Cervical Region Flashcards by Jacob Barnes

What are the regions of the spine and how much vertebrae does each have?

Cervical (7), thoracic (12), lumbar (5), sacrum (5), coccyx (4)

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What is kyphosis?

Primary, posterior convexity (thoracic and sacral)

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What is lordosis?

Secondary, anterior convexity (cervical and lumbar)

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What is a vertebral end plate?

Thin layers of hyaline cartilage that covers the vertebral body

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Describe the parts of the intervertebral discs

Resilient/deformable (allows them to serve as shock absorbers), made of two parts: nucleus pulposis and annular fibrosis, nerve and blood supply are only in outer annulus

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What is annulus fibrosis?

Outercircumference of ring of disc

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What is nucleus pulposis?

Avascular/aneural, disc can be compressed/stretched

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Describe the anterior longitudinal ligament of the spine

Rests in C1/occiput to sacrum, it resists hyper extension of spine

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Describe the posterior longitudinal ligament of the spine

It rests in C2 to sacrum, it resists hyper flexion and prevents posterior disc herniation

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Describe the ligamentum flavum of the spine

Rests lamina to lamina, it assists return from flexion

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Describe the supraspinatus ligament of the spine

Rests in the tips of the spinous process from C7 to sacrum

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Describe the interspinous ligament of the spine

It rests between the spinous process from C7 to the sacrum

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Describe the intertransverse ligament of the spine

It rests between the transverse process from C7 to the sacrum

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What muscles are located in the extrinsic superficial area of the back?

Trapezius, latissimus dorsi, levator scapulae, and rhomboids

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What innervate all extrinsic superficial muscles except for the trapezius? And what do the muscles control?

Anterior rami of cervical nerves; they control the upper limbs

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What muscles are located in the extrinsic intermediate area of the back?

Serratus posterior (it’s superior and deep to rhomboids and inferior and deep to the lats)

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What innervate the serratus posterior?

Intercostal nerves

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What muscles are in the superficial intrinsic area of the back?

Cervicis and capitis

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What muscles are in the intermediate intrinsic area of the back?

Erector spinae (iliocostalis, longissimus, spinalis)

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What muscles are in the deep intrinsic area of the back?

Transversospinalis (semispinalis, multifidus, rotatores)

What is a spinal cord segment and how is it named?

It is a portion of the cord that gives rise to rootless and roots that form one pair of bilateral spinal nerves; it is named as the same nerves that come from it

What is a spinal cord segment and how is it named?

It is a portion of the cord that gives rise to rootless and roots that form one pair of bilateral spinal nerves; it is named as the same nerves that come from it

How do we have 7 cervical vertebrae but 8 cervical spinal nerves?

C1-7 all exit superiorly of the vertebrae, but C8 exits inferior of C7 vertebra

What outside structures are innervated by the recurrent meningeal nerves?

Anterolateral vertebral bodies/discs, periosteum, and anterior longitudinal ligament

What inside structures are innervated by the recurrent meningeal nerves?

Periosteum, ligamentum flavum, posterior anulus, posterior longitudinal ligament, dura mater, blood vessels

Which structures of the vertebral column are innervated by posterior rami of spinal nerves?

Skin, ligaments, joints and deep back muscles

Which structures of the vertebral column are innervated by anterior rami of spinal nerves?

Muscles and skin of the Anterolateral region and the limbs

What defines cervical vertebrae from the other vertebrae?

They have small vertebral bodies, thin discs, C1-6 has transverse foramen (holes), anterior and posterior tubercles on transverse process

What are “typical” cervical vertebrae?

C3-7

What cervical vertebrae is considered “atypical”

C1-2

Why is C1 atypical?

It holds the cranial up and has no vertebral body/spinous process, it’s the widest cervical vertebra, lateral masses connect to occipital condyle, named the “atlas”

Why is C2 atypical?

Strongest cervical vertebra, large superior facets connect to C1, large buried spinous process, Dens (odontoid process) pivots for C1 and head to rotate, it is named the “axis”

Describe craniovervical joint C0-1

Named the atlanto-occipital (A-O) joint, the bones involved are atlas and occipital condyles, has a synovial joint that is condyloid in shape and has tiny loose joint capsules

What are the motions of the atlanto-occipital joint?

Capital flexion/extension of head (nodding), some sideways tilting of head

Describe craniocervical joint C1-2

Named the atlanto-axial joint, involves the atlas and axis bones, during rotation the dens of C2 is the pivot point/axis held in a socket formed by the anterior arch of atlas and transverse ligament of atlas

What are the motions of the atlanto-axial joint?

Responsible for about half of rotation range of motion in the neck

What would happen if the transverse ligament were to break?

The dens would move backward into spinal cord, or atlas would move forward which would pull the arch against the spinal cord (could be deadly)

What would happen if the alar ligament breaks?

Full rotation would appear (high cervical instability)

What structures of the spine guide it’s movement in each region?

Intervertebral discs, facet joints, capsules of facet joints, back muscles, ligaments, surrounding tissue bulk

Why does the cervical spine have more movement than the rest of the spine?

Thicker discs compared to the vertebral bodies, loose facet capsules, large facet joints, less surrounding tissue bulk

What is a carotid sinus?

Dilation of internal carotid artery, bororeceptor (measures/reacts to changes in pressure of artery), innervated by glossopharyngeal nerve (CN IX) and some from vagus nerve (CN X)

What is the carotid body?

Chemoreceptor (monitors blood/oxygen levels), stimulated by low oxygen levels and initiates faster/deeper breathing, faster HR, and increased blood pressure

Map out arterial blood flow from the heart to the right common carotid artery

Ascending aorta, arch of aorta, brachiocephalic, right common carotid (Left side) Ascending aorta, arch of aorta, left common carotid

Map out arterial blood flow from the heart to the arteries that follow the subclavian

Ascending aorta, arch of aorta, brachiocephalic, right subclavian> vertebral, internalthoracic, thyrocervical, costcocervical, dorsal scapular arteries (For left side) Ascending aorta, arch of aorta, left subclavian> vertebral, internalthoracic, thyrocervical, costcocervical, dorsal scapular arteries

Map out from heart to circle of Willis

Ascending aorta, arch of aorta, brachiocephalic cephalic, right subclavian, vertebral, basilar, circle of Willis (Left side) Ascending aorta, arch of aorta, left subclavian, vertebral, basilar, circle of Willis

Map out venous drainage from external jugular vein

External jugular, brachiocephalic, superior vena cava

Map out venous drainage from subclavian drain

Subclavian vein, right venous angle (lymph drains) (Subclavian vein can also follow into brachiocephalic vein like the external jugular)

What happens to each vertebral artery at the atlas during head rotation

Could tear/close off (occlude) with head rotation