4. Cervical Spine Flashcards
Vertebral body
Weight-bearing portion of vertebra
Vertebral arch
Composed of pedicles and lamina; surrounds SC
Vertebral foramen
Space within vertebral arch
Intervertebral foramen
Opening between vertebrae on each side of column, allowing passage of spinal nerves
Intervertebral discs
Make up 20-30% of spinal column length; Increase in size from cervical to lumbar; > disc height = > mobility
Cervical disc thickness
3mm
Lumbar disc thickness
9 mm
Cervical Vertebrae - Defining Characteristics
Small body; Spinous processes are short & extend horizontally
C1
Atlas; no body or spinous process; articulates with occipital condyles superiorly; Facet on internal surface of anterior arch for articulation with dens
C2
Axis; Anterior facet for articulation on dens
Anterior atlantoaxial lig.
Runs along anterior of body; limits extension of C1-C2
Anterior longitudinal lig.
runs along anterior of body; limits extension
Posterior longitudinal lig.
Runs along posterior of body; limits flexion
Ligamentum flavum
Connects lamina to lamina; limits flexion
Ligamentum nuchae
Connects tips of spinous processes; limits flexion
Alar
CONNECTS ODONTOID TO OCCIPUT; LIMITS ROTATION
Atlanto-occipital joint
(Occiput-C1); Nodding; NO DISC; flex, lat flex; NO ROTATION
Atlanto-axial joint
MOST MOBILE JOINT OF SPINE; no disc; flex, lat flex, rotation
C4-C6
Greatest amount of flexion
C2-C4
Greatest amount of lateral flexion
Cervical discs
More fibrous; less likely to herniate
Rectus capitus action
cervical flexion
Scalenes
cervical flexion
Trapezius action
elevation, lat flexion, extension
Levator scapulae
elevation, lat flexion, rotation, flex
Splenius
Lateral flexion
Sternocleidomastoid
Opposite lateral rotation
Cervical plexus
Gives rise to phrenic n.
Important Cervical Spine HX Questions
Neck stiffness; headache; vision changes
Important TMJ Hx Questions
Jaw pain/click/lock; malocclusion; bruxism
Torticollis
Permanent spasm; slight lat rot and looking up
Mandibular RoM
Should be able to place 3 fingers in mouth
Occiput/jaw angle dermatome
C2/3
Supraclavicular/lateral shoulder dermatome
C4
Lateral upper arm dermatome
C5
Thumb, lat forearm dermatome
C6
3rd digit dermatome
C7
5th digit; ulnar forearm dermatome
C8
Medial arm & elbow dermatome
T1
Adson Maneuver
Assesses Thoracic Outlet Syndrome; palpate radial pulse while patient abduct, extends, and ER shoulder; pt holds breath; (+) = pulse disappears
Thoracic Outlet Syndrome
Involves subclavian a. compression;
Compression Test
Push down on head to apply pressure to cervical spine; (+) = radiating arm pain from nerve root lesion or disc herniation; OR (+) = local cervical pain from facet joint, transverse process, spinous process
Valsalva Test
Increases venous pressure and CSF pressure; (+) = pain; herniated disc will most likely radiate
Brudzinski’s Sign
Tests for meningitis; Passive neck flexion; (+) = Involuntary hip/knee flexion when neck is raised
Kernig’s Sign
Test for meningitis; Passive flexion of hip/knee, then extension; (+) = Hip/knee resistance with passive flexion; causing neck pain
Chvostek Test
Test of facial nerve; Tap parotid gland over masseter; (+) = tetany; twitch if Ca++ levels low
Jaw Reflex Test
Test of trigeminal nerve; Pt mouth slightly open, provider’s finger on chin, tap with hammer; (+) = Mouth clenches tightly or opens dramatically
Cervical Disc Herniation
Pain in dermatomal distribution of the arm; numbness & tingling; decrease/alteration in sensation
Cervical Stenosis
Narrowing of intervertebral foramen placing pressure on SPINAL NERVE ONLY
Hyperextension injury
Whiplash; Injury to sternocleidomastoid strain; Anterior longitudinal ligament strain; possible fx of spinous process; possible disc herniation; due to anterior neck muscles are physiologically weaker than posterior
Cervical Strain
Muscle/tendon stretch or tear; Caused by forceful movement; Strain occurs IN MUSCLE THAT DOES OPPOSITE ACTION
Cervical Sprain
Ligament or capsule stretch or tear
