Cervical Spine Flashcards
Which cervical vertebrae are atypical
Atlas
Axis
C7
How is the atlas different from a typical cervical vertebra
No vertebral body or spinous process
Shaped like a ring- 2 lateral masses separated by anterior and posterior arch
How does the axis differ from a typical vertebra
Anterior portion extends inferiorly
Dens (vertebral projection from superior surface)
Spinous process is large/elongated and bifid
How does c7 differ from a typical vertebrae?
Largest cervical vertebrae
Large spinous process
Describe typical cervical vertebral body
Unicinate processes arise from posterolateral margins which give the upper surface a concave shape
Transverse processes of a typical cervical vertebra contain __________
Transverse foramen
Describe the Atlanta-occipital joint
“Yes” jt
Convex occipital condoles articulate with concave superior faces of atlas
Synovial condyloid jt
The Atlanto-axial jt has 3 articulations. What are they?
Median AA jt (dens and anterior arcs of axis/transverse ligament)
2 lateral AA jts ( inferior facet of axis with superior facet of axis)
What type of jt is the median AA jt
Synovial pivot jt
Lateral AA jts are what type of jt? Do they follow the convex-concave rule?
Synovial plane jt
No! They are biconvex with meniscoids
That is the role of the transverse ligament in relation to C1 and C2?
Prevent anterior displacement of C1 on C2
The alar ligaments are taunt in ______ with _________
Neck flexion
Axial rotation
Function of the alar ligaments:
Limit lateral flexion and prevent distraction of C1 on C2
What conditions can compromise the integrity of the transverse ligament resulting in instability of c1/c2
Rheumatoid arthritis & Down syndrome
What is the orientation of cervical facet jts
Approximately 45 degrees off the frontal plane and transverse planes
Osteokinematics of cervical vertebrae are
Flexion
Extension
Lateral Flexion
rotation
What are the Osteokinematics of protraction?
Upper cervical extension and lower cervical flexion
What are the Osteokinematics of retraction in the cervical spine?
Upper cervical flexion
Lower cervical extension
How does prolonged protraction result in a forward head posture?
It causes lengthening of the deep neck flexors and scapular retractors and tightening of the pecs and upper trap/levator scap
What is the primary motion that occurs at the atlanto-occipital jt?
Flexion/ext
Also does some lateral flexion
“Yes” jt
Arthrokinematics of AO movement in the sagittal plane
Convex occipital condole on concave articular facet of atlas (opposite roll and glide)
(Flex/ext)
Arthrokinematics of AO movement in the frontal plane
Convex occipital condoles on concave superior articular facet of atlas (opposite roll and glide)
(Lat flex)
Arthrokinematics of AO movement in the transverse plane
Negligible-limited by deep jt congruency
Rotation
During cervical flexion, in the AO jt the occipital condyles roll ____________ and slide ____________. During extension this process is _______________.
Anterior
Posterior
Reversed
What is the primary motion that occurs are the AA jt?
“No” jt, rotation
Arthrokinematics of AA jt movement in the transverse plane
Medial AA jt- rotation of anterior arc and transverse ligament around the dens
Lateral AA jt-
-ipsilateral: inferior facet of the atlas glides posteriorly on the superior facet of the axis
- contralateral: inferior facet of the atlas glides anteriorly on the superior facet of the axis
Arthrokinematics of the AA jt movement in the sagittal plane
Middle AA jt- anterior arch and transverse ligament allow for a “tilt” of the atlas on the axis (dens)
Lateral AA jt- ligaments and spinal cord block gliding of the inferior facet of the atlas on the superior facet of the axis
Arthrokinematics of the AA jt in the frontal plane
Negligible
What ligament limits rotation at the AA jt?
Alar ligament
What ligament limits tilting of axis at the AA jt with flexion?
Transverse ligament
In the lower cervical spine _______________ and __________ occur simultaneously in the __________ direction.
Lateral flexion and rotation
Same
With spinal coupling, performing movements in isolation would ……
Cause the facet jts to come in contact with one another blocking motion.
Arthrokinematics of c3-c7 facet jts in the sagittal plane
Flexion: inferior facet glides anterior and superior
Extension: inferior facet glides posterior and inferior
Same thing occurs bilateral
Arthrokinematics of the c3-c7 (facet jt) movement in the transverse plane
Ipsilsterally: inferior facet glides posterior and slightly inferior
Contralateral: inferior facet glides anterior and slightly superior
Arthrokinematics of c3-c7 (facet jts) in the frontal plane
Ipsilateral: inferior facet glides inferior and slightly posterior
Contralateral: inferior facet glides superior and slightly anterior
Describe the Arthrokinematics of R rotation at C4-C5
Right (ipsilateral) c4 facet SLIDE POSTERIOR and SLIGHTLY INFERIOR on C5 facet
Left (contralateral) C4 facet SLIDES ANTERIOR and SLIGHTLY SUPERIOR on C5 facet
Function of cervical spine
Stability and protection
Mobility
The cervical spine provides protection for the _____________ by way of the __________________ and protects the _______________ by way of the __________________.
Spinal cord by way of the ledge vertebral canal (especially at c1)
Vertebral artery by way of the transverse foramen
Stability in the cervical spine is especially important in what jts?
AO & AA
The atlas is designed to allow for ________ to prevent __________
Free space
Impingement
When cervical movement is added to eye movement the visual field can reach:
330 degrees
Musculature of the anterior-lateral craniocervical region
SCM
Scalenes
Longus Collin
Longus capitis
Muscles of the posterior craniocervical region
Splenius cervicis
Splenius capitis
Suboccipital muscles
Muscles of the thorax that have action on the neck
Erector Spinae Semispinalis capitis and cervicis Rotatores Multifidi Interspinalis Inertransversarius
Causes of Muscular imbalance in the cervical spine
- Excessive hyper extension straining the SCM, Longus colli and anterior or scalenes causing chronic spasm/guarding
- Inhibition, pain, weakness, or fatigability of deep flexors resulting in dominant SCM and anterior scalene
- Ergonomics
Optimal posture allows for ___________________ of flexor and extensor muscles. This contributes to __________________ of the cervical spine.
Co-contraction
Vertical stability
