Henry Gray (18251861). Anatomy of the Human Body. 1918.
on either side of the neck. In man it is merely the rudiment of an important elastic ligament, which, in some of the lower animals, serves to sustain the weight of the head.
The Interspinal Ligaments (ligamenta interspinalia; interspinous ligaments) (Fig. 301).The interspinal ligaments thin and membranous, connect adjoining spinous processes and extend from the root to the apex of each process. They meet the ligamenta flava in front and the supraspinal ligament behind. They are narrow and elongated in the thoracic region; broader, thicker, and quadrilateral in form in the lumbar region; and only slightly developed in the neck.
The Intertransverse Ligaments (ligamenta intertransversaria).The intertransverse ligaments are interposed between the transverse processes. In the cervical region they consist of a few irregular, scattered fibers; in the thoracic region they are rounded cords intimately connected with the deep muscles of the back; in the lumbar region they are thin and membranous.
Movements.The movements permitted in the vertebral column are: flexion, extension, lateral movement, circumduction, and rotation.
In flexion, or movement forward, the anterior longitudinal ligament is relaxed, and the intervertebral fibrocartilages are compressed in front; while the posterior longitudinal ligament, the ligamenta flava, and the inter- and supraspinal ligaments are stretched, as well as the posterior fibers of the intervertebral fibrocartilages. The interspaces between the laminæ are widened, and the inferior articular processes glide upward, upon the superior articular processes of the subjacent vertebræ. Flexion is the most extensive of all the movements of the vertebral column, and is freest in the lumbar region.
In extension, or movement backward, an exactly opposite disposition of the parts takes place. This movement is limited by the anterior longitudinal ligament, and by the approximation of the spinous processes. It is freest in the cervical region.
In lateral movement, the sides of the intervertebral fibrocartilages are compressed, the extent of motion being limited by the resistance offered by the surrounding ligaments. This movement may take place in any part of the column, but is freest in the cervical and lumbar regions.
Circumduction is very limited, and is merely a succession of the preceding movements.
Rotation is produced by the twisting of the intervertebral fibrocartilages; this, although only slight between any two vertebræ, allows of a considerable extent of movement when it takes place in the whole length of the column, the front of the upper part of the column being turned to one or other side. This movement occurs to a slight extent in the cervical region, is freer in the upper part of the thoracic region, and absent in the lumbar region.
The extent and variety of the movements are influenced by the shape and direction of the articular surfaces. In the cervical region the upward inclination of the superior articular surfaces allows of free flexion and extension. Extension can be carried farther than flexion; at the upper end of the region it is checked by the locking of the posterior edges of the superior atlantal facets in the condyloid fossæ of the occipital bone; at the lower end it is limited by a mechanism whereby the inferior articular processes of the seventh cervical vertebra slip into grooves behind and below the superior articular processes of the first thoracic. Flexion is arrested just beyond the point where the cervical convexity is straightened; the movement is checked by the apposition of the projecting lower lips of the bodies of the vertebræ with the shelving surfaces on the bodies of the subjacent vertebræ. Lateral flexion and rotation are free in the cervical region; they are, however, always combined. The upward and medial inclinations of the superior articular surfaces impart a rotary movement during lateral flexion, while pure rotation is prevented by the slight medial slope of these surfaces.
In the thoracic region, notably in its upper part, all the movements are limited in order to reduce interference with respiration to a minimum. The almost complete absence of an upward inclination of the superior articular surfaces prohibits any marked flexion, while extension is checked by the contact of the inferior articular margins with the laminæ, and the contact of the spinous processes with one another. The mechanism between the seventh cervical and the first thoracic vertebræ, which limits extension of the cervical region, will also serve to limit flexion of the thoracic region when the neck is extended. Rotation is free in the thoracic region: the superior articular processes are segments of a cylinder whose axis is in the mid-ventral line of the vertebral bodies. The direction of the articular facets would allow of free lateral flexion, but this movement is considerably limited in the upper part of the region by the resistance of the ribs and sternum.
In the lumbar region flexion and extension are free. Flexion can be carried farther than extension, and is possible to just beyond the straightening of the lumbar curve; it is, therefore, greatest at the lowest part where the curve is sharpest. The inferior articular facets are not in close apposition