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Spine > Cervical Spine > Flashcards

Cervical Spine Flashcards

1
Q

Cervical Spine Regions

A

Upper Cervical: Occiput, C1, C2
Midcervical: C2-C7
Cervicothoracic: C7-T3ish

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2
Q

Upper Cervical Articulations

A

Occiput-C1: facet (Convex) surfaces of occiput articulate with atlas (Concave) (C1)
C1-C2: Dens of C2 articulated with anterior arch of C1. Also articulation with facet joints of C1 and C2.

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3
Q

Occiput-C1 Motion

A

Shake head Yes
Flexion and Extension

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4
Q

C1-C2 Motion

A

Rotate head No
Rotation

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5
Q

What four ligaments keep the upper cervical stable?

A
  • Anterior Atlanto-Occipital membrane
  • Posterior Atlanto-Occipital membrane
  • Alar ligaments
  • Transverse ligament
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6
Q

What vertebrae does not have a spinous process?

A

C1

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7
Q

Mid Cervical Articulations

A
  • Vertebral bodies with intervertebral discs
  • Uncovertebral joints: uncinate process articulates with the inferior body of the vertebra above; help guide motion, not much movement occurs here
  • Facet joints: formed by the inferior articulate facet of the vertebrae above and the superior articulate facet of the vertebrae below; 45 degree angle; F/E/R/SB
  • Articular pillar: line of consecutive facet joints of the cervical spine (between the line of the mastoid and the occipital protuberance
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8
Q

Makeup - Intervertebral Disc

A
  • End Plate (Superior bony layer of the body and cartilaginous layer of the disc; blends with the annulus fibrosis)
  • Annulus fibrosis (Annular layers of collagen); Different orientations of collagen allow for multiple directions of force.
  • Nucleus pulposus (Gelatinous inner structure); Exerts force in all directions on the nucleus pulposus
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9
Q

Intervertebral Disc

A
  • Allos for compressive, tension and rotational motion
  • Largest avascular structure in the body
  • Nutrients come from loading and unloading of vertebral end plate
  • Motions allowed: F/E/R/SB
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10
Q

Mid Cervical Facet Joints

A
  • Oriented at 45 degrees between the frontal and horizontal plane
  • Freedom of movement in all 3 planes
  • During motion, facets slide on each other
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11
Q

What ligaments provide stability around the mid cervical spine?

A
  • Disc
  • Anterior longitudional ligament
  • Posterior longitudional ligament
  • Ligament nuchae
  • Interspinous and intertransverse ligaments
  • Ligamentum flavum
  • Facet joint capsule
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12
Q

What makes the cervicothoracic different?

A
  • As the spine transitions from cervical to thoracic the angle changes from 45 to 60 degrees. Thus, moving inferior moving the facest to transition into more frontal plane alignment.
  • Less movement due to attachments to the ribs
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13
Q

Posterior Upper Cervical Musculature - Why are they important?

A
  • Suboccipital muscles (Palpate along the based of the occiput)
  • People often develop cervicogenic headaches due to these muscles
  • Involved in Flexion, Extension, Rotation, Side bending
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14
Q

Posterior Cervical Musculature

A

Superficial: Upper trapezius and SCM
Deep: Erector Spinae muscles

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15
Q

Antero-Lateral Cervical Musculature

A
  • SCM
  • Scalenes
  • Longus colli
  • Longus capitus
  • Suprahyoid
  • Infrahyoid
  • Suboccipitals (Rectus Capitus anterior and lateralis)
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16
Q

Central Foramen- What passes through it?

A

Spinal Cord (Red arrow pointing to location)

17
Q

What passes through the intervertebral foramen?

A
  • Spinal nerve root of the body BELOW passes through
  • Ex: C4-C5 = C5 nerve root passing through
  • Ex: C7-T1 = C8 nerve root
18
Q

How many cervical nerves are there?

A

8

19
Q

What are the primary arteries of the cervical region and where do they ascend?

A

Vertebral A.
- Ascend through the transverse process of C1-C6
- Takes a 90 degree turn posteriorly after C1 and forms Basilar A

Common Carotid
- Adcends anterior to the transverse process of C-spine
- Bifurcates to internal and external carotid at C4

20
Q

What cervical artery is most likely to be damaged and why?

A
  • Vertebral A.
  • Most at risk as it runs through the TP of C1-C6 so if the vertebrae are damaged so is the artery.
21
Q

What are the 3 Primary Veins of the Cervical Region

A
  • External Jugular
  • Internal Jugular
  • Anterior Jugular
22
Q

Cervical Sagittal Plane of Motion:

A

Flexion/Extension

Occiput on C1: Condyles slide and glide on C1
C1-C2: little motion
C2-T3: R and L inferior articular facet slides on superior articular facet
- Flexion: Facets “open” on both R and L side
- Extension: Facets “close” on both R and L side

23
Q

Norms for Flexion and Extension cervical spine

A

Flexion: 45-60 degrees
Extension: 70-90 degrees

24
Q

Cervical Horizontal/Transverse Plane Motion

A

Rotation

Occiput-C1: little motion
C1-C2: 50% of motion occurs here. C1 rotates around the dens. Facets slide on each other
C2-T3: other 50% of motion occurs here
- Inferior articular facets slide on superior articular facets
- Rotate R: facets on the Right “close” and on left “open”
- Rotate L: facets on the left “close” and on the right “open”

25
Q

Cervical Frontal Plane Motion

A

Sidebending

Occiput-C1: little motion
C1-C2: “coupled motion” in OPPOSITE DIRECTION
- Mid Cervical SBR: C1-C2 rotates left
- Mid Cervical SBL: C1-C2 rotates right
C2-T3: majority of motion
- Inferior articular facets slides on superior articular facet
- SB R: facets on the right “close” and on left “open”
- SB L: factes on the left “close” and on the right “open”

26
Q

How does coupling motion occur in the cervical spine during sidebending?

A

C2-C7:
- Due to the 45 degree inclination of the facets mechanical coupling exists in the frontal and horizontal planes. AKA cervical rotation and side bending occur simultaneously
- “ipsilateral coupling”: side bending of mid cervical spine to R occurs with rotation to the R

C1-C2:
- Due to the passive tension on the alar ligaments, during side bending of cervical spine, a contralateral rotation occurs at C1-C2
- “Contralateral coupling”: side bending of mid cervical to the R occurs with rotation of upper cervical to the L

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