Cervical Anatomy 2

Question 1

Uncinate processes form this joint

Answer 1

joint of Luschka (aka uncovertebral joints)

Question 2

Uncinate processes: location

Answer 2

• sides of vertebral bodies
• articulates with body above
• just anterior to spinal nerve

Question 3

purpose of uncinate processes

Answer 3

limits lateral translation

Question 4

Why have uncinate processes here and not L-spine?

Answer 4

• c-spine is mobile and needs additional stability
• facets in lumbar help block lateral translation, tissue to help block excess motion
• neck is more open and it’s a big head on a little stem
• PROTECT THE VERTEBRAL ARTERY FROM LATERAL TRANSLATION

Question 5

What movements do the uncovertebral joints limit?

Answer 5

• lateral translation

- lateral flexion

Question 6

uncovertebral joints and DJD/DDD

Answer 6

• located anterior to spinal nerves
• DJD may cause osteophytes that are more likely to compress a nerve
• lose disc height » approximation of joints » joint degeneration

Question 7

In the C-spine, the PLL continues cranially as _________

Answer 7

tectorial membrane

Question 8

What are the functions of the tectorial membrane?

Answer 8

• holds head on
• helps hold dens in place
• limits extremes of flexion/extension
• gen’l multi-directional stability to craniocervical junction
• reinforces posterior sides of IV discs

Question 9

What ligaments attach to the dens?

Answer 9

• alar ligaments

- transverse ligament

Question 10

alar ligaments

Answer 10

• attach dens to occiput
• restrict rotation and lateral flexion
• restricts extremes of all other potential motions at AO joint

Question 11

transverse ligament

Answer 11

not attached to dens to allow for rotation

Question 12

transverse ligament tested by

Answer 12

Sharp-Purser test (translates C1 on C2)

Question 13

Why is ligamentous instability around the dens important to recognize?

Answer 13

• instability can cause brainstem compression » DEATH

Question 14

percentage of cervical sagittal plane motion that occurs between occiput, C1, C2

Answer 14

25%

Question 15

What are the predominant motions that occur at the OA joint and how much occurs here?

Answer 15

• flexion (5˚)
• extension (10˚)
• rotation (negligible)
• lateral flexion (5˚)

Question 16

arthrokinematics of OA joint

Answer 16

• convex on concave
• rolls posteriorly in extension while sliding forward
• rolls anteriorly in flexion while sliding back

Question 17

OA: flex/ext importance

Answer 17

• easy » metabolically efficient

- helps keep eyes where we need them

Question 18

Predominant motions that occur at AA (and how much occurs here)

Answer 18

• flexion (5˚)
• extension (10˚)
• rotation (35-40˚)
• lateral flexion (negligible)

Question 19

percentage of cervical rotation that occurs at C1-C2

Answer 19

50%

Question 20

arthrokinematics of AA joint

Answer 20

• tilting

- results in gapping or closing of the joint

Question 21

demonstrating motion at AA joint

Answer 21

• max flexion + rotation

- can’t get motion from OA jt because of Fryette’s law

Question 22

facet orientation in C-spine

Answer 22

inclined obliquely (superior/anterior) between frontal and horizontal planes

Question 23

Closed packed position in c-spine

Answer 23

full extension

Question 24

facet orientation of c-spine allows for this type of motion

Answer 24

• all motions

- combined lateral flexion/rotation most common

Question 25

rotation in c-spine is accompanied by

Answer 25

ipsilateral flexion (Fryette 2)