Bones and joints of the neck Flashcards

1
Q

Describe the bones and cartilages present in the anterior neck?

A

Hyoid bone

Thyroid cartilage

Cricoid cartilage

Tracheal cartilage

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2
Q

Describe the bones and cartilages present in the posterior neck?

A

Atlas (C1)

Axis (C2)

C3-7

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3
Q

What can happen to the cartilages in the neck with age?

A

Ossification

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4
Q

When are the bones and cartilages of the neck susceptible to injury?

A

Manual forces applied to neck

Manual strangulation

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5
Q

Describe the five neck regions?

A

1 Back of neck/vertebral region

2 Posterior triangle

3 Sternomastoid region

4 Anterior triangle

5 Root of the neck

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6
Q

What does the posterior triangle of the neck transmit?

A

Structures to the upper limb and back

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7
Q

What does the root of the neck transmit structures to?

A

Thorax

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8
Q

Where does the anterior triangle of the neck transmit structures to?

A

Head

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9
Q

Describe the shape of the cervical spine?

Why is it this shape?

A

Lordosis (inward curvature)

Due to shape and size of IV discs

Maintained by postvertebral muscles, which extend the head on the neck and extend the cervical spine

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10
Q

Describe a typical cervical vertebra?

A

Body

Transverse mass with anterior and posterior tubercles

Transverse foraminae (between anterior and posterior tubercles)

Bifid spinous process

Long spinous process

IV foramen

Unicnate process (C3-C6)

Articular surfaces oriented at 45 degress

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11
Q

Describe the purpose of bifid spinous processes in cervical vertebrae?

A

Increased surface area for several muscles and ligaments that attch at this location

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12
Q

How can vertebrae be counted externally?

A

Use C7 (vertebra prominens) as landmark

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13
Q

Describe the purpose of uncinate processes on C3-C6?

A

Keeps majority of movements in sagittal plane

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14
Q

Describe the lateral vertebral muscles?

A

SCALENES

Scalenus anterior, scalenus medius and scalenus posterior

Located deep to prevertebral fascia

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15
Q

Describe the attachments of the scalenus muscles?

A

Attach to transverse processes (anterior and posterior tubercles)

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16
Q

Describe the importance of scalenus anterior?

A

Key landmark in neck

Scalenus medius behind (arises from posterior tubercles)

Subclavian artery and brachail plexus lie between scalenus anterior in front and scalenus medius behind

Phrenic nerve sits on scalenus anterior

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17
Q

Where are the prevertebral muscles located?

A

Deep to prevertebral fascia

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18
Q

Describe some of the variations of the vertebral column that may occur?

A

Cranial or caudal shift > cervical or lumbar ribs

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19
Q

Describe the consequences of a cervical rib?

A

Nerve entrapment

Lower trunk (C8/T1) coming up from thorax and may be irritated/compressed/trapped by rib

20
Q

Describe the atlas?

A

No body (ring of bone)

Anterior and posterior arches

Facet for dens (anterior arch)

Facet for occipital condyles

Longest transverse processes

21
Q

Describe the axis?

A

Dens (odontoid process)

Surfaces on dens for articulation with anterior arch of atlas

Strong spinous process

22
Q

Describe the spinal cord and nerves within the cervical spine?

A

Nerve roots short and horizontal

C1 and C2 nerve roots pass behind facet joints

Below C2, nerve roots pass between facet joint and transverse foramen

23
Q

Describe the effects of ageing on the cervical vertebrae?

A

Osteophytic outgrowths can develop

Involve facet region and region where unicinate process is

Osteophytes can migrate towards transverse foramen and area of nerve root

24
Q

What is the significance of the anterior tubercle of C6?

A

Carotid tubercle

Separates common carotid from vertebral artery

25
Q

How are the vertebral arteries transmitted in the neck?

A

Transverse foraminae C6-C1

26
Q

Where is the point of bifurcation of the common carotid artery?

A

C4 vertebra

27
Q

Describe the IV discs of the cervical spine?

A

Relatively largest in body

28
Q

Describe the role of the IV discs in the cervical spine?

A

Form cervical lordosis

Prevent forward slip and limit rotation

29
Q

What is the joint between C1 and the skull called?

A

Atlanto-occipital joint

30
Q

What is the joint between C1 and C2 called?

A

Atlanto-axial joint

31
Q

Can disc prolapse occur in the cervical spine?

A

Yes

Less common than in lumbar spine

Usually occur in anterior direction

Usually trauma related

32
Q

Describe the orientation of the facet joints in the cervical spine?

A

Oriented at 45 degrees between coronal and horizontal planes

33
Q

What innervates the capsules of the facet joints in the cervical spine?

A

Posterior rami

34
Q

Describe the injuries that can occur at facet joints?

Which structures can be damaged?

A

Whiplash injury (acceleration of head in AP direction)

Compression injury in hyper-extension

Injury to facet capsule, articular surfaces, supporting ligaments

35
Q

Describe the structure of the atlanto-occipital joints?

A

2 lateral synovial joints

Between occipital condyles and facets on atlas

Loose fibrous capsule

36
Q

Describe the structure of the atlanto-axial joints?

A

3 synovial joints

Median pivot joint between dens of C2 and anterior arch of atlas

2 lateral facet joints

37
Q

What holds the pivot joint in the atlanto-axial joint in place?

A

Transverse ligament

38
Q

Which movements does the atlanto-occipital joint allow?

A

Flexion/extension

39
Q

Which movemements does the atlanto-axial joint allow?

A

Rotation

40
Q

Describe the ligamentum nuchae?

A

Continuous wih supraspinous ligament

From external occipital protuberance to spinous process of C7

41
Q

Describe the posterior atlanto-occipital membrane?

A

Ligament between atlas and occiput

Equivalent to ligamentum flavum at other vertebral levels

42
Q

Describe the anterior atlanto-occipital membrane?

A

Connects atlas to occiput anteriorly

Equivalent to anterior longitudinal ligament

43
Q

Describe the membrana tectoria?

A

Connects atlas to occiput

Equivalent to posterior longitudinal ligament

44
Q

Describe the function of the ligaments in the cervical spine?

A

Resist movements in sagittal plane (F/E)

45
Q

Describe the specialised ligaments between the occiput and the axis?

A

Transverse ligament : stabilises dens

Alar ligaments: resist range of rotation of atlas around dens

46
Q

When are the alar ligaments susceptible to injury?

A

Head flexed and rotated and muscles relaxed

47
Q
A