cervical Flashcards
Why is there a bifid spinous process in the mid cervical spine?
For attachement of ligamentum nuchae - except the transition to tpsine
Why is the angle of the articular process?
45 degrees
Foramen Transverasum
6th vert entry, and 1st very exit for vertebral artery
C/T junction level
C6
Transition to upper c/s
C2-3
Uncovertebral joints/Joint of vonlushka
Uncinated process to protect disc and stabilize c/s. Saddle joints. decrease disc herniations
Intra-articular inclusions
- Intra-articular fat pads (AO jt)
- Fibro-adipose meniscoid (not in AO)
- Capsular rims: wedge shapped
Function of zygapophysial joints
- Compensate for incongruency
- Distribute synovial fluid
- Preservation of articular edges
- Transmission of forces
- Fill space
Acute neck pain like due to
Zygapopgysial Joint dysfunction
Uncovertebral joints
- limit lateral bending
- guide flexion and extension
Bogduk: U joints
clefts facilitate rotation and SB in plain facet
Panjabi: U joints
Uncinate process protects against disc herniation
C1-3 anastamose with…
CN9 and 10.
Can refer up to C2-3, creating cervicogenic HA
C4 and below refer to
scapula
C7 refers to
top of 1st rib
McKenzie: Dysfunction
aberrant function of musculoskeletal system
McKenzie: Derangement
disc
McKenzie: Postural
time dependent
PLL
becomes thicker and forms the tectoral membrane in the upper c/s
Intratransverse lig
Stabilize AA segment and protects spinal cord from dens
Alar Lig
- Dens to occiput, stabilize dens.
- tightens with side cocking
Apical lig
- dens to occiput, holds dens to foramen magnum
- Has proprioceptive properties
Cruiciform lig
- transverse and longitudinal portions
- holds axis tight against atlas
- prevents anterior shear of axis
Ligamentum Nuchae
- Connections to spinal dura between Occiput-C2
- Innervated by upper c/s nerves
- Dense, bilaminar, tiangular midline fibroelastic intermuscular septum
- Occipital protuberence to spine of C7
Snell: lig nuchae
C1 and C5-6: nuchal lig convergence prevents anterior shear
Nerves: Facet degeneration
Sensory problems more common
Nerves: disc herniation
motor problems more common
Posterior Scalenes
TP C5-7 to 2nd rib
Middle Scalenes
TP C2-7 to 1st rib
Anterior Scalenes
TP C3-6 to 1st rib
Longus Coli
Bodies C5-T3 to ant arch of atlas
-Can flatten lordosis
Rec cap post minor
- SP of axis to inf nuchal line
- HAs, O/AA control
Rec cap post major
- post arch of atlas to inf nuchal line
- Extension/rotation, AO stability
Obliquus sup
-TP of atlas to occipital bone
Obliquus inf
- SP of axis to TP of atlas
- largest suboccipital
SCM
manubrium to mastoid
-SCM fires because ant cervical m. are weak
Levator scap
TP C1-4 to sup med border of scap.
Dvorak: Inclination of lower facets
- 45 deg to horizontal
- lower segments steeper than upper
Mercer: angular vs linear displacement
- Upper cervical: anterior linear motion
- lower cervical: anterior angular displacement
Bogduk arthrokinematics
-SB and rotation occurs around an oblique axis, perpendicular to plane of z-joints
Craniovertebral region (C0-3) anatomy
- No discs
- apophyseal joints do weight bearing
- no vertebral body C1. C2 has dens
- VA runs through TP, back and around. Ant trans of atlas can compress VA
Fryette’s 1st law: c/s
In the UPPER cervical spine, C1-2 = contralatearl SB and rotation always.
Fryette’s 2nd law: c/s
In the MID and LOWER c/s, C2-6 = ALWAYS ipsilatearl SB and rotation.
Fryettet’s 3rd law
Motion introduced into any motion segment, available motion in other planes is reduced
Why is the mid-lower c/s ALWAYS type 2 motion?
- Universal joint: J of VL = saddle joint
- Presence of disc and its location
- Muscle pulls
- 45 deg facet orientation