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Anatomy 2 Unit 2 > 8 - Craniovertebral jts & disarticulation > Flashcards

8 - Craniovertebral jts & disarticulation Flashcards

1
Q

Dens =

A

odontoid process

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2
Q

What are the characteristics of these “special” vertebrae, C1 & C2?

A

Atlas (C1)
Supports the skull
No body
No spinous process
Anterior arch & Posterior arch
Large lateral masses support the occipital condyles of the skull superiorly and articulate with the axis inferiorly
Foramen transversarium located in the large transverse process

Axis (C2)
Dens (Odontoid process) located on the body’s superior surface
Foramen transversarium located in the small transverse process
Spinous process is large and bifid

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3
Q

Craniovertebral Joints- Atlanto-occipital joint

=

A

Contributes to nodding movement (“Yes”)

Allow for tilting of the head, side-to-side

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4
Q

Craniovertebral Joints- Atlanto-axial joint

A

Contributes to rotation movement (“No”)

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5
Q

Both craniovertebral joints are synovial joints with no

A

discs

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6
Q

Atlantoaxial

A

Anterior arch of C1 & dens of C2
Synovial, pivot joint
ROM: rotation (supplies 50% of cervical rotation

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7
Q

Atlanto-occipital

A

Occipital condyles & superior facets of C1
Synovial, condyloid joint
ROM: flexion/extension

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8
Q

Dura Mater & Tectorial Membrane

A

Cranial vault is lined with periosteal dura mater

Continuous inferiorly into spinal column

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9
Q

Beneath this is the tectorial membrane

A

A superior extension of the posterior longitudinal ligament

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10
Q

Beneath the tectorial membrane are the

A

craniovertebral joints and deep ligaments

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11
Q

Remember that the dura is continuous inferiorly

A

along the length of the spinal cord.

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12
Q

Tectorial Membrane is superficial to the

A

dura mater

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13
Q

A & P Longitudinal Ligaments is superficial to the

A

dura mater

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14
Q

Anterior Atlanto-occipital Membrane is the superior extension of the

A

Anterior Longitudinal ligament

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15
Q

Anterior Atlanto-occipital Membrane attaches to

A

base of occipital bone superiorly at margin of foramen magnum

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16
Q

Anterior atlanto-occipital membrane Covers

A

anterior arch of atlas inferiorly

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17
Q

Extends from anterior margin of foramen magnum to cover the

A

anterior arch of C1 – the atlas

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18
Q

Posterior Atlanto-occipital Membrane

A

Posterior membrane between atlas & occipital bone

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19
Q

Posterior Atlanto-occipital Membrane

A

Uppermost extent of ligamentum flavum
Fills in gaps between posterior vertebral arches
These form part of posterior wall of vertebral canal

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20
Q

Ligamentum Flava Fills in gaps between

A

posterior vertebral arches

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21
Q

Deep Ligaments

A

Transverse ligament of the atlas
Cruciform (cruciate) ligament of the atlas
Alar (check) ligaments
Apical ligament of the dens (apical dental)

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22
Q

Transverse Ligament of Atlas - holds

A

dens of axis (C2) tightly to anterior arch of atlas (C1)

Very strong, bow-shaped ligament

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23
Q

fractures of the dens usually occur at its

A

base and often these fractures do not reunite due to the position of the transverse ligament

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24
Q

Cruciform (Cruciate) Ligament - Formed by

A

transverse ligament of atlas & 2 bands

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25
Superior longitudinal band – attaches to Cruciform ligament
foramen magnum base
26
Cruciform ligament - Inferior longitudinal band –
attaches to dens of C2 post.
27
Both bands (Crura) vertically
oriented. Thus, all 3 form a crucifix (cross)
28
Alar (Check) Ligament - extends from
Strong paired ligaments | Extends from dens to medial portions of occipital condyles
29
Alar check ligament - checks
lateral rotation of skull/head
30
Alar check ligament - strong
Strong paired ligaments nearly as thick as a pencil
31
Apical Ligament of Dens
Slender band ascending from apex of dens
32
Apical ligament of dens attaches to
anterior margin of foramen magnum
33
Apical ligament of dens Located deep to
superior longitudinal band of cruciform ligament
34
Neurovascular Structures-
``` Internal jugular v. – Internal carotid a. – Sympathetic trunk – CN VII – CNs IX, X, XI – CN XII – ```
35
IJV
emerges from jugular foramen
36
Internal carotid a. –
enters carotid canal
37
Sympathetic trunk –
gives rise to internal carotid plexus
38
CN VII –
emerges from stylomastoid foramen
39
CNs IX, X, XI –
emerge from jugular foramen
40
CN XII –
emerges from hypoglossal canal
41
Pharynx – hangs from
pharyngeal tubercle
42
Carotid sheath – located
lateral & posterolateral to pharynx
43
Sympathetic trunk – located
posteromedial to carotid sheath
44
Ganglia at base of Skull
CNs IX & X – | Sympathetic trunk – gives rise to Superior Cervical Ganglion & sends off internal carotid plexus (travels on ICA)
45
CN IX and X ganglia
each give rise to superior and inferior ganglia (sensory ganglia within the jugular foramen)
46
Sympathetic trunk
gives rise to Superior Cervical Ganglion & sends off internal carotid plexus (travels on ICA)
47
Glossopharyngeal N. (CN IX) travels with
Travels with the stylopharyngeus m. between the ICA & ECA
48
Glossopharyngeal n. CN IX runs along lateral side of
m. & innervates it Descends to the pharynx & back of tongue
49
CNs IX & X continue on as their main trunks of nerve after
leaving the superior and inferior ganglia within the jugular foramen
50
CN IX runs along the
stylopharyngeus m and innervates it then continues inferiorly to pharynx and back of tongue
51
Vagus N. (CN X) gives off
2 branches at base of skull
52
Pharyngeal n. – arises ~
2 cm inferior to skull base; traveling between ICA & ECA to innervate the pharynx
53
Superior Laryngeal n. – arises just below
pharyngeal br.; travels inferior to innervate larynx
54
Pharyngeal Plexus of nerves formed by
union of pharyngeal brs. Of CN IX & CN X
55
CN IX - pharyngeal plexus of nerves -
primarily contributes sensory fibers to plexus & innervates stylopharyngeus m.
56
CN X – pharyngeal plexus of nerves
supplies motor innervation to most pharyngeal mm. & carries p-symp.
57
Symp. fibers from superior cervical ganglion are
included in pharyngeal plexus of nerves
58
Accessory N. (CN XI) runs immediately
lateral to CN X at base of skull
59
Accessory n (CN XI) usually travels between
Usually travels between ICA & IJV as it descends
60
Accessory nerve supplies
Supplies the SCM & Trapezius mm.
61
Hypoglossal N. (CN XII) - emerges from
Emerges from hypoglossal canal
62
Hypoglossal N. (CN XII) - Runs inferior within
submandibular triangle
63
Hypoglossal N. (CN XII) - supplies
Supplies mm. of tongue
64
Removal of the Head
Craniovertebral joints – logical sites for removal All ligaments holding joints together must be severed Retropharyngeal space – logical plane for separation (of head & viscera from vertebral column) Contains loose fibrous tissue easily separated
65
Retropharyngeal space located between
buccopharyngeal fascia & alar fascia
66
Retropharyngeal space - Extends from
base of skull to superior mediastinum
67
Retropharyngeal space - Easily accessed
posterior to carotid sheaths
68
Structures of Prevertebral Region
``` Sympathetic trunks CNs IX, X, XI & XII Cervical spinal nn. Vertebral vessels Pharyngeal plexuses of vv ```
69
CN IX
most anterior & travels to posterior tongue & pharynx
70
CN X –
found centrally in carotid sheath & travels into thorax
71
CN XI –
most posterior & travels to SCM & Trapezius
72
CN XII –
moves laterally & travels to tongue
73
C1-C4 –
cervical plexus; posterior to longus capitis/colli mm.
74
C3-C5 –
form phrenic nn.; descends ant. to anterior scalene mm.
75
C5-C8 –
forms brachial plexus; runs between anterior & middle scalene mm.
76
Cervical plexus –
nerve network formed by ventral rami of C1–C4.
77
The cervical and brachial plexuses emerge between
the anterior and middle scalene muscles.
78
Somatic Cervical plexuses
contributions from C1-C4.
79
Cervical plexus
nerve network formed by ventral rami of C1–C4. | There are sensory and motor contributions/components.
80
Cervical plexus, Ansa cervicalis (C1-C3):
motor branches to infrahyoid strap muscles | + more motor branches; & Phrenic n. (some sensory
81
ansa cervicalis is formed by
a superior limb, C1 fibers associated with the hypoglossal nerve and an inferior limb formed by C2 and C3.
82
ansa cervicalis provides motor fibers to the
infrahyoid strap muscles.
83
C1 branches (that travel along the hypoglossal n CN XII) innervate the
geniohyoid m and the thyrohyoid m.
84
C1-C2 motor branches innervate
anterior and lateral rectus capitis and longus capitis and colli muscles
85
C3 motor branches to the
longus capitis and colli and levator scapulae muscles
86
C4 motor branches to
longus capitis and colli, levator scapulae and middle scalene muscles
87
Sole motor innervation to the diaphragm = ]
phrenic n. (fibers shown in green)
88
Phrenic nerve is 30% .
sensory
89
Irritation to both the superior and inferior surfaces of the CENTRAL part of the diaphragm is carried by
sensory fibers in the phrenic nerve.
90
Irritation to the superior and inferior surfaces of the PERIPHERAL portions of the is carried by the
intercostal nn.
91
Pharyngeal Plexus of Veins
2 pharyngeal plexuses of vv. External Plexus Internal plexus
92
External Plexus
forms outside of pharyngobasilar fascia
93
Internal Plexus –
between pharyngobasilar fascia & constrictor mm.
94
Both Internal and external plexuses drain into
pterygoid plexus of vv. & IJV at angle of mandible & multiple inferior brs.
95
Vertebral a.– arises from
subclavian a.
96
Vertebral v. – drains into
brachiocephalic v.
97
Both vertebral a and v located anterior to
cervical spinal nn.
98
Both VA and VV enter transverse foramina of
C6 & above
99
Vertebral Veins | Veins arise in the
suboccipital triangle & form plexuses
100
Vertebral veins Plexuses descend thru
transverse foramina | Continue to receive intervertebral & muscular vv. along path
101
Vertebral veins Ultimately drain into
brachiocephalic vv.
102
Cervical vertebrae specific feature
transverse foramen (only a few have bifid spinous process).
103
Posterior longitudinal ligament becomes
tectorial membrane at dura mater. (C2 is the cutoff)
104
Ligamentum flava is segmented
at each vertebrae
105
12 goes out and then back
in around oropharynx structures back to tongue
106
Glossopharyngeus m dives between
superior and middle constrictor in pharyngeal wall.

Anatomy 2 Unit 2 (15 decks)

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