DOCSLIB.ORG

Anatomy of the Spinal Ligaments • Anatomy of the Spinal Ligaments • Intrasegmental System Filip M

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Anatomy of the Spinal Ligaments • Anatomy of the Spinal Ligaments • Intrasegmental System Filip M Outline and learning objectives Anatomy of the Spinal Ligaments • Anatomy of the spinal ligaments • Intrasegmental system Filip M. Vanhoenacker • Intersegmental system • Craniocervical junction University of Gent and Antwerp • Basic function and histology of the spinal ligaments General Hospital St-Maarten Mechelen • Understand anatomy in the interpretation of pathologic processes Intrasegmental system Intrasegmental system • Holds individual vertebrae together • Holds individual vertebrae together • Ligamenta flava • Ligamenta flava • Extent: C2 - sacrum • Extent: C2 - sacrum • Connecting laminae • Connecting laminae • Protect spinal cord and nerves • Protect spinal cord and nerves • Interspinous ligaments • Interspinous ligaments • Connecting adjoining processes • Connecting adjoining processes • Intertransverse ligaments • Intertransverse ligaments Intrasegmental system Intrasegmental system • Holds individual vertebrae together • Holds individual vertebrae together • Ligamenta flava • Ligamenta flava • Extent: C2 - sacrum • Extent: C2 - sacrum • Connecting laminae • Connecting laminae • Protect spinal cord and nerves • Protect spinal cord and nerves • Interspinous ligaments • Interspinous ligaments • Connecting adjoining processes • Connecting adjoining processes • Intertransverse ligaments • Intertransverse ligaments 1 Intrasegmental system Intersegmental system • Holds individual vertebrae together • Holds multiple vertebrae together • Ligamenta flava • Primary stabilizer of the spine • Extent: C2 - sacrum • Connecting laminae • Anterior longitudinal ligament • Protects spinal cord and nerves • Extent: C2– sacrum • Connecting annulus - body • Interspinous ligaments • Connecting adjoining processes • Posterior longitudinal ligament • Intertransverse ligaments • Supraspinous ligaments • Insignificant bands www.primalpictures.com Intersegmental system Intersegmental system • Holds multiple vertebrae together • Holds multiple vertebrae together • Primary stabilizer of the spine • Primary stabilizer of the spine • Anterior longitudinal ligament • Anterior longitudinal ligament • Extent: C2– sacrum • Extent: C2– sacrum • Connecting annulus - body • Connecting annulus - body • Posterior longitudinal ligament • Posterior longitudinal ligament • Supraspinous ligaments • Supraspinous ligaments Intersegmental system Intersegmental system • Holds multiple vertebrae together • Holds multiple vertebrae together • Primary stabilizer of the spine • Primary stabilizer of the spine • Anterior longitudinal ligament • Anterior longitudinal ligament • Extent: C2– sacrum • Connecting annulus - body • Posterior longitudinal ligament • Extent: C2– sacrum • Posterior longitudinal ligament • Connecting annulus – body • Supraspinous ligaments • Supraspinous ligaments 2 Intersegmental system Intersegmental system • Holds multiple vertebrae together Posterior longitudinal ligament at disk space • Primary stabilizer of the spine • broad • tight adherence • Anterior longitudinal ligament Posterior longitudinal • Posterior longitudinal ligament • Extent: C2– sacrum ligament at vertebral • Connecting annulus – body body • lateral fibrovascular • Supraspinous ligaments complex (veins): loose • septum medium: tight Courtesy F. Lecouvet. Masson 2007 Intersegmental system Intersegmental system Anatomic barrier for Anatomic barrier of spread of pathology in septum medium and the anterior epidural lateral expansions space Curtain sign on imaging Curtain sign on imaging • tumors • tumors • infections • infections • preferential lateral • preferential lateral migration of disk migration of disk extrusions extrusions • trauma: lateral • trauma: lateral fragments fragments Intersegmental system Intersegmental system Anatomic barrier of Anatomic barrier of septum medium and septum medium and lateral expansions lateral expansions Curtain sign on imaging Curtain sign on imaging • tumors • tumors • infections • infections • preferential lateral • preferential lateral migration of disk migration of disk extrusions extrusions • trauma: lateral • trauma: lateral fragments fragments 3 Intersegmental system Intersegmental system Anatomic barrier of • Holds multiple vertebrae together septum medium and lateral expansions • Primary stabilizer of the spine Curtain sign on imaging • Anterior longitudinal ligament • tumors • infections • Posterior longitudinal ligament • preferential lateral • Supraspinous ligaments migration of disk extrusions • trauma: lateral fragments Intersegmental system Craniocervical junction • Holds multiple vertebrae together • Complex ! • Primary stabilizer of the spine • External ligaments • Anterior longitudinal ligament • Anterior • Posterior • Posterior longitudinal ligament • Ligamentum nuchae • Supraspinous ligaments •Connecting tip of spinous processes • Internal ligaments Craniocervical junction Craniocervical junction • Complex ! • Complex ! • Anterior external ligaments • Posterior external ligaments • anterior longitudinal ligament • extension lig. flava • anterior atlanto-occipital • posterior atlanto-occipital • anterior atlanto-axial • posterior atlanto-axial • Internal ligaments • Internal ligaments 4 Craniocervical junction Craniocervical junction • Complex ! • Complex ! • Ligamentum nuchae • Ligamentum nuchae • external occipital • external occipital protuberance protuberance • spinous process of C7 • spinous process of C7 • Internal ligaments • Internal ligaments Craniocervical junction Craniocervical junction • External ligaments • External ligaments • Internal ligaments • Internal ligaments • Anterior • Anterior •Apical (thin) •Apical (thin) •Alar (thick) •Alar (thick) • Middle • Middle • Posterior • Posterior Craniocervical junction Craniocervical junction • External ligaments • External ligaments • Internal ligaments • Internal ligaments • Anterior • Anterior • Middle: cruciform • Middle: cruciform • Transverse lig • Transverse lig • Accessory lig • Accessory lig • Superior fibers • Superior fibers • Inferior fibers • Inferior fibers • Posterior • Posterior 5 Craniocervical junction Craniocervical junction • External ligaments • External ligaments • Internal ligaments • Internal ligaments • Anterior • Anterior • Middle • Middle: cruciform • Posterior • Transverse lig • tectorial membrane • Accessory lig • clivus • Superior fibers • continues as PLL • Inferior fibers • Posterior Craniocervical junction Craniocervical junction • External ligaments • External ligaments • Internal ligaments • Internal ligaments • Anterior • Anterior • Middle • Middle • Posterior • Posterior • tectorial membrane • tectorial membrane • clivus • clivus • continues as PLL • continues as PLL www.primalpictures.com Craniocervical junction Craniocervical junction Transverse ligament Alar ligaments Ozsarlak O.: Cervical trauma. In: Van Goethem J, et al. Spinal Imaging. Springer-Verlag. 2007; pp 279-324 6 Craniocervical junction Craniocervical junction Transverse ligaments Transverse ligaments Craniocervical junction Function and Histology • Maintain mechanical stability • Allow flexible motion • Protection of spinal cord from excessive motion • Hyperextension • Flexion • Function ~ histological composition (elastin-to-collagen ratio) • high = flexible ligament (lig. flava and supraspinous lig.) • low = stiff; resist tension (e.g. ALL) Apical ligament atlanto-occipital membrane thin dural split Function and Histology Function and Histology Stress-vs-strain curve (from Belkoff S.M. 2007) Viscoelasticity: stiffness increases with increasing loading rate 7 Function and Histology Conclusion Intra- and extrasegmental spinal ligaments Craniocervical junction • External • Internal: 3 layers Elastin-to-collagen ratio determines function • Flexibility • Resistance to tension Knowledge of anatomy clue to correct interpretation of pathology Stiff spine: prone to ligamentous failure and neurological damage References • Belkoff S.M.: Biomechanics of the spine. In: Van Goethem J, et al. Spinal Imaging. Springer-Verlag. 2007; pp 87- 93 • Krakenes J.: Whiplash injuries. In: Van Goethem J, et al. Spinal Imaging. Springer-Verlag. 2007; pp 257-277 • Ozsarlak O.: Cervical trauma. In: Van Goethem J, et al. Spinal Imaging. Springer-Verlag. 2007; pp 279-324 • Netter F.H. Atlas of Human Anatomy, Ciba-Geigy • www. primalpictures.com 8.
Load more

Recommended publications
  • Diapositiva 1
    Thoracic Cage and Thoracic Inlet Professor Dr. Mario Edgar Fernández. Parts of the body The Thorax Is the part of the trunk betwen the neck and abdomen. Commonly the term chest is used as a synonym for thorax, but it is incorrect. Consisting of the thoracic cavity, its contents, and the wall that surrounds it. The thoracic cavity is divided into 3 compartments: The central mediastinus. And the right and left pulmonary cavities. Thoracic Cage The thoracic skeleton forms the osteocartilaginous thoracic cage. Anterior view. Thoracic Cage Posterior view. Summary: 1. Bones of thoracic cage: (thoracic vertebrae, ribs, and sternum). 2. Joints of thoracic cage: (intervertebral joints, costovertebral joints, and sternocostal joints) 3. Movements of thoracic wall. 4. Thoracic cage. Thoracic apertures: (superior thoracic aperture or thoracic inlet, and inferior thoracic aperture). Goals of the classes Identify and describe the bones of the thoracic cage. Identify and describe the joints of thoracic cage. Describe de thoracic cage. Describe the thoracic inlet and identify the structures passing through. Vertebral Column or Spine 7 cervical. 12 thoracic. 5 lumbar. 5 sacral 3-4 coccygeal Vertebrae That bones are irregular, 33 in number, and received the names acording to the position which they occupy. The vertebrae in the upper 3 regions of spine are separate throughout the whole of life, but in sacral anda coccygeal regions are in the adult firmly united in 2 differents bones: sacrum and coccyx. Thoracic vertebrae Each vertebrae consist of 2 essential parts: An anterior solid segment: vertebral body. The arch is posterior an formed of 2 pedicles, 2 laminae supporting 7 processes, and surrounding a vertebral foramen.
    [Show full text]
  • Ligamentum Flavum in Lumbar Spinal Stenosis, Disc Herniation and Degenerative Spondylolisthesis. an Histopathological Description
    Acta Ortopédica Mexicana 2019; 33(5): Sep.-Oct. 308-313 Artículo original Ligamentum flavum in lumbar spinal stenosis, disc herniation and degenerative spondylolisthesis. An histopathological description Ligamento amarillo en estenosis lumbar espinal, hernia de disco y espondilolistesis degenerativa. Una descripción histopatológica Reyes‑Sánchez A,* García‑Ramos CL,‡ Deras‑Barrientos CM,§ Alpizar‑Aguirre A,|| Rosales‑Olivarez LM,¶ Pichardo‑Bahena R** Instituto Nacional de Rehabilitación «Luis Guillermo Ibarra Ibarra». ABSTRACT. Introduction: Changes in ligamentum RESUMEN. Introducción: Los cambios en el liga- flavum (LF) related to degeneration are secondary mento flavum (LF) relacionados con la degeneración to either the aging process or mechanical instability. son secundarios al proceso de envejecimiento o a la Previous studies have indicated that LF with aging inestabilidad mecánica. Estudios anteriores han indi- shows elastic fiber loss and increased collagen content, cado que LF con envejecimiento muestra pérdida de fi- loss of elasticity may cause LF to fold into the spinal bras elásticas y aumento del contenido de colágeno, la canal, which may further narrow of the canal. Material pérdida de elasticidad puede hacer que el LF se pliegue and methods: A total of 67 patients operated with the en el canal espinal, disminuyendo su espacio. Material surgical indications of lumbar spinal stenosis (LSS), y métodos: Se incluyeron 67 pacientes operados de es- lumbar disc herniation (LDH) and lumbar degenerative tenosis lumbar espinal (LSS), hernia de disco lumbar spondylolisthesis (LDS) were included. LF samples were (LDH) y espondilolistesis degenerativa (LDS). Se ob- obtained from patients who had LSS (39), LDH (22) tuvieron muestras de LF de pacientes que tenían LSS and LDS (6).
    [Show full text]
  • Axially Loaded Magnetic Resonance Imaging Identification of the Factors
    Journal of Clinical Medicine Article Axially Loaded Magnetic Resonance Imaging Identification of the Factors Associated with Low Back-Related Leg Pain Tomasz Lorenc 1 , Wojciech Michał Glinkowski 2,* and Marek Goł˛ebiowski 1 1 1st Department of Clinical Radiology, Medical University of Warsaw, 02-004 Warsaw, Poland; [email protected] (T.L.); [email protected] (M.G.) 2 Department of Medical Informatics and Telemedicine, Center of Excellence “TeleOrto” for Telediagnostics and Treatment of Disorders and Injuries of the Locomotor System, Medical University of Warsaw, 00-581 Warsaw, Poland * Correspondence: [email protected] Abstract: This retrospective observational study was conducted to identify factors associated with low back-related leg pain (LBLP) using axially loaded magnetic resonance imaging (AL-MRI). Ninety patients with low back pain (LBP) underwent AL-MRI of the lumbar spine. A visual analog scale and patient pain drawings were used to evaluate pain intensity and location and determine LBLP cases. The values of AL-MRI findings were analyzed using a logistic regression model with a binary dependent variable equal to one for low back-related leg pain and zero otherwise. Logistic regression results suggested that intervertebral joint effusion (odds ratio (OR) = 4.58; p = 0.035), atypical liga- menta flava (OR = 5.77; p = 0.003), and edema of the lumbar intervertebral joint (OR = 6.41; p = 0.003) p were more likely to be present in LBLP patients. Advanced disc degeneration ( = 0.009) and synovial cysts (p = 0.004) were less frequently observed in LBLP cases. According to the AL-MRI examinations, the odds of having LBLP are more likely if facet effusion, abnormal ligamenta flava, and lumbar Citation: Lorenc, T.; Glinkowski, W.M.; Goł˛ebiowski,M.
    [Show full text]
  • Chapter 02: Netter's Clinical Anatomy, 2Nd Edition
    Hansen: Netter's Clinical Anatomy, 2nd Edition - with Online Access 2 BACK 1. INTRODUCTION 4. MUSCLES OF THE BACK REVIEW QUESTIONS 2. SURFACE ANATOMY 5. SPINAL CORD 3. VERTEBRAL COLUMN 6. EMBRYOLOGY FINAL 1. INTRODUCTION ELSEVIERl VertebraeNOT prominens: the spinous process of the C7- vertebra, usually the most prominent The back forms the axis (central line) of the human process in the midline at the posterior base of body and consists of the vertebral column, spinal cord, the neck supporting muscles, and associated tissues (skin, OFcon- l Scapula: part of the pectoral girdle that sup- nective tissues, vasculature, and nerves). A hallmark of ports the upper limb; note its spine, inferior human anatomy is the concept of “segmentation,” and angle, and medial border the back is a prime example. Segmentation and bilat l Iliac crests: felt best when you place your eral symmetry of the back will be obvious as you hands “on your hips”; an imaginary horizontal study the vertebral column, the distribution of the line connecting the crests passes through the spinal nerves, the muscles of th back, and its vascular spinous process of the L4 vertebra and the supply. intervertebral disc of L4-L5, a useful landmark Functionally, the back is involved in three primary for a lumbar puncture or epidural block tasks: l Posterior superior iliac spines: an imaginary CONTENThorizontal line connecting these two points l Support: the vertebral column forms the axis of passes through the spinous process of S2 (second the body and is critical for our upright posture sacral segment) (standing or si ting), as a support for our head, as an PROPERTYattachment point and brace for move- 3.
    [Show full text]
  • Download PDF File
    Folia Morphol. Vol. 70, No. 2, pp. 61–67 Copyright © 2011 Via Medica R E V I E W A R T I C L E ISSN 0015–5659 www.fm.viamedica.pl Human ligaments classification: a new proposal G.K. Paraskevas Department of Anatomy, Medical School, Aristotle University of Thessaloniki, Greece [Received 24 January 2011; Accepted 22 March 2011] A high concern exists among physicians about surgically important ligaments such as cruciate and collateral ligaments of the knee, patellar ligament, tibiofibular syndesmosis, collateral ligaments of the ankle, and coracoclavicular ligament. However, the classification of the ligaments is insufficient in the literature, due to their origin from connective tissue. A new classification is proposed, based on various parameters such as the macroscopic and microscopic features, the function and the nature of their attachment areas. (Folia Morphol 2011; 70, 2: 61–67) Key words: ligaments, classification, Nomina Anatomica INTRODUCTION connective tissue surrounding neurovascular bundles There was always some confusion concerning the or ducts as “true ligaments” [4]. classification of ligaments of the human body, presu- The “false ligaments”, could be subdivided in the mably due to their origin from the connective tissue following categories: that is considered a low quality tissue compared to oth- a) Splachnic ligaments, which are further subdivid- ers. Moreover, orthopaedists are focused only on surgi- ed into “peritoneal” (e.g. phrenocolic ligament), cally important ligaments. For these reasons there is an “pericardiac” (e.g. sternopericardial ligaments), absence of a well-designated classification system that “pleural” (e.g. suprapleural membrane), and subdivides the ligaments into subgroups according to “pure splachnic ligaments” (e.g.
    [Show full text]
  • The Role of Calcium Deposition in the Ligamentum Flavum Causing A
    Paraplegia(1995) ll, 219-223 © 1995 International Medical Societyof Paraplegia All rightsreserved 0031-1758/95 $9.00 The role of calcium deposition in the ligamentum flavum causing a cauda equina syndrome and lumbar radiculopathy H Baba\ Y Maezawa1, N Furusawa1, S Imura1 and K Tomita2 IDepartment of Orthopaedic Surgery, Fukui Medical School, Shimoaizuki 23, Matsuoka, Fukui 910-11, Japan; 2Department of Orthopaedic Surgery, School of Medicine, Kanazawa University, Takaramachi 13-1, Kanazawa 920, Japan Our report concerns five patients who underwent lumbar decompressive surgery for cauda equina syndrome and radiculopathy secondary to degenerative stenosis associated with calcium deposition in the ligamentum flavum. The resected ligamentum flavum showed diffuse to massive calcium crystal deposition with a histologically marked degeneration in the elastic fibres. Energy dispensive radiographic microanalysis confirmed the crystal to be calcium pyrophosphate dihydrate in all patients, hydroxyapatite mixed in three and calcium orthophosphate mixed in one. The deposition appeared to be a change that is associated with the degenerative process in the ligament and, in some cases having marked deposition in a localised event, it causes or aggravates the neurological symptoms Keywords: lumbar spinal stenosis; cauda equina syndrome; radiculopathy; ligamentum flavum; calcium crystal deposition Introduction flavum with calcification compressed the dural sac at A number of reports in the literature describes the the levels suspected to be responsible for the cauda anatomical changes in the stenotic lumbar spine which equina syndrome and radiculopathy. According to produce the intermittent symptoms of cauda equina classification of Arnoldi et ai, 6 all patients showed a claudication and sciatica.1,2 The pathoanatomy in the degenerative type of stenosis radiologically; two had degenerative process includes hypertrophy of the mild spondylolisthesis anteriorly and one had scoliosis.
    [Show full text]
  • Radiologic Imaging of Symptomatic Ligamentum Flavum Thickening with and Without Ossification
    991 Radiologic Imaging of SymptomatiC Ligamentum Flavum Thickening with and Without Ossification A. Stoll man 1,2 Thickening of the ligamenta flava with and without ossification in the thoracic and R. Pinto1 lumbar regions is a frequent finding on CT scanning; however, it is not widely appreciated V. Benjamin3 as a possible primary cause of compressive cord, cauda equina, and nerve-root symp­ I. Kricheff1 toms. We present observations from a series of seven patients whose symptoms were caused exclusively or largely by thickened ligamenta flava in the thoracic and lumbar regions. The findings were best demonstrated on myelography. One of our cases had been missed on previous MR, as would be expected with the null signal of calcification. CT scanning necessitates an extended window to ensure discrimination of an ossified ligament from thecal metrizamide. Thickened ligamenta flava are often found in con­ junction with degenerative disease and spinal stenosis at multiple levels and should not be ignored as a possible major contributing factor to the patient's symptoms. In addition, those patients with a secondary block from a thickened ligamentum flavum should be studied from above with C1-C2 puncture to rule out other levels of clinically significant disease. Attention to the particular findings of thickened ligamenta flava is important since surgical intervention must involve removal of the entire offending ligament(s); otherwise clinical symptoms may not be relieved. Ligamenta flava (LF) thickening with and without ossification is a frequent finding on CT scanning; however, it is not widely appreciated as a possible primary cause of cord, cauda equina, or nerve-root symptoms [1-3].
    [Show full text]
  • Model of Pathological Collagen Mineralization Based on Spine Ligament Calcification
    materials Article Model of Pathological Collagen Mineralization Based on Spine Ligament Calcification Sylwia Orzechowska 1,* , Renata Swisłocka´ 2 and Włodzimierz Lewandowski 2 1 M. Smoluchowski Institute of Physics, Jagiellonian University, Łojasiewicza 11, 30-348 Kraków, Poland 2 Department of Chemistry, Biology and Biotechnology, Bialystok University of Technology, 15-351 Białystok, Poland; [email protected] (R.S.);´ [email protected] (W.L.) * Correspondence: [email protected] Received: 21 March 2020; Accepted: 27 April 2020; Published: 4 May 2020 Abstract: The aim of the study was to determine the time of mineral growth in human spine ligaments using a mathematical model. The study was based on our previous research in which the physicochemical analysis and computed microtomography measurements of deposits in ligamenta flava were performed. Hydroxyapatite-like mineral (HAP) constituted the mineral phase in ligament samples, in two samples calcium pyrophosphate dehydrate (CPPD) was confirmed. The micro-damage of collagen fibrils in the soft tissue is the crystallization center. The growth of the mineral nucleus is a result of the calcium ions deposition on the nucleus surface. Considering the calcium ions, the main component of HAP, it is possible to describe the grain growth using a diffusion model. The model calculations showed that the growth time of CPPD grains was ca. a month to 6 years, and for HAP grains >4 years for the young and >5.5 years for the elderly patients. The growth time of minerals with a radius >400 µm was relatively short and impossible to identify by medical imaging techniques. The change of growth rate was the largest for HAP deposits.
    [Show full text]
  • Computed Tomographic Demonstration of Spine in Ankylosing Spondylitis
    Ann Rheum Dis: first published as 10.1136/ard.47.1.62 on 1 January 1988. Downloaded from Annals of the Rheumatic Diseases, 1988; 47, 62-64 Computed tomographic demonstration of calcification of the ligamenta flava of the lumbosacral spine in ankylosing spondylitis ELIESER AVRAHAMI,' IRENA WIGLER,2 DORIT STERN,' DAN CASPI,2 AND MICHAEL YARON2 From the Departments of'Radiology and 2Rheumatology, Sourasky Medical Center, and Tel-Aviv University Sackler School of Medicine, Israel SUMMARY An axial computed tomographic (CT) scan of the lumbosacral regions was performed in 65 patients. The patient population was divided into two groups. The first (control) group included 40 elderly patients without calcification of the ligamenta flava. The second group included 25 patients with ankylosing spondylitis. More than 90% of those in the second group showed calcified lumbosacral ligamenta flava. In two patients these calcifications produced spinal stenosis. The diagnostic and practical importance of these findings are discussed. copyright. Calcification of the ligamentum flavum was first lumbosacral region (L3-S1). The patients were recognised in 1929.1 Only recently, however, was it divided into two groups. Group 1 included 40 found that such calcifications induced myelopathy.2 3 patients, 20 female and 20 male, aged between 41 Since then similar reports have been presented, most and 65 years, who underwent CT examination of the of which referred to the location of this condition in lumbosacral spine after complaints of low back pain. the thoracic spine, producing myelopathy.f7 Some Group 2 included 25 male patients, aged 20-54 of the reported cases, included mainly in the years, with ankylosing spondylitis, without CT morphological studies, were associated with calcifi- findings of prolapsed disc.
    [Show full text]
  • SPINAL STENOSIS Spin15 (1)
    SPINAL STENOSIS Spin15 (1) Spinal Stenosis Last updated: December 19, 2020 ETIOLOGY ................................................................................................................................................ 1 PATHOPHYSIOLOGY ................................................................................................................................. 1 CLINICAL FEATURES ............................................................................................................................... 1 Cervical radiculopathy ..................................................................................................................... 1 Cervical spondylotic myelopathy ..................................................................................................... 1 Lumbar stenosis ................................................................................................................................ 3 DIAGNOSIS................................................................................................................................................ 3 Cervical stenosis ............................................................................................................................... 4 Lumbar stenosis ................................................................................................................................ 4 Studies .............................................................................................................................................. 4 MEDICAL
    [Show full text]
  • SACRUM = 5 FUSED VERTEBRAE Ant
    SACRUM = 5 FUSED VERTEBRAE Ant. View Lateral Mass = fused transverse processes Anterior and Posterior Sacral foramina = Intervertebral Foramina for sacral spinal nerves Post. View Medial Crest = fused spinous processes Sacro- Sacro-Iliac Joint- transmits Iliac Joint weight from vertebrae to pelvis (Innominate Bone) COCCYX = 3-5 FUSED VERTEBRAE RUDIMENTARY TAIL BONES C. LIGAMENTS Adjacent vertebrae held tightly together (protect spinal cord) 1. ANTERIOR LONGITUDINAL LIGAMENT - Strong band joins bodies on anterior side Anterior view CORONAL SECTION - through Vertebral anterior Canal (view ligaments as if standing in vertebral canal) posterior Sagittal SAGITTAL SECTION actually in median sagittal plane Coronal VIEW FROM INSIDE VERTEBRAL COLUMN On post. Side of bodies LOOK ANTERIOR LOOK POSTERIOR 2. POSTERIOR 3. LIGAMENTA FLAVA - LONGITUDINAL yellow elastic bands LIGAMENT- weaker, connecting laminae narrower band (inside vertebral canal) SAGITTAL SECTION 4. INTERSPINOUS AND SUPRASPINOUS LIGAMENTS - connect spines INTERSPINOUS ANT SUPRASPINOUS Greatly thickened in cervical region to form LIGAMENTUM NUCHAE - from Ext. Occip. Protuberance of skull to C7; Support Head, Provide muscle attachments SUMMARY: LOCATION OF LIGAMENTS 1. ANTERIOR LONGITUDINAL LIGAMENT BODY 2. POSTERIOR LONGITUDINAL LIGAMENT LAMINA 3. LIGAMENTA FLAVA 4. INTERSPINOUS AND SPINOUS SUPRASPINOUS LIGAMENTS PROCESS D. JOINTS BETWEEN VERTEBRAE Discs named joint for adjacent capsule L1 vertebra Articular Disc between Processes Joints L1, L2 (Facets) between L2 Articular 2. Inter-
    [Show full text]
  • Fibrotic Thickening of the Ligamentum Flavum
    University of Nebraska Medical Center DigitalCommons@UNMC MD Theses Special Collections 5-1-1942 Fibrotic thickening of the ligamentum flavum Wilbur W. Overmiller University of Nebraska Medical Center This manuscript is historical in nature and may not reflect current medical research and practice. Search PubMed for current research. Follow this and additional works at: https://digitalcommons.unmc.edu/mdtheses Part of the Medical Education Commons Recommended Citation Overmiller, Wilbur W., "Fibrotic thickening of the ligamentum flavum" (1942). MD Theses. 941. https://digitalcommons.unmc.edu/mdtheses/941 This Thesis is brought to you for free and open access by the Special Collections at DigitalCommons@UNMC. It has been accepted for inclusion in MD Theses by an authorized administrator of DigitalCommons@UNMC. For more information, please contact [email protected]. .-. FIBROTIC TfilC!CENING OF THE LIG.AMENTU1! FLAVUM ****** by Wilbur c. Overmiller Senior Thesis ****** Presented to the College or Medicine University of Nebraska, Omaha 1942 •. J ··-· -<:---:.·:�-..: ·-.· - -. ,;;., TABLE OF CONTENTS Introduction • • • • • . • • • • • • • 1 History • • • • • • • • • • • • • • • . 2 Incidence • • • • . • • • • • • . • • • 6 Anatoll\Y' • • • • • • • • • • • • • . • • 8 Pathology • • • • • • • • • • • • • • • 13 Etiology •••••••••••••••• 20 Symptomatology • •• . • 23 Findings •••••••••••••••• 28 Differential Diagnosis ••• •••••• 38 Treatment • • • • • • • • • • • • • • • 39 Prognosis • • • • • • • • • • • • • • • 41 Summary • • • • • •
    [Show full text]