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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
Q

Superior longitudinal band – attaches to

Cruciform ligament

A

foramen magnum base

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26
Q

Cruciform ligament - Inferior longitudinal band –

A

attaches to dens of C2 post.

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27
Q

Both bands (Crura) vertically

A

oriented. Thus, all 3 form a crucifix (cross)

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28
Q

Alar (Check) Ligament - extends from

A

Strong paired ligaments

Extends from dens to medial portions of occipital condyles

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29
Q

Alar check ligament - checks

A

lateral rotation of skull/head

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30
Q

Alar check ligament - strong

A

Strong paired ligaments nearly as thick as a pencil

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31
Q

Apical Ligament of Dens

A

Slender band ascending from apex of dens

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32
Q

Apical ligament of dens attaches to

A

anterior margin of foramen magnum

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33
Q

Apical ligament of dens Located deep to

A

superior longitudinal band of cruciform ligament

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34
Q

Neurovascular Structures-

A 
Internal jugular v. – 
Internal carotid a. – 
Sympathetic trunk – 
CN VII – 
CNs IX, X, XI – 
CN XII –
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35
Q

IJV

A

emerges from jugular foramen

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36
Q

Internal carotid a. –

A

enters carotid canal

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37
Q

Sympathetic trunk –

A

gives rise to internal carotid plexus

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38
Q

CN VII –

A

emerges from stylomastoid foramen

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39
Q

CNs IX, X, XI –

A

emerge from jugular foramen

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40
Q

CN XII –

A

emerges from hypoglossal canal

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41
Q

Pharynx – hangs from

A

pharyngeal tubercle

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42
Q

Carotid sheath – located

A

lateral & posterolateral to pharynx

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43
Q

Sympathetic trunk – located

A

posteromedial to carotid sheath

44
Q

Ganglia at base of Skull

A

CNs IX & X –

Sympathetic trunk – gives rise to Superior Cervical Ganglion & sends off internal carotid plexus (travels on ICA)

45
Q

CN IX and X ganglia

A

each give rise to superior and inferior ganglia (sensory ganglia within the jugular foramen)

46
Q

Sympathetic trunk

A

gives rise to Superior Cervical Ganglion & sends off internal carotid plexus (travels on ICA)

47
Q

Glossopharyngeal N. (CN IX) travels with

A

Travels with the stylopharyngeus m. between the ICA & ECA

48
Q

Glossopharyngeal n. CN IX runs along lateral side of

A

m. & innervates it

Descends to the pharynx & back of tongue

49
Q

CNs IX & X continue on as their main trunks of nerve after

A

leaving the superior and inferior ganglia within the jugular foramen

50
Q

CN IX runs along the

A

stylopharyngeus m and innervates it then continues inferiorly to pharynx and back of tongue

51
Q

Vagus N. (CN X) gives off

A

2 branches at base of skull

52
Q

Pharyngeal n. – arises ~

A

2 cm inferior to skull base; traveling between ICA & ECA to innervate the pharynx

53
Q

Superior Laryngeal n. – arises just below

A

pharyngeal br.; travels inferior to innervate larynx

54
Q

Pharyngeal Plexus of nerves formed by

A

union of pharyngeal brs. Of CN IX & CN X

55
Q

CN IX - pharyngeal plexus of nerves -

A

primarily contributes sensory fibers to plexus & innervates stylopharyngeus m.

56
Q

CN X – pharyngeal plexus of nerves

A

supplies motor innervation to most pharyngeal mm. & carries p-symp.

57
Q

Symp. fibers from superior cervical ganglion are

A

included in pharyngeal plexus of nerves

58
Q

Accessory N. (CN XI) runs immediately

A

lateral to CN X at base of skull

59
Q

Accessory n (CN XI) usually travels between

A

Usually travels between ICA & IJV as it descends

60
Q

Accessory nerve supplies

A

Supplies the SCM & Trapezius mm.

61
Q

Hypoglossal N. (CN XII) - emerges from

A

Emerges from hypoglossal canal

62
Q

Hypoglossal N. (CN XII) - Runs inferior within

A

submandibular triangle

63
Q

Hypoglossal N. (CN XII) - supplies

A

Supplies mm. of tongue

64
Q

Removal of the Head

A

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
Q

Retropharyngeal space located between

A

buccopharyngeal fascia & alar fascia

66
Q

Retropharyngeal space - Extends from

A

base of skull to superior mediastinum

67
Q

Retropharyngeal space - Easily accessed

A

posterior to carotid sheaths

68
Q

Structures of Prevertebral Region

A 
Sympathetic trunks
CNs IX, X, XI & XII
Cervical spinal nn.
Vertebral vessels
Pharyngeal plexuses of vv
69
Q

CN IX

A

most anterior & travels to posterior tongue & pharynx

70
Q

CN X –

A

found centrally in carotid sheath & travels into thorax

71
Q

CN XI –

A

most posterior & travels to SCM & Trapezius

72
Q

CN XII –

A

moves laterally & travels to tongue

73
Q

C1-C4 –

A

cervical plexus; posterior to longus capitis/colli mm.

74
Q

C3-C5 –

A

form phrenic nn.; descends ant. to anterior scalene mm.

75
Q

C5-C8 –

A

forms brachial plexus; runs between anterior & middle scalene mm.

76
Q

Cervical plexus –

A

nerve network formed by ventral rami of C1–C4.

77
Q

The cervical and brachial plexuses emerge between

A

the anterior and middle scalene muscles.

78
Q

Somatic Cervical plexuses

A

contributions from C1-C4.

79
Q

Cervical plexus

A

nerve network formed by ventral rami of C1–C4.

There are sensory and motor contributions/components.

80
Q

Cervical plexus, Ansa cervicalis (C1-C3):

A

motor branches to infrahyoid strap muscles

+ more motor branches; & Phrenic n. (some sensory

81
Q

ansa cervicalis is formed by

A

a superior limb, C1 fibers associated with the hypoglossal nerve and an inferior limb formed by C2 and C3.

82
Q

ansa cervicalis provides motor fibers to the

A

infrahyoid strap muscles.

83
Q

C1 branches (that travel along the hypoglossal n CN XII) innervate the

A

geniohyoid m and the thyrohyoid m.

84
Q

C1-C2 motor branches innervate

A

anterior and lateral rectus capitis and longus capitis and colli muscles

85
Q

C3 motor branches to the

A

longus capitis and colli and levator scapulae muscles

86
Q

C4 motor branches to

A

longus capitis and colli, levator scapulae and middle scalene muscles

87
Q

Sole motor innervation to the diaphragm = ]

A

phrenic n. (fibers shown in green)

88
Q

Phrenic nerve is 30% .

A

sensory

89
Q

Irritation to both the superior and inferior surfaces of the CENTRAL part of the diaphragm is carried by

A

sensory fibers in the phrenic nerve.

90
Q

Irritation to the superior and inferior surfaces of the PERIPHERAL portions of the is carried by the

A

intercostal nn.

91
Q

Pharyngeal Plexus of Veins

A

2 pharyngeal plexuses of vv.
External Plexus
Internal plexus

92
Q

External Plexus

A

forms outside of pharyngobasilar fascia

93
Q

Internal Plexus –

A

between pharyngobasilar fascia & constrictor mm.

94
Q

Both Internal and external plexuses drain into

A

pterygoid plexus of vv. & IJV at angle of mandible & multiple inferior brs.

95
Q

Vertebral a.– arises from

A

subclavian a.

96
Q

Vertebral v. – drains into

A

brachiocephalic v.

97
Q

Both vertebral a and v located anterior to

A

cervical spinal nn.

98
Q

Both VA and VV enter transverse foramina of

A

C6 & above

99
Q

Vertebral Veins

Veins arise in the

A

suboccipital triangle & form plexuses

100
Q

Vertebral veins Plexuses descend thru

A

transverse foramina

Continue to receive intervertebral & muscular vv. along path

101
Q

Vertebral veins Ultimately drain into

A

brachiocephalic vv.

102
Q

Cervical vertebrae specific feature

A

transverse foramen (only a few have bifid spinous process).

103
Q

Posterior longitudinal ligament becomes

A

tectorial membrane at dura mater. (C2 is the cutoff)

104
Q

Ligamentum flava is segmented

A

at each vertebrae

105
Q

12 goes out and then back

A

in around oropharynx structures back to tongue

106
Q

Glossopharyngeus m dives between

A

superior and middle constrictor in pharyngeal wall.

Anatomy 2 Unit 2 (15 decks)

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