Cervical Spine

Question 1

Norm values of cervical flex, ext, lat flex, and rot

Answer 1

Flex: 60
Ext: 75
Lat flex: 45
Rot: 80

Question 2

General characteristics of cervical vertebrae

Answer 2

-small
-spinal process is short and bifid
-foramen in each TP (foramen transversarium)

Question 3

What does the vertebral a supply? Where does it enter?

Answer 3

-upper SC, cerebellum, posterior part of brain
-skips C7 and enters C6

Question 4

C1 characteristics

Answer 4

-atlas
-shaped like a ring
-no vertebral body or spinous process
-2 large lateral masses that create large TP for muscle attachments

Question 5

C2 characteristics and function

Answer 5

-axis
-characteristics: anterior portion of body extends inferiorly, vertical projection (dens)
-functions: provide motion into axial rot, transmit combined load of head and atlas

Question 6

What ligaments limit amount of head rot? Location?

Answer 6

alar ligaments; sides of dens to lateral margins of foramen magnum

Question 7

What ligament prevents posterior and anterior displacement?

Answer 7

transverse ligament of atlas

Question 8

Atlanto-occipital joint characteristics

Answer 8

-superior facets of atlas articulates w/ convex occipital condyles
-true synovial joint
-allows head nod up and down

Question 9

Atlanto-axial joints characteristics

Answer 9

-2 lateral and 1 median
-where 50% of rot happens

Question 10

What is the tectorial membrane?

Answer 10

continuation of posterior longitudinal lig, covers dens and cruciate lig, inserts at anterior rim of foramen magnum

Question 11

What is a cruciate ligament?

Answer 11

transverse ligament + superior and inferior longitudinal bands
-superior: transverse to occipital bone
-inferior: transverse lig to body of C2

Question 12

Base of dens vs on body fracture

Answer 12

-base of dens: transverse lig can go between dens and body and cut off blood supply (cause necrosis)
-body: lig won’t reach where fracture is; better healing process

Question 13

What happens with a rupture to transverse ligament?

Answer 13

-dens is free -> atlanto-axial subluxation

Question 14

What is AAI? Who is it seen in? Interventions?

Answer 14

-atlantoaxial instability
-Down Syndrome
-symptomatic (posterior fusion C1 to C2); asymptomatic (precautions to avoid neck injury, regular appts)

Question 15

How do you rupture alar ligaments?

Answer 15

flexion and rotation of head

Question 16

Characteristics of C3 to C6 (body, surfaces, joints)

Answer 16

-small rectangular bodies
-superior and inferior body surfaces not as flat as vertebrae
-superior surfaces have uncinate processes articulate with uncovertebral joints or joints of Luschka
-uncovertebral joints add stability

Question 17

What is Wolff’s law?

Answer 17

bone will grow/strengthen under stress

Question 18

What causes cervical osteophytes?

Answer 18

-increased compression force on uncovertebral joint

Question 19

Characteristics C3 to C6 (pedicles, TP, vertebral canal)

Answer 19

pedicles: short and curved posterior-lateral, very thin laminae extends posterior-medial from each pedicle

TP: terminates in anterior and posterior tubercle

Vertebral canal: large triangle, accommodates SC w/ cervical and brachial plexus formation

Question 20

What angle are articular processes of typical C3 to C6?

Answer 20

40-60 degrees from horizontal

Question 21

C7 characteristics

Answer 21

-vertebral prominens
-only atypical segment
-large TP
-large single pointed SP
-sometimes presents hypertrophic anterior tubercle that accommodates an extra rib (can impinge brachial plexus)

Question 22

Main functions, innervation, vascular supply of suboccipital muscles

Answer 22

-extend and rotate the head at the atlantoaxial joint
-posterior ramus of 1st cervical n
-branches of vertebral and occipital arteries

Question 23

What are the borders of the suboccipital triangle

Answer 23

-medial border: rectus capitis posterior major
-lateral border: obliquus capitis superior
-inferior border: obliquus capitis inferior

Question 24

Contents of suboccipital triangle

Answer 24

posterior ramus of C1 (suboccipital n), vertebral a and associated veins

Question 25

Rectus capitis posterior major OIIA

Answer 25

origin: spinous process of C2

Insertion: lateral portion of occipital below inferior nuchal line

Action: extension of head and rot

Question 26

Rectus capitis posterior minor OIIA

Answer 26

Origin: posterior tubercle of C1

Insertion: medial portion of occipital below inferior nuchal line and dura mater

Action: ext of head

Question 27

Obliquus capitis superior OIIA

Answer 27

Origin: TP of C1

Insertion: occipital between superior and inferior line

Action: extends

Question 28

Obliquus capitis inferior OIIA

Answer 28

Origin: SP of C2

Insertion: TP of C1

Action: rotation of head