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msk 2 > applied anatomy biomechanics > Flashcards

applied anatomy biomechanics Flashcards

1
Q

CxSp function

A 
Support weight of head
Position special senses for optimal function
	 mobile & stable
	 vertical & horizontal plane
Protect spinal cord
Protect Vertebral Arteries
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2
Q

blood supply

A

cervical arteries ascend within confines of cervical spine

foramen in TP of the vertebrae
from C6 up
bony canal for arteries

4 arteries form circle of willis in brain
neck pain - dizzy ?
hind brain experiencing lack of blood supply

vertebral foramen more lateral in atlas than in axis
blood vessel needs to turn

atlas on axis motion - pivot movement 40-45 degrees of rotation

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3
Q

osteology

A

Upper cervical spine C0-2
Mid-lower cervical spine C3-7

vertebral artery splits into ant and posterior - gutter
exiting nerve roots lie in a gutter - more likely to be compromised but also positive protective

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4
Q

ATLAS

A 
atlas supporting the occiput 
missing a vertebral body 
anterior arch posterior arch 
TP - very wide 
support weight of the head
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5
Q

AXIS

A

dens - body of atlas attached on

SAF - articular with inferior of atlas

spinous process not always the same size

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6
Q

typical cervical vertebra

A

body to foramen - even

bifid spinous process in most C segments

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7
Q

ligaments

A

transverse ligament
help stabilise dens with alar ligaments help control ligament of dens and C2

transverse stops dens moving and compromising the SC

The ligaments in this region have become highly specialised to maintain stability without sacrificing mobility
Transverse ligament: stabilises the atlanto-axial segment and protects the spinal cord from the dens
Alar ligament: controls motion both at the C0/1 and C1/2 joints
Tectorial membrane: the thickened end of the posterior longitudinal ligament

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8
Q

ADI

A

Normal radiological Atlanto-Dens Interval (ADI):
In flexion, less than 3mm in children
IN flexion, less than 3.5mm in adults

Ant. shift of C1 on C2 of > 3-5 mm implies injury to transverse ligament
Ant. shift > 5 mm implies injury transverse & alar ligaments

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9
Q

Atlanto-occipital joints

A

Condyloid joint: convex, oval shaped occipital condyles fit into concave, elliptical shaped superior articular facets on atlas

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10
Q

Atlanta-axial joints

A

Atlanto-Axial joints (C1-2)
Plane joints: between lateral masses of atlas and inferior articular facets on atlas
Pivot joint: between Dens and anterior arch of atlas and Cruciform (transverse) ligament

rotary pivot - most important movement

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11
Q

cervical joints
facet
uncovertebral
interbody

A 
Facet / Apophyseal joints – 
45˚ plane
Weight bearing
Meniscoid inclusions  C1-7 attached to capsule: protect articular cartilage
Uncovertebral joints  - 
joints / pseudoarthroses – C3-6
degenerate early in life – danger of osteophytes (compromise of nerve roots at that level likely)
protect disc from shear
Interbody joints = discs
Small
NP less distinct 
less H2O
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12
Q

cervical disc

A

Small
NP less
distinct
less H2O

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13
Q

exiting nerve roots

A

C3-C4 short nerve root
dorsal - facet joints supply
and ventral ramus

C4 - compromised nerve root at the level below

C5 inflamed and irritated nerve root leaving at that level

know dermatomal pattern

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14
Q

Dermatomes

A

C5 finished around the elbow
C6 radial side of forearms
C7 middle fingers
C8 - medial side of the hand

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15
Q

muscles

A

levator scapula
tight - common

upper mid lower traps
splenius wapitis
splenius carvicis

deep muscles
inferior oblique
superior oblique
rectus captious posterior major and minor

direct connections between dura matter and rectus captious posterior minor

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16
Q

foramen magnum

A

traps most superficial attachment

sub occipital muscles are deep

17
Q

muscles torque

A

SCM working together - biggest torque producing flexion
scalene anterior working together second best

anterior middle scalene - flexion to the same side

18
Q

flexion

A

test separately
upper and lower cervical spine
flexion - separation of spinous processes

atlas to axis - small tilt barely any slide

RESTRAINTS –
Ligamentum nuchae
Interspinous & supraspinous ligts
Ligamentum flava
Facet joint capsules
Posterior AF
PLL
Transverse ligament
19
Q

cervical extension

A

occiput on atlas posterior glide

slide of facet joints

restraint from stretching anterior longitudinal ligament

occipital condyles roll back on the atlas
as they glide forward

20
Q

cervical extension

A

RESTRAINTS:
Oesophagus & trachea
Anterior AF
ALL

21
Q

cervical movement

A

saggital plane movement
combination of flexion and extension
greatest at C5-6

highest incidence of degenerative change

matched of flexion and extension

more movement than other segments on the spine

C0/C1 more movement than C1/C2

22
Q

protraction

retraction

A

position of head relative to thorax

flexion of lower C spine
extension of higher C Spine
some shortening sub occipital muscles
practice retraction mvmt

23
Q

side flexion

A

facet joints slide closed
other side slide open
slide open easier to palpate

24
Q

restraints to side flexion

A 
RESTRAINTS:
Intertransverse ligaments
Contralateral AF
Facet joint capsule
Alar ligaments
25
Q

cervical rotation restraints

A

AF
Facet joint capsule
Contralateral Alar ligaments (excessive rotn may damage)

26
Q

lateral flexion vs rotation

A

lateral flexion less than rotation
significant C1/C2 rotation
most of lateral flexion occurring at occiput and Atlas

occiput and atlas
saggiato plane movement

27
Q

C2-C7

motion - normative data

A

FLEXION - 50 degs
EXTENSION - 70 degs
LAT FLEXION - 40 degs
ROTATION - 90 degs

28
Q

coupled movement

A

C0-2:

C0-1 (OA jt):
Literature confused

C1-2 (AA jt): variable
pattern

Consider C0-2 as
functional unit 
(L) Rotn C1-2 causes (R) SF C0-1  CONTRALATERAL Coupling

C2-C7 ipsilateral - coupling (L) Rotn causes (L) Sideflexion at same segmental level
Due to Facet joints

msk 2 (13 decks)

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