Anatomy - Neck Flashcards
What are characteristics of typical cervical vertebrae?
- transverse mass: anterior and posterior tubercles
- transverse foraminae transmits vertebral a.
- bifid spinous process increase surface area for muscle attachments
- uncinate process
- I-V foramen
What are the 4 layers of deep cervical fascia?
- investing layer
- pretracheal layer
- prevertebral area
- carotid sheath
What are the 3 lateral vertebral muscles?
- scalenus anterior
- scalenus medius
- scalenus posterior
Which neurovascular structures run between scalenus anterior and scalenus medius?
- phrenic nerve
- brachial plexus
- subclavian artery
Where do the lateral vertebral muscles attach?
Attach to transverse mass of cervical vertebrae (tubercles)
Where are the lateral vertebral muscles located?
Deep to prevertebral fascia
What are characteristics of the C1 vertebra?
Atlas:
- no body
- anterior and posterior arches
- facet for dens
- upper surfaces articulate with occipital condyles
- long transverse process
What are characteristics of the C2 vertebra?
Axis:
- dens (odontoid process)
- surfaces on dens articulate with anterior arch of C1
- strong spinous process gives attachment to strong stabiliser muscles
What is the passage of cervical nerve roots?
C1 and C2 pass behind facet joints
The rest pass between body and facet
At what spinal segment does the common carotid artery bifurcate?
C4
Through which foraminae is vertebral a. transmited?
Transverse foraminae C6-C1
Where may compression of common carotid artery occur?
At anterior tubercle of C6 (carotid tubercle)
What are the superior joints (suboccipital) of the cervical spine?
Atlanto-occipital (0-C1)
Atlanto-axial (C1-C2)
What are characteristics of intervertebral discs of the cervical spine?
- thick disc with central nucleus
- form cervical lordosis
- relative to size of body, cervical I-V discs are largest
- prevent forward slip and rotation
What is an uncovertebral joint?
Uncinate process articulates with superior margins of body
Non-synovial joint
What sort of injury occurs in hyperextension of facet joints?
compression injury
What sort of movement does the atlanto-occipital joint permit?
Loose fibrous capsule permits nodding movement (flexion/extension)
Where are the atlanto-occipital joints?
- 2 lateral synovial joints
- between occipital condyles and upper surfaces of atlas
T/F
Superior cervical joints contain an intervertebral disc?
False
What sort of movement do the atlanto-axial joints permit?
Rotation
Transverse ligament allows minimal flexion/extension
What is the ligament between atlas and occiput?
Posterior atlanto-occipital membrane
What ligaments are between axis and occiput?
Membrane tectoria/posterior longitudinal ligament (PLL)
Anterior atlanto-occipital membrane
What movements do the ligaments of the cervical spine limit?
Resist movements in sagittal plane - flexion/extension
What is the function of the transverse ligament?
Stabilises dens - prevents posterior translation of dens into the vertebral canal
What is the function of alar ligaments?
Restricts range of rotation of atlas around dens
What are the effects of aging on the cervical spine?
- Lordosis flattens when water content of I-V disc nucleus reduces
- Osteophytes may develop from uncinate processes and facet surfaces which may irritate nerve roots and occlude vertebral artery
What are the margins of the posterior neck?
Extends from superior nuchal line of the skull to C7/T1 disc
What are the compartments of the neck?
- Visceral compartment
- 2 vascular compartments (carotid sheath)
- Vertebral compartment
What structures are contained within the vertebral compartment?
- Cervical vertebrae
- Postural muscles
What structures are contained within the visceral compartment?
- Thyroid and parathyroid glands
- Thymus gland if present
- Trachea and oesophagus
What structures are contained within the vascular compartments?
- Carotid sheath
- Common carotid artery or ICA and ECA (if post-bifurcation)
- Internal jugular vein
- Vagus
What structures are contained within the superficial fascia?
- Platysma muscle (innervated by cervical branch of facial nerve)
- External jugular vein
- Anterior jugular vein