Anatomy - Vertebral Column And Cervical Spine

Question 1

Vertebral artery

Answer 1

• supplies cervical spinal cord and brain
• branches from subclavian artery
• neck rotation may compromise the vertebral artery, especially between C1 and C2
• excessive rotation to the right kinks the left vertebral artery
• verterbal artery dissection is rare but is a leading cause of stroke in young person

Question 2

Cervical spinal nerves supply

Answer 2

• neck
• diaphragm
• upper limb
• skin on back of scalp

Question 3

What is in the floor of the suboccipital triangle

Answer 3

• posterior arch of atlas
• vertebral artery
• posterior ramus of C1

Question 4

Compression test

Answer 4

• compresses IVF, facets and may increase pain associated with muscle spasms
• may reproduce the upper limb referred pain and help localise the neurological level of the existing pathology

Question 5

Distraction test

Answer 5

• relieves pain due to narrowing of IVF

- also relieves C spine pain

Question 6

Vertebral canal

Answer 6

• houses spinal cord and nerve roots
• it can be compromised
• neck hyperextension reduces the AP diameter and combined with degenerative changes or trauma and a congenitally small canal, increased risk of neurological damage

Question 7

Pain referral

Answer 7

• Headaches - C1-3
• Shoulder pain - C1-8
• Upper limb pain - C5-8

Question 8

Spurling maneuver

Answer 8

• hyperextension and flexion of neck ipsilateral to the side of lesion cause radicular pain in neck and down the affected arm

Question 9

C spine injury

Answer 9

• dislocation (with or without tear of ligament)
• crush or compression fracture
• hyperextension with degenerative change
• burst fracture
• herniated disc