C-spine iRA/tRA Flashcards
what are the typical cervical vertebrae?
C3-C7
C3-C7 body: anterior is ____
convex
C3-C7 body: posterior is ____
flat or slightly concave
what part of C1 (atlas) articulates with the dens?
the posterior surface of the anterior arch
the posterior arch of C1 has a groove for what artery on its superior surface?
vertebral artery
the posterior tubercle on the posterior arch of C1 is an attachment for which ligament?
ligamenta flava
the transverse processes of C1 are palpable between what 2 bony landmarks?
mastoid process and ramus of mandible
the superior facets of C2 (axis) are oriented slightly ____
convex
the inferior facets of C2 are oriented ____ and ____
inferiorly and anteriorly
how is the odontoid process (dens) of C2 tilted?
- posteriorly: up to 14 deg
- laterally: 10 deg or less
what ligaments stabilize the dens?
- transverse ligament
- apical ligament
- alar ligaments
what 3 parts make up the IV discs?
- nucleus pulposus
- annulus fibrosis
- vertebral endplates
describe what a vertebral endplate is
- cartilaginous disc affixed to the inferior and superior surface of the IV disc
- transition between disc and vertebra
- failure of this structure can be problematic
T/F: there is no clear boundary between the nucleus and annulus in the c-spine
true
what is the significance of the semifluid material of the nucleus?
it transmits pressure in all directions if deformed
which part of the vertebral endplate is made of hyaline cartilage?
toward the vertebral body
which part of the vertebral endplate is made of fibrocartilage?
toward the nucleus
T/F: the vertebral endplate covers the entire nucleus and annulus
False! It covers the nucleus, but not the entire annulus
the vertebral endplate is weakly attached to ____ and strongly attached to ____
- vertebral bodies
- IV disc
are IV discs strongly or poorly vascularized?
poorly
how do IV discs get nutrition?
- nutrition is accomplished with diffusion (compression and distraction)
- compression: fluid leaves
- distraction: fluid returns
describe the anterior annulus of the c-spine disc
- thick and strong
- lambdoid orientation
describe the posterior annulus of the c-spine disc
- thin
- longitudinal fibers
- transverse fissure
what is the significance of the transverse fissure on the posterior annulus?
allows for swingng motion of cervical vertebral bodies
what are the 3 primary functions of the c-spine disc?
- allow motion to occur
- transmit forces
- absorb energy/attenuate forces
what type of joint are zygapophyseal joints?
synovial
describe the fibro-adipose meniscoid found in z-joints
- leaf-like fold of synovium that encloses fat, collagen , and blood vessels
- folds into the corners of the joint to fill space + protect joint surfaces in extremes of motion
- projects up to 5mm into jt cavity
- highly innervated
what structure is innervated by the dorsal rami medial branch?
z-joint capsule
describe the sinuvertebral nerve
- comes off ventral ramus
- goes 1/3 of the way deep into the annulus
- with disc degeneration, typically don’t feel pain until it reaches the outer layers of the disc
what are the joints of Luschka?
- synaovial jts that glide w c-spine movement
- enclosed in a capsule that blends w the disc
- can get stress concentrations here (with degeneration, osteophytes can cause nerve root impingement)
what muscles are part of the spinotransverse group at the c-spine?
- multifidus
- semispinalis cervicis and capitis
what is important about the spinotransverse muscles (especially the multifidus)?
they stabilize the c-spine
what movements do the suboccipitals do?
- B/L: extend the upper c-spine
- Uni: ipsi rotation and/or lateral flexion
what does the longus colli do?
- B/L: straighten cervical curvature and flex neck
- Uni: flexion and ipsi flexion of neck
- Plays a role in static positioning
what are the attachments of the scalenes?
- ant: C3-C6 to rib 1
- middle: C2-C7 to rib 1
- post: C4-C6 to rib 2
cervical flexion ROM
80-90 deg
cervical extension ROM
70 deg
cervical lateral flexion ROM
20-45 deg
cervical rotation ROM
70-90 deg
