Cervical Anatomy

Question 1

upper cervical spine

Answer 1

Joints between the occiput, atlas and axis

craniovertebral joints

C1 C2 are atypical
C3 is transitional segment

Question 2

From C3 downwards the facet joints are

Answer 2

inclined in a plane slightly anterior

Question 3

Lateral masses of the C1 contain

Answer 3

Superior and inferior articulating facets that are concave

Question 4

Lower cervical spine

Answer 4

C3 to C7

Small vertebra body that is wider in the lateral dimension

uncinate processes located on superior surface of the vertebral body
Forms joints of Luschla

Question 5

joints of luschka

Answer 5

uncovertebral joints

Only found in the cervical spine C3 to C7

Articulates with the inferior surfaces of the body above

limit sidebending
protecting the cervical nerve roots

Support the intervertebral disks from protruding
From the medial wall of the intervertebral foramen
Become weight-bearing with age and dehydration

Question 6

ZPJs in the cervical spine do not protect the IVD as much as

Answer 6

They do in the lumbar spine

Question 7

herniation of the nucleus pulposus usually occurs in

Answer 7

Lower cervical spine

Question 8

uncovertebral joint symptoms

Answer 8

very little pain
vague discomfort

Stiffness is greater than pain
No referred or neurological symptoms
Morning stiffness

Question 9

uncovertebral joint signs

Answer 9

loss of extension
Neck in forward flex position
Limited side bending in flexion, neutral, and extension
decreased rotation
Crepitus /grinding

Question 10

Disc changes in the lumbar spine

Answer 10

age related fissuring
Middle life or old age
Associated with pain
Trauma associated fissures

Question 11

disc fissuring in the cervical spine

Answer 11

uncus grows upwards from the lateral edge of the vertebral body at about eight years
uncovtebral clefts appear by 12 years
Fine fissures extend across the disc by the late 20s or early 30s

35 to 40 the nucleus and posterior annulus are usually completely fissured
only the anterior annulus and longitudinal ligaments remaining intact

Question 12

Disc thinning and resorption are frequently seen at

Answer 12

C5 to C6 or C6-C7
By the 70s or 80s

Spontaneous fusion is quite common at lower cervical levels

Question 13

loss of disc height results in formation of

Answer 13

uncovertebral osteophytes
And hard posterior disc protrusion
Which encroach on the intervertebral and spinal canals

Question 14

The upper cervical discs fissures before or after lower cervical discs

Answer 14

Before

Question 15

in C1-C3 no nucleus pulposus to herniate posteriorly so…

Answer 15

no inflammatory and immune mediated chemicals to irritate the nerve roots
Lower incidence of upper cervical disc injury, and radiculopathy

Question 16

lower cervical spine does have nuclei that can herniate so…

Answer 16

Contains inflammatory and immune mediated chemicals irritates the roots
Higher incidence of lower, cervical disc injury and radiculopathy

Question 17

cervical disc age changes

Answer 17

compression and distortion by UV osteophytes and disc protrusions

disc space narrow
Osteophytes project into the IV foramina and posterior disc
Osteophytic bars into the spinal canal with potential compressive effects on

Nerve roots, vertebral, arteries, and spinal cord

Question 18

cervical sinuvertebral nerves have what type of course in the vertebral canal? And what level do they supply?

Answer 18

They have a upward course in the vertebral canal
supply the disk at their level of entry and the disk above

Question 19

branches of vertebral nerve supply

Answer 19

Lateral aspects of the cervical discs

Question 20

Cervical disk lesions are far less or more common

Answer 20

less Common then lumbar disc lesions

Question 21

no nucleus in which cervical discs

Answer 21

No nucleus in the upper four cervical discs

Question 22

incidence of bulge or herniation, which level is the greatest? and what age?

Answer 22

C4-C5

41-50

Question 23

cervical radiculopathy

Answer 23

Can irritate the dorsal root ganglion chemically

Question 24

Discogenic symptoms

Answer 24

Cervical spine, relatively pain-free, stiff or sore

Deep, burning toothache, pain around the scapular border, supraspinous fossa and scapula
Referral to the shoulder

Question 25

inferior facet is angled

Answer 25

Downwards and forwards

Question 26

superior facet faces

Answer 26

Upper and back

Question 27

innervation of the facet joints

Answer 27

Medial branch of the dorsal ramus of each spinal nerve

Question 28

Facet joint symptoms

Answer 28

Sharp localized
Unilateral
Spasm
Referral into the upper extremity
Neck pain is greater than upper extremity pain

Question 29

Facet joint signs

Answer 29

Limited extension
Limited rotation to the same side
Limited lateral flexion to the same side

Question 30

Degenerative joint disease facet inflammation

Answer 30

Painful, cervical facet joint distraction, induces an immediate and sustained increase of prostaglandin expression in the DRG implicating peripheral inflammation in the initiation and maintenance of the facet joint pain