subarachnoid space- between arachnoid and pia and contains CSF

which ligaments forms the anterior and posterior boundaries of the spinal cord AND where they attach. TQ

anterior boundary: posterior longitudinal ligament attach tightly to bodies and IVD

posterior boundary: ligamentum flavum, attach to lamina

What action does the PLL prevent

prevents hyperflexion and posterior spinal disc herniation

What action does the Ligamentum Flavum prevent and allow?

allows for upright posture

straightens column after flexion

prevents hyperflexion

What is the purpose of the filum terminal and what is it derived from?

Anchors cord to the sacrum and coccyx and prevents vertical movement

derived from the pia mater

What is the filum terminal an extension of (TQ)

Pia mater

which spinal cord anchor prevents vertical movement?

Filum Terminal

What is the purpose of the denticulate ligaments and what is it derived from?

Anchors the cord laterally to prevent side to side movement

derived from the pia mater

What is the embryonic development of the nucleus pulposus (TQ)

embryonic notochordal tissue becomes the nucleus pulposus

What are IVDs developed from

notochord and sclerotomes

what is the annulus fibrosis developed from

somatic mesenchyme surrounds notochordal cells

what is a mechanism the body has to respond to stress on IVDs

osteophytes (bone spurs) to stabilize segements

describe the composition cartilaginous end plates (TQ)

composed of Hyaline (at centrum) and Fibrocartilage (at IVD)

describe the function cartilaginous end plates (TQ)

-prevents centrum (VB) from undergoing atrophy and pressure

-keeps IVD withing anatomical borders

-extremely porous for diffusion of gases, nutrients and waste material

What is the joint classification of the IVD (100% TQ)

Cartilaginous (amphiarthrosis) symphysis joint

What are the three different innervations of the IVD (posterior, anterior, lateral) and what are the "aka" terms. (100% TQ)

Posterior: sinu-vertebral nerve (aka recurrent meningeal nerve)

Lateral: gray ramus communicans

anterior: sympathetic branches/sympathetic trunk ganglia

posterior outer 1/3 of the annulus fibrosis receives innervation from? (TQ)

sinu-vertebral nerve (aka recurrent meningeal nerve)

What are the boundaries and contents of IVF (intervertebral foramina) (100% TQ)

Superior

Inferior

Anterior

Posterior

Superior: inferior vertebral notch (aka pedicles) or segment below

Inferior: superior vertebral notch of the segment below

Anterior: IVD, vertebral bodies, PLL

Posterior: Pre/post zygophophyseal joints, capsular ligament, ligamentum flavum

Describe the artery of Adamkiewicz, where it enters and what it is a principle supplier to

the Anterior medullary feeder artery!!

-enters T9/10

- ONLY major arterial supply to the anterior spinal artery

-Principle supplier of lumbar enlargement (L2/L3)

75% of thoracic IVD herniations occur below t8 which can compromise artery

The principle supplier of the lumbar enlargement (L2/3) is?

artery of adamkiewicz (anterior medullary feeder artery)

Explain the neural contents of the IVF (100% TQ)

Neural tissue:

- Ventral and dorsal nerve roots

- dorsal root ganglion (DRG)

- Mixed spinal nerves)

Explain the arterial contents of the IVF (100% TQ)

Arteries:

- spinal branch arteries arising from segmental artery (puserior/posterior intercostal arteries)

several branches given off before entering IVF: osseous branches and anterior/posterior spinal plexus

Explain the vein contents of the IVF (100% TQ)

intervertebral veins in epidural space

external vertebral venous plexus (Batson's plexus)

drains into segmental vein

Explain the lymphatic contents of the IVF (100% TQ)

Lymphatic capillaries in epidural space

Which transforaminal ligament attaches vertebral bodies to inferior articular processes of the same vertebrae?

superior transforaminal ligaments

which transforaminal ligament attaches IVD to inferior articular processes of the segment above?

Middle transforaminal ligaments

which transforaminal ligament attaches vertebral bodies to the superior articular process of the same vertebrae?

Inferior transforaminal ligament

Which ligament attached vertebral body and ICD to transverse process of vertebra below?

superior corporotransverse ligaments (blue star in image)

which ligament attaches vertebral body and IVD to the transverse process of vertebra above?

inferior corporotransverse ligament (green star in image)

Give the 4 examplea of fibrous joints including movements allowed and classifications

fibrous joint= more than two boney surfaces connected by a thin layer of Dense CT (ligament attachment)

Suture- syndesmosis (immovable)

syndesmosis- ALL JOINTS connected by a ligament, amphiarthrosis (interosseous membrane between radius and ulna)

Gomphosis- teeth in alveoli

Schindylesis-vomer bone with rostrum of sphenoid articulate together

what is it called with a suture ossifies?

synostoses

Give examples of cartilaginous joints including classifications (synchondrosis, symphysis) and which type of cartilage each uses

cartilaginous joint=cartilage fills space between opposing bones

Symphysis used Fibrocartilage: ex- IVD, pubic symphyses

Synchondrosis uses Hyaline cartilage: ex- epiphyseal plate, costochondral bones

Symphysis joints are only occurring where in the body?

Do they allow movement or not?

the median plane (midline)

allow slight movement (amphiarthrotic)

Give examples of synovial joints including movements allowed and classifications

synovial joints= joint cavity filled with synovial fluid

Any joint with a synovial membrane!

what 4 consistent structures are present in a synovial joint (100% TQ)

1. Articular capsule

2. Synovial membrane

3. Articular cartilage

4. Synovial Fluid

What is a uniaxial degree of freedom

move in one plane (ex: hinge joint)

what is biaxial degree of freedom

move in two planes (ex; condylar)

what is multiaxial degree of freedom

move in more than two planes (ex: ball and socket joints)

what is nonaxial degree of freedom

bones push against each other and do not move ex: plane joints in carpal bones

What are the three ways synovial joints are classified?

1) # of bones

2) Types of movements allowed at joint

3) morphological appearance

How do we classify synovial joints based on # of bones?

A) Simple- two bones form a joint

B) Complex- two bones joint and form two joint compartments

C) Compound- more than two bones form joint

What are the different ways we can classify bones based on morphologic appearance? (HINT you must know both names)

- Synovial plane (diarthrosis arthrodial)

-Synovial saddle (diarthrosis sellar)

-Synovial ellipsoidal (diarthrosis condylar)

-Synovial pivot (diarthrosis trochoid)

-Ball and socket (spheroid)

Synovial Hinge (ginglymoid)

Describe the articular capsule (aka fibrous capsule) (TQ)

4 different mechanoreceptors located in superficial and deep layers

Type 1-3: Encapsulated mechanoreceptors with proprioceptive function

type 4: non-encapsulated; unmyelinated free nerve endings

What are type I-III mechanoreceptors in the articular capsule specialized for?

proprioception with being encapsulated

What do type 4 mechanoreceptors in the articular cartilage respond to ?

potential mechanical extreme injury (nociceptors)

describe the synovial membrane modifications (3) 100% TQ

1- Synovial villi- finger like projections that increase surface area for secretion-absorption

2- Articular Fat Pads- Fibrous layer filling gaps between joint tissue

3- Synovial menisci and intra-articular discs- fibrocartilage projections that separate joint articular surfaces (meniscoids)

Descibe the articular synovial membrane (2 layers) and what their role is

outler fibrous layer:

- conn tissue, blood vessels, lymphatics, nerve endings; continuous with articular capsule

inner cellular (luminal layer)

- synovial fluid secretion

which articular synovial membrane layer is continuous with the articular capsule?

outer fibrous layer

what is another name for the inner cellular layer of the articular synovial membane? (TQ)

Synovial lamina intima

What two types of cells are found in the cellular layer (synovial lamina intima) of the synovial membrane? What are their roles? (TQ)

Type A synoviocytes- phagocytic

Type B synoviocytes- secrete protein and hyaluronic acid for synovial fluid

Describe the articular cartilage:

What is the articulating surface covered with?

How does it get nutrients?

- covered with hyaline cartilage

-avascular, lacks innervation and lymphatics

-nutrition/waste elimination provided by synovial fluid

What percent of volume does water account for in articular cartilage

what is the remaining volume consisting of?

60-80% water

12-24% collagen type II fibers

8-16% proteoglycan gel

What is responsible for water retention in articular capsules

GAGs

Describe the function of synovial fluid (100% TQ)

provides nutritional source for articular cartilage and supplying lubricant, which increases joint efficiency and reduces erosion of articular surfaces

synovial lamina intima cells in synovial fluid secrete what for the final consistency?

wandering blood cells (WBCs) and connective tissue cells

T/F: there is a high volume of synovial fluid found in human joints

FALSE: there is a low volume in human joints

Differentiate between typical and atypical cervical vertebrae

Describe the orientation of superior and inferior articular facets

What forms articlar pillars?

Which muscles attach to articular pillars

Describe which osseous structure houses the vertebral artery

Describe the anterior and posterior tubercles and their associated structures

Understand the 5 osseous parts of typical cervical transverse processes

Which nerve structure runs along the costotransverse bar

Describe the carotid tubercle (C6)

Describe a typical cervical vertebra including joint surfaces and muscle and ligament attachments

Understand and describe the cervical lordotic curvature

Describe osseous structures located on the anterior and posterior arch of C1

Understand homologous structures of C1

Describe ligaments and joint surfaces associated with C1

Describe the ponticulus posticous, vertebral artery, acuate foramen, and retro transverse foramen of C1

Describe muscles, ligaments, and joint/surfaces associated with C2 and C7

Describe the vertebral artery: embryology, subdivisions (branch of which artery?)