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203 MEDIMAGE - HAL > 4. Cervical Spine > Flashcards

4. Cervical Spine Flashcards

1
Q

which vertebrae does the ‘atlas’ refer to

A

C1

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2
Q

what is the superior articulation of C1

A

base of skull (occiput)

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3
Q

what is the joint between the base of skull and C1 called

A

atlanto-occipital joint

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4
Q

what 3 movement types are permitted at the atlanto-occipital joint

A

extension and flexion

slight lateral flexion

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5
Q

comparing between the C1 to a normal cervical vertebrae and C2 what does it lack that all others have

A

vertebral body

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6
Q

how do the superior articular facets of C1 compare to the other vertebrae

A

larger, broader and flatter for C1

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7
Q

is the articular facet for the C2 dens on the anterior or posterior arch

A

anterior arch

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8
Q

what is the transverse antlantal ligament’s function and where is it located

A

maintains the dens process in articulation

on the C1 anterior arch holds the odotoid peg in place

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9
Q

which vertebrae is the axis

A

C2

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10
Q

how many joints make up the atlanto-axial joint

and what joint is this between

A

between C1 and C2

3 joints
2 between articular facets and 1 between the dens and anterior arch of C1

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11
Q

what movements are permitted between C1 and C2

A

rotation

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12
Q

how many cervical vertebrae are there and how many cervical nerves are there

A

7 vertebrae

8 nerves

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13
Q

where in relation to their respective vertebrae do the C1 and 2 nerve roots emerge and is the same true for all other cervical nerves?

A

cervical roots emerge superior tp their respective vertebra while thoracic and lumbar nerve emerge beneath their vertebrae

hence there is an extra c8 nerve

C1 nerve is above C1 transverse process
C7 nerve is above C7 transverse process and C8 emerges below the C7 transverse process

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14
Q

how many cervical vertebrae are there

how many are typical vertebrae

which ones are the atypical vertebrae

A

7

5 typical

C1 and 2 are atypical

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15
Q

what distinguishes a cervical vertebrae from a thoracic or lumbar vertebrae

A

presence of a transverse foramen

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16
Q

why are the transverse processes gutter shaped

A

this is where the spinal nerves and important arteries run so create a gutter in the bone

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17
Q

what do you notice about the C7 spinous process

A

very long and not bifid so appear more thoracic in form

first spinous process you can see on the skin and a good surface landmark

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18
Q

where are the uncinate processes of the cervical vertebrae and what joints do they form

A

from the uncovertebral joints

its the upper lip of the vertebral body edge s which articulate with the body of the vertebrae above to form the joint

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19
Q

___ joints are unique to the cervical region

what movements do they permit and limit

A

synovial joints

permit = flex/extension
limits lateral flexion and rotation

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20
Q

what are the intervertebral discs primarily made of and what joints do they create and where are these joints located

A

fibrocartilage

forms symphysis joints between the adjacent vertebrae (all midline joints are symphyses)

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21
Q

how many IV discs are there in the cervical region

why

A

6

no disc between the C1 and C2 vertebrae as C1 doesnt have a body and dens projects upwards

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22
Q

the IV discs are name after which vertebrae

A

the ones above and below (eg between C5/6 = C5-6 disc)

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23
Q

how would you describe IV disc appearance on the x-ray images

A

radiolucent (dark)

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24
Q

the cervical spine transmits what portion of the spinal cord

A

first portion

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25
Q

where is the spinal cord formed

A

brain stem

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26
Q

what space does the spinal cord run through in the cervical vertebrae

A

spinal canal

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27
Q

what is the intervertebral foramina formed by and why would it be a region of interest clinically

A

its the gap formed between the pedicle/transverse processes of adjacent vertebrae

narrowing of these spaces due to inflammation, arthritis or trauma may lead to neurological symptoms by compression of nerve roots (especially in the neck and upper limb)

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28
Q

what is the larynx’s primary function

ie. its a _____ structure

A

airway structure

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29
Q

which 3 structures is the pharynx split into

A

nasopharynx
oropharynx
laryngopharynx

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30
Q

where is the nasopharynx located behind

A

nasal cavity

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31
Q

where is the oropharynx located behind

A

oral cavity

32
Q

where is the laryngopharynx located behind

A

behind the larynx

33
Q

which cavity is the primary entrance for food

which cavity is the primary entrance for air

what do you notice about the passage of food and air in relation to each other in this region and what consequences might this have

A

food = oral cavity

air = nasal cavity

they cross each other so food is at risk of going down airways

34
Q

is the trachea above the larynx

A

no its below

35
Q

the larynx’s main structure is a tube made of what 3 structures

what are they bound together by

A

2 cartilaginous structures and one bone bound to eachother by fibro-elastic membranes

36
Q

from superior to inferior what are the 2 cartilaginous structures and one bone of the larynx

which forms the adams apple

A

hyoid bone
thyroid cartilage
circoid cartilage

thyroid cartilage

37
Q

after the cricoid the airway becomes known as

A

trachea

38
Q

what is the difference between the cricoid cartilage and other 2 (hyoid bone and thyroid cartilage)

A

the cricoid is a full ring but others are ‘C-shaped’

39
Q

proximally the epiglottis is made from ___ ____

A

elastic cartilage

40
Q

how is epiglottis anchored to the thyroid and hyoid?

A

by a ligament

41
Q

what is the epiglottis function and how does its form produce that function

A

depresses when food is passing down to prevent it entering the larynx

unlike other cartilages its made of elastic cartilage - that plus the ligaments holding it to the hyoid/thyroid helps it spring back open after food has passed

42
Q

the pharynx is the most anterior/posterior set of spaces in its region

A

posterior

43
Q

the laryngopharynx is found directly ___ to the larynx and is created by a series of muscles that mostly attach to ___________

A

posterior

posterior aspect of laryngeal structures

44
Q

why is the laryngopharynx primarily muscular while the larynx and trachea have cartilage

A

pharynx must expand to accommodate food

larynx needs structure to stop it collapsing

45
Q

why is the airways are mostly made of C-shape structures

A

pharynx/oesophagus can expand into the airways a little as food passes down (vertebral column isnt very forgiving)

46
Q

what is the consequence of the cricoid’s full ring structure

A

potential site of constriction/blockage as things pass down

47
Q

the cricoid marks the transition of ___ into the ____

A

laryngopharynx into the oesophagus

48
Q

which laryngeal structure approximates the location of the carotid bifurcation

A

hyoid anterior aspect

49
Q

what is the vertebral level roughly does the oesophagus begin

A

C6 (C5-6)

50
Q

what is the vertebral level that corresponds with the hyoid bone

A

C3 (C3-4)

51
Q

what is the vertebral level does the trachea begin

A

C6 (C5-6)

same as the oesophagus

52
Q

what arteries are the largest of those in the neck and how do they run up the neck

A

common carotid arteries

run vertically up each side of the neck in the carotid sheath

53
Q

which 2 arteries do the common carotids split into

A

external and internal carotid artery

54
Q

out of the internal and external carotid arteries which primarily supplies the brain

what does the other artery do

A

internal = supplies brain

external = supplies things external to the cranium mostly (eg neck, face, mouth, nose, ears etc)

55
Q

what other arties also supply the brain in addition to the internal carotid artery? where do they arise from

A

the vertebral arteries which arise off the subclavian arteries

56
Q

describe the course of the vertebral arteries in relation to the cervical vetebrae

A

they course through the transverse foramina of C1-6 (NOT C7!!)

57
Q

which veins runs with the carotid vessels in the carotid sheath

A

internal jugular veins

58
Q

the IJVs join the ___ veins to form the _____ ___ at the root of the neck

A

subclavian veins

brachiocephalic trunks

59
Q

the brachiocephalic trunks form at the root of the neck behind which joints

A

sternoclavicular joints

60
Q

which structures does the sternocleidomastoid muscle attach to and what aspects do they attach

A

attach to the medial aspect of the clavicle and manubrium

61
Q

which 2 vessels can be located deep to the sternocleidomastoid muscle

A

carotids and IJVs

62
Q

the thyroid gland sits atop the trachea between which 2 vessels

what is the thyroid glands position relative to the thyroid cartilage

A

between the carotids and IJV

relative to the thyroid cartilage, the thyroid gland is more inferior (mostly around the trachea but lateral parts may extend up to the level of the thyroid cartilage)

63
Q

describe the flow of blood from the aortic arch to the brain in terms of the order of arteries they flow through on the right side

A

aortic arch -> brachiocephalic trunk

brachiocephalic trunk -> right subclavian and right common carotid

right subclavian -> right vertebral

right common carotid -> right external and internal carotid

64
Q

describe the flow of blood from the aortic arch to the brain in terms of the order of arteries they flow through on the left side

A

aortic arch -> left common carotid and left subclavian

left subclavian -> left vertebral

left common carotid -> left external and internal carotid

65
Q

the IJV turn into which veins

A

brachiocephalic trunks

66
Q

the vagus nerves supply _____ innervation to which structures

A

parasympathetic innervation

supplies almost all the thoracic and abdominal viscera

67
Q

the vagus nerves run down the neck in the ___ ___ between which 2 vessels

A

carotid sheath

between the common carotid and IJV on each side

68
Q

each vagus nerve gives off to which nerve

A

recurrent laryngeal nerve

69
Q

the left and right RL nerve takes what path to innervate the larynx and control the airways

A

left hooks around the arch of the aorta
right hooks around the right subclavian artery

hooks around major artery and runs back up between the trachea and oesophagus and posterior to the thyroid gland

70
Q

what is the consequence of damaging the RL nerves

A

laryngeal pathology results in hoarse voice and airway obstruction

71
Q

which nerves run lateral to the vagus nerves

A

phrenic nerves

72
Q

which muscles do the phrenic nerves run over and which artery and vein do they pass between

A

run over anterior scalene muscles

pass between the subclavian artery and vein on each side

73
Q

what does the phrenic nerve innervate and what is its root value

A

innervates diaphragm

nerve roots C3-5

74
Q

what is the phrase to remember what the C3-5 roots innervate

A

C3,4,5 keeps the diaphragm alive

75
Q

what nerve roots form the cervical plexus and what areas and functions of the body do they innervate

A

C1-4

neck = sensory and motor

76
Q

what nerve roots form the brachial plexus and what areas and functions of the body do they innervate

A

C5-T1

upper limb = sensory and motor

203 MEDIMAGE - HAL (6 decks)

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