2.1. Cervical Spine Anatomy Flashcards by ashley c

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

scanning examination

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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

scanning examination

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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

stability, mobility

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upper cervical spine

cervicoencephalic or cervicocranial

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lower cervical spine

cervicobrachial

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cervicoencephalic is from C_ to C_?

C0-C2

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shows the relationship between the cervical spine and the
occiput

cervicoencephalic or cervicocranial

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injuries in the cervicoencephalic involves ___, ___, ___

brain, brainstem, and spinal cord

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

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

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C0 to C1; two
uppermost joints

atlanto-occipital joints

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atlanto-occipital joints motions (2)

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

side flex: 10 degrees

rotation: negligible

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principal motion atlanto-occipital joints

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

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

odontoid process

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type of joint of atlanto-occipital

ellipsoid

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anterior membrane is
strengthened by ___

anterior longitudinal ligament

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replaces the ligamentum flavum between the atlas and occiput

posterior membrane

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

tectorial membrane

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tectorial membrane is a continuation of ____

posterior longitudinal ligament

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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

alar ligaments

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

flexion, rotation

C1, C2

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C1 to C2 joint

atlanto-axial joints

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constitute the most mobile articulations of the spine

atlanto-axial joints

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atlanto-axial joints motions (3)

flexion-extension: 10°

side flexion: 5°

rotation: 50°

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primary movement of atlanto-axial joints

rotation: 50°

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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.

decrease

acts as a pivot point for the rotation

odontoid process of C2

middle or median joint

pivot (trochoidal) joint

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.

transverse ligament of the atlas

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

transverse ligament of the atlas

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 ___

cruciform ligament

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

usually starting at C6 but entering as high as C4

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

rotation, extension, and traction movements

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

20°

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

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

Symptoms related to the vertebral artery (7)

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

pain in this area is commonly referred into the upper extremity

cervicobrachial area

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

neck extension

cervical levels of cervicobrachial area

C3 to C7

Symptoms related to pathology in cervicobrachial area (7)

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

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

direction of the superior facets of the cervical spine

upward, backward, and medially

facet joints often included in the examination of the cervical spine

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

direction of the inferior facets of the cervical spine

downward, forward, and laterally

rotation and side flexion both occurring with either flexion or extension

coupled movement

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

between C0 and C2 C7 and T1

greatest flexion-extension of the facet joints occurs where?

between C5 and C6

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

between C2 and C7

vertebral levels where degeneration most likely occur (3)

C4 to C5 C5 to C6 C6 to C7

neutral or resting position of the cervical spine

midway between flexion and extension

closed packed position

Full extension

capsular pattern

Side flexion and rotation equally limited extension

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

25%

where no disc is found (2)

between the atlas and the occiput (C0 to C1) between the atlas and the axis (C1 to C2)

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

TRUE

functions as a buffer to axial compression in distributing compressive forces

nucleus pulposus

acts to withstand tension within the disc

annulus fibrosus

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.

TRUE

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.

FALSE: weight is minimal if normal lordotic posture is maintained

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

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

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

TRUE

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

TRUE

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

FALSE: C2 is the first palpable vertebra

How many cervical nerve roots are there?

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

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.