1 C Spine Anatomy Flashcards
What makes up the Upper C Spine?
Joints between the Occiput, Atlas, and Axis
- Craniovertebral joints
- C1/C2 are atypical vertebrae
- C3 Transitional Segment
What makes up the Lower C Spine?
Joints between C3-C7/T1
What are typical cervical vertebrae?
C3-C7
- SMaller body
- Uncinate processes located on superior surface of vertebral body
Describe the Joints of Luschka function
- Limits sidebending (protect cervical roots )
- Support intervertebral discs from protruding
- Form medial wall of interverbral foramen/canal + fissures
- Becines weught bearing with age and disc dehydration
Which joints in the C spine contribute to stability?
- ZPJ + Uncovertebral joints
Describe the aging pathology of the Uncovertebral Joints
- Can break down over time
- Source of Osteophyte formation
- Vertebral artery Interference
- Changes from dehydraiton of vertebral disc
- Leads to crepitus and decreased ROM
- Herniation can occur in lower C spine during deterioration
- Fatty tissue plugs can bleed in trauma = fissuring
What are Uncovertebral joint symptoms?
- Very little pain = vague discomfort
- Stiffness > Pain
- AM Stiffness
- No reffered or neurological symptoms
How are the UNC joints a source of pain?
- contain both synoviocytes and chondrocytes = synovial in nature
- Immunoreactivity = presence of nerve fibers from both somatic and autonomic nervous systems
What are Uncovertebral joint signs?
- Loss of extension
- Neck in forward flexed position
- Limited side bend in flexion, neutral and extension
- Decresed rotation
- Crepitus/grinding
Describe normal fissuring during the aging process (early to 40’s)
- Starts at 8-9 years old
- By 12 clefts appear
- fissures extend across discs by late 20s and 30s
- By 35-40 posteruir annulus is complete (anterior annulus and longitudinal lig intact
- Normal in cervical for subjects over 35 years
Describe normal fissuring during the aging process (50’s +)
- 50-60’s = disc thinning and disc resorption are seen at C5-6 or C6-7
- 70’s-80s spontaneous fusion is common at lower C spine
- Loss of disc height results in formation of uncovertebral ostephytes and hard posterior disc protrusions = encroach on interverebral and spinal canals (common lower C rediculopathy)
Does the upper or lower C spine have a higher incidence of injury and ridiculopathy?
- Lower C spine
- Contains nuclues
- Inflammatory and immune mediated chemicals can irritate nerve roots
No nucleus in upper 4 Cervical discs
Cervical disc lesions are less common than lumbar
Describe age related compression in the C spine
- compression by UV osteophytes and disc protrusions
- Narrowing = uncovertebral osteophytes project into the IV foramina an dposterior disc and osteophytic bars go into spinal cord
- compresses nerve roots, vertebral arteries and spinal cord
What are some trauma related incidences with cervical radiculopathy
- Annulus tears
- end plate injuries
- annulus bruising
Can lead to irritation of dorsal root ganglion chemically (bleeding + inflammatory/immune mediators)
Describe Discogenic Symptoms
- Cervical spine relatively pain free/stiff/sore
- Deep burning, toothache pain around the scapular border, supraspinous fossa, and scapula
- Referral to the shoulder
