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MSK > 2.1. Cervical Spine Anatomy > Flashcards

2.1. Cervical Spine Anatomy Flashcards

1
Q

Examination of the cervical spine involves determining whether the injury or pathology occurs in the cervical spine or in a portion of the upper limb

A

scanning examination

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2
Q

In the initial assessment of a patient who complains of pain in the neck and/or upper limb, this procedure is always carried out unless the examiner is absolutely sure of the location of the lesion

A

scanning examination

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3
Q

Cervical spine is an area in which ______ has been sacrificed for ______, making the cervical spine particularly vulnerable to injury because it sits between a heavy head and a stable thoracic spine and ribs

A

stability, mobility

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4
Q

upper cervical spine

A

cervicoencephalic or cervicocranial

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5
Q

lower cervical spine

A

cervicobrachial

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6
Q

cervicoencephalic is from C_ to C_?

A

C0-C2

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7
Q

shows the relationship between the cervical spine and the
occiput

A

cervicoencephalic or cervicocranial

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8
Q

injuries in the cervicoencephalic involves ___, ___, ___

A

brain, brainstem, and spinal cord

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9
Q

Injuries in cervicoencephalic lead to symptoms such as? (9)

A

headache,
vertigo,
poor concentration,
irritability,
fatigue,
hypertonia of sympathetic
nervous system,
cognitive dysfunction,
cranial nerve dysfunction,
sympathetic system dysfunction

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10
Q

C0 to C1; two
uppermost joints

A

atlanto-occipital joints

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11
Q

atlanto-occipital joints motions (2)

A

flex/extend (nodding of head): 15-20 degrees

side flex: 10 degrees

rotation: negligible

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12
Q

principal motion atlanto-occipital joints

A

flex/extend (nodding of head): 15-20 degrees

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13
Q

During development, the vertebral body of C1
evolves into the ___

A

odontoid process

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14
Q

type of joint of atlanto-occipital

A

ellipsoid

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15
Q

anterior membrane is
strengthened by ___

A

anterior longitudinal ligament

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16
Q

replaces the ligamentum flavum between the atlas and occiput

A

posterior membrane

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17
Q

broad band covering the dens and its ligaments,
is found within the vertebral canal and is a continuation of the posterior longitudinal ligament

A

tectorial membrane

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18
Q

tectorial membrane is a continuation of ____

A

posterior longitudinal ligament

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19
Q

two strong rounded cords found on each side of the upper dens passing upwards and laterally to attach on the medial sides of the occipital condyles

A

alar ligaments

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20
Q

alar ligaments limit ___ and ___ and play a major role in stabilizing, C__ and C__, especially in rotation

A

flexion, rotation

C1, C2

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21
Q

C1 to C2 joint

A

atlanto-axial joints

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22
Q

constitute the most mobile articulations of the spine

A

atlanto-axial joints

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23
Q

atlanto-axial joints motions (3)

A

flexion-extension: 10°

side flexion: 5°

rotation: 50°

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24
Q

primary movement of atlanto-axial joints

A

rotation: 50°

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25
Q

With rotation, there is a ____ in height of the cervical spine at this level as
the vertebrae approximate because of the shape of the
facet joints.

A

decrease

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26
Q

acts as a pivot
point for the rotation

A

odontoid process of C2

27
Q

middle or median joint

A

pivot (trochoidal) joint

28
Q

At the atlanto-axial
joints, the main supporting ligament is the ____, which holds the dens of the
axis against the anterior arch of the atlas.

A

transverse ligament of the atlas

29
Q

It is this ligament that weakens or ruptures in rheumatoid arthritis.

A

transverse ligament of the atlas

30
Q

As the ligament crosses the dens, there are two projections off the ligament, one going superiorly to the
occiput and one inferiorly to the axis. The ligament and the projections form a cross, and the three parts taken together are called the ___

A

cruciform ligament

31
Q

At what vertebral level does the vertebral artery enter through the transverse processes?

A

usually starting at C6 but entering as high as C4

32
Q

The vertebral and internal carotid arteries are stressed primarily by what movements? (3)

A

rotation, extension, and traction movements

33
Q

Rotation and extension of as little as ___ have been shown to significantly decrease vertebral artery blood flow.

A

20°

34
Q

The greatest stresses are placed on the vertebral arteries in four places:

A

enters the transverse process of C6

within the bony canals of the vertebral transverse processes

between C1 and C2

between C1 and the entry of the arteries into the skull

35
Q

Symptoms related to the vertebral artery (7)

A

vertigo,
visual disturbances,
tinnitus,
nausea,
“drop attacks” (falling
without fainting),
stroke or death (rare cases)

35
Q

pain in this area is commonly referred into the upper extremity

A

cervicobrachial area

36
Q

most common mechanism
for non-penetrating injury to the vertebral artery

A

neck extension

37
Q

cervical levels of cervicobrachial area

A

C3 to C7

38
Q

Symptoms related to pathology in cervicobrachial
area (7)

A

neck and/
or arm pain,
headaches,
restricted range of motion (ROM), paresthesia,
altered myotomes and dermatomes,
radicular signs,
sympathetic dysfunction

39
Q

How many are the facet (apophyseal) joints in the cervical
spine?

A

14

40
Q

direction of the superior facets of the cervical spine

A

upward, backward, and medially

40
Q

facet joints often included in the examination of the cervical spine

A

upper four facet joints in the two upper thoracic vertebrae (T1 to T2)

41
Q

direction of the inferior facets of the cervical spine

A

downward, forward,
and laterally

42
Q

rotation and side flexion both occurring with either flexion or extension

A

coupled movement

43
Q

vertebral levels where coupled movements occur in opposite directions (2)

A

between C0 and C2

C7 and T1

44
Q

greatest flexion-extension of the facet joints occurs where?

A

between C5 and C6

44
Q

vertebral levels where coupled movements occur in same directions (1)

A

between C2 and C7

45
Q

vertebral levels where degeneration most likely occur (3)

A

C4 to C5
C5 to C6
C6 to C7

46
Q

neutral or resting position of the cervical spine

A

midway between flexion and extension

47
Q

closed packed position

A

Full extension

48
Q

capsular pattern

A

Side flexion and rotation equally limited

extension

49
Q

intervertebral discs make up approximately
___% of the height of the cervical spine

A

25%

50
Q

where no disc is found (2)

A

between the atlas and the occiput (C0 to C1)

between the atlas and the axis (C1 to C2)

51
Q

T OR F: It is the discs
rather than the vertebrae that give the cervical spine
its lordotic shape

A

TRUE

52
Q

functions as a buffer to axial compression in distributing
compressive forces

A

nucleus pulposus

52
Q

acts to withstand tension within the disc

A

annulus fibrosus

53
Q

T OR F: There are seven vertebrae in the cervical spine with the body of each vertebra (except C1) supporting the weight of those above it.

A

TRUE

54
Q

T OR F: The facet joints may bear some of the weight of the vertebrae above, but this weight is maximal if the normal kyphotic posture is maintained.

A

FALSE: weight is minimal if normal lordotic posture is maintained

55
Q

T OR F: The spinous process protects the spinal cord,
while the vertebral arch provide for attachment of muscles.

A

FALSE: Vertebral arch protects the spinal cord while spinous process provide for attachment of muscles

56
Q

T OR F: In the cervical spine, the spinous processes are at the level of the facet joints of the same vertebra.

A

TRUE

57
Q

T OR F: Generally, the
spinous process is considered to be absent or at least
rudimentary on C1.

A

TRUE

58
Q

T OR F: The first palpable vertebra
descending from the external occiput protuberance is the
spinous process of C3.

A

FALSE: C2 is the first palpable vertebra

59
Q

How many cervical nerve roots are there?

A

8

60
Q

T OR F: In the cervical spine, each nerve root is named for the vertebra above it.

A

FALSE: In the cervical spine, each nerve root is named for the vertebra BELOW it. But the nerve root exits above the cervical vertebra level.

MSK (7 decks)

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