Cervical Spine Flashcards
What is considered upper cervical region and lower cervical region?
Upper = occiput, atlas (C1), axis (C2)
Lower = C3-C7
What are your atypical cervical vertebrae?
Atlas, axis, and C7
What are the defining functions and features of the atlas?
Function = cradle occiput and transmit forces from occiput to lower C-spine.
- Has no vertebral body or spinous process!
- Shaped like a ring with 2 lateral masses separated by anterior and posterior arch.
What are the defining functions and features of the axis?
Function = transmit combined load of the head/atlas to c-spine and provide axial rotation of the head/atlas.
- Anterior portion of the body extends inferiorly.
- Has vertical projection called the Dens
- Has a large, elongated, bifid spinous process.
What are the defining features of C7?
- It is the largest of the cervical vertebrae
- Has many characteristic of a thoracic vertebrae
- Has a large spinous process
What are the features of a typical cervical vertebrae (C3-C6)?
- small body
- uncinate processes on posterolateral margins
- Transverse foramen on the transverse process
- Bifid spinous process
- Intervertebral disc is crescent shape
What is the articulation of the atlanto-occipital (AO) joints?
Convex occipital condyle articulating with concave superior facet of atlas.
“yes” joint
What is the articulation of the atlanto-axial (AA) joint?
Median AA joint = dens and anterior arch of atlas/transverse ligament
Lateral AA joints = inferior facets of the atlas with superior facets of the axis.
Biconvex with meniscoids
What is the primary role of the transverse ligament?
Prevent anterior displacement of C1 on C2.
What is the function of the alar ligament?
Becomes taut in neck flexion and with axial rotation.
Limit lateral flexion and prevent distraction of C1 on C2.
What conditions can compromise the integrity of the transverse ligament leading to instability?
RA and down syndrome
What plane do cervical facet joints lie off of?
45 degrees off the frontal and transverse plane.
What are the osteokinematics of the cervical spine?
Flexion
Extension
Lateral flexion
Rotation
What does each cervical level perform during protraction?
Upper cervical extension and lower cervical flexion
What does each cervical level perform during retraction?
Upper cervical flexion and lower cervical extension.
What is the primary motion that occurs at the AO joint?
Flexion and extension
The AO joint moves in both the sagittal and frontal planes. What are the arthrokinematics for each plane?
Sagittal and Frontal plane = convex occipital condyles on concave superior articular facet of atlas.
*OPPOSITE roll and glide.
What is the primary motion of the AA joint?
Rotation
What are the arthrokinematics of the AA joint in the transverse plane?
- Anterior arch and transverse ligament/dens
- Inferior facet of the atlas/superior facet of the axis.
- Ipsilateral posterior glide
- Contralateral anterior glide
What are the arthrokinematics of the AA joint in the sagittal plane?
- Anterior arch and transverse ligament/dens
- Inferior facet of the atlas/superior facet of the axis
*tilt of atlas on axis
What ligament limits rotation at the AA joint?
Alar ligament
What ligament limits tilting of axis at the AA joint with flexion?
Transverse ligament
What motions are coupled in the lower cervical spine?
Lateral flexion and rotation are coupled in the SAME direction.
What are the arthrokinematics of C3-C7 in the sagittal plane?
Flexion = inferior facet glides anterior and superior
Extension = inferior facet glides posterior and inferior
What are the arthrokinematics of C3-C7 in the transverse plane?
Same side as rotation = inferior facet glides posterior and slightly inferior
Opposite side as rotation = inferior facet glides anterior and slightly superior
What are the arthrokinematics of C3-C7 in the frontal plane?
Same side as lateral flexion = inferior facet glides inferior and slightly posterior
Opposite side of lateral flexion = inferior facet glides superior and slightly anterior
What are the functions of the cervical spine?
- Stability and protection
- stability is important at AO and AA joints - Has most flexibility
- Designed to allow for more free space to prevent impingement
- Mobility