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Biomechanics Exam II > Cervical Spine > Flashcards

Cervical Spine Flashcards

1
Q

More muscles are associated with what region of the spine compared to the others?

A

Cervical

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2
Q

What is the most mobile region of the vertebral column?

A

Cervical spine

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3
Q

What is the overall job of the cervical spine?

A

Maintain head posture while allowing a lot of mobility

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4
Q

Which spinal curve is the least distinct?

A

Cervical

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5
Q

Which spinal curves are considered secondary/compensatory curves?

A

Cervical and lumbar

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6
Q

What is the most complex region of the axial skeleton?

A

Occiput-Atlas-Axis

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7
Q

Where in the spine do we see no intervertebral disc at the site of articulation?

A

Atlanto-occipital and atlanto-axial articulations

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8
Q

What are important upper cervical muscles?

A

Rectus capitus posterior major and minor
Rectus capitus lateralis and anterior
Superior and inferior obliques

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9
Q

What are important stabilizing ligaments of the upper cervical region?

A 
Transverse ligament of atlas
Alar
PLL
Anterior and posterior atlanto-occipital membrane
Ligamentum nuchae
Apical ligament
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10
Q

What is unique about the superior articular process of atlas?

A

1 called lateral masses
2 peanut-like shaped facets
3 concave and medial

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11
Q

How does the shape of the atlas lateral masses affect its rotational ability?

A

Little rotation possible

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12
Q

The shape of the articulation at occiput-atlas favors what axis?

A

θX

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13
Q

Even though flexion-extension occurs in a rotational manner at occiput-C1, how do we evaluate for restriction with palpation?

A

Occipital “glide”

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14
Q

What is the reference point for evaluation of flexion-extension at occiput-C1?

A

Occipital condyles

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15
Q

Instead of saying the occipital condyles translated P-A, what is the proper motion?

A

Rotates posterior and superior (PS flexion, + θX)

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16
Q

Instead of saying the occipital condyles translated A-P, what is the proper motion?

A

Rotates anterior and superior (AS extension, - θX)

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17
Q

What limits flexion at the occiput-C1 region?

A

Posterior neck muscular tension

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18
Q

What limits extension at the occiput-C1 region? **

A

Suboccipital muscle compression against the occiput

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19
Q

What is the average range of flexion-extension seen at occiput-C1?

A

14-35 degrees

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20
Q

What limits axial rotation at occiput-C1?

A

1 Anterior and posterior walls of C1 sockets
2Joint capsule tension
3 Alar ligament tension ***

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21
Q

What is the range of minimal axial rotation exhibited at the occiput-C1 region?

A

4-8 degrees to each side

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22
Q

In what region of the cervical spine has lateral flexion only been induced in cadavers but not seen physiologically in a live human in NORMAL motion?

A

Occiput-atlas

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23
Q

When induced in cadavers, what is the range of lateral flexion seen at occiput-C1?

A

4-11 degrees

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24
Q

What attachment limits Z axis rotation at occiput-atlas?

A

Alar ligament

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25
Q

What is unique about the articulation of facets at atlas-axis?

A

Biconvex articulation due to articular cartilage formation

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26
Q

What is the combined degree of X axis rotation seen at C1-C2?

A

20 degrees

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27
Q

How does increased curvature of the dens on C2 affect θX?

A

Increases amount of θX

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28
Q

What is the term for a path that identifies where one body will rotate relative to another body at a given instant in time?

A

IAR: Instant axis of rotation

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29
Q

What are the roles of C2?

A

1 transmit axial load of head to cervical spine

2 permit LOTS of Y axis rotation

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30
Q

What restrains the axial rotation found at C1-C2?

A

Alar ligaments

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31
Q

If a patient presents with almost ZERO motion in his/her neck, what area of the cervical spine is usually to blame?

A

C1-C2

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32
Q

If a patient presents with minimal motion in his/her neck, what area of the cervical spine is usually to blame?

A

Lower cervicals

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33
Q

What region of the cervical spine exhibits 43 degrees (plus or minus 5) of axial rotation making up over 50% of the rotation of the entire neck?

A

C1-C2

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34
Q

What is the order in which axial rotation occurs in the cervical spine?

A

1st 45% occurs at C1-C2, then occiput region, the lower cervicals

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35
Q

When visualizing on X-ray, what appearance of a C1 lateral mass indicates rotational anteriority on that side?

A

Bigger lateral mass

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36
Q

What fills the spaces between the cartilages where the surfaces of the articular cartilages diverge both anteriorly and posteriorly?

A

Intraarticular meniscoids

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37
Q

What is the function of intraarticular meniscoids?

A

Keep a film of synovial fluid applied to the surfaces of articular cartilages that are not in contact with one another

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38
Q

What motion displaces the intraarticular meniscoids?

A

Y axis rotation

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39
Q

What other motion minimally is coupled with θY at C1-C2?

A

Y translation

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40
Q

When C1-C2 goes from neutral to a rotated state, in which direction do we seen Y translation?

A
  • Y translation
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41
Q

When C1-C2 goes from a rotated to neutral state, in which direction do we seen Y translation?

A

+ Y translation

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42
Q

What is lateral bending limited to about 5 degrees at the C1-C2 articulation?

A

Bony anatomy and alar ligaments

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43
Q

Why is only little Z axis translation seen at C1-C2?

A

Tight articulation of C1 ring around dens due to ligaments

44
Q

According to Panjabi and White, how much X axis translation is seen at C1-C2?

A

None (there is only “apparent” translation)

45
Q

What motion at C1-C2 is considered controversial?

A

X axis translation

46
Q

During lateral flexion at C1-C2, to which direction does the spinous process of C2 rotate?

A

Toward the convexity of the lateral bend AKA OPPOSITE side

47
Q

When laterally bending the cervical spine, to which direction does the spinous process rotate?

A

Contralateral side

48
Q

What two motions are coupled in the cervical spine?

A

1 Axial rotation about a longitudinal axis

2 Lateral rotation about a sagittal axis

49
Q

+ θX in the cervical spine is coupled with what other motion?

A

+ Z translation

50
Q
  • θX in the cervical spine is coupled with what other motion?
A
  • Z translation
51
Q

+ θZ in the cervical spine is coupled with what other motion?

A
  • θY
52
Q
  • θZ in the cervical spine is coupled with what other motion?
A

+ θY

53
Q

In what region of the cervical spine do we see less rotation with lateral bending?

A

Lower cervicals

54
Q

What is the primary motion at occiput-C1? ***

A

Flexion-extension

55
Q

What is the primary motion at C1-C2? ***

A

Axial rotation

56
Q

What is the primary motion of the lower cervicals? ***

A

Flexion-extension

57
Q

Where in the cervical spine do we see the steepest arch of a vertebra when moving from flexion to extension?

A

C6 and C7

58
Q

Where in the cervical spine are the arches flat when moving from flexion to extension?

A

C2

59
Q

What causes the acuity of the arcs to decrease when moving from flexion to extension in the cervical spine?

A

Degeneration

60
Q

In what part of the cervical spine does more translation occur with flexion/extension?

A

Upper cervical spine

61
Q

What motion is limited by the anterior longitudinal ligament?

A

Negative θX (extension)

62
Q

What motion is limited by the posterior longitudinal ligament?

A

Positive θX (flexion)

63
Q

What motion is limited by the ligamentum flavum?

A

Slows the last few degrees of flexion (positive θX)

64
Q

What motion is limited by the interspinous ligament?

A

Positive θX (flexion)

65
Q

What motion is limited by the ligamentum nuchae?

A

Positive θX (flexion)

66
Q

What motion is limited by the inter transverse ligament?

A

Contralateral lateral flexion (θZ)

67
Q

In which direction does the transverse diameter of the rectangular vertebral body of the cervical spine increase?

A

Superior to inferior

68
Q

What is the shape of the superior and inferior surfaces of the cervical vertebral bodies?

A

Sellar or saddle-shaped

69
Q

What motion is reduced and what motion is promoted in the cervical spine?

A

Reduced - X axis translation

Promoted - X axis rotation

70
Q

Uncinate processes serve what purposes when it comes to motion?

A

1 limit pure lateral flexion

2 guides to couple lateral flexion with axial rotation

71
Q

Degeneration of uncovertebral joints results in what?

A

Bony outgrowth with potential for damage

72
Q

Bony outgrowth due to uncovertebral joint degeneration could impinge what adjacent anatomy?

A

1 vertebral artery

2 cervical spinal nerves

73
Q

Which annulus of the intervertebral disc in the cervical region is thick and strong?

A

Anterior

74
Q

Which annulus of the intervertebral disc is minimal if even present due to uncinate processes?

A

Lateral

75
Q

Which annulus of the cervical intervertebral disc is only a concentrated central bunch of fibers?

A

Posterior

76
Q

What is the average degree of facet orientation in the cervical spine? ***

A

45 degrees

77
Q

What is the superior facet orientation in the cervical spine?

A

Posterior, superior, medial (BUM)

78
Q

What is the inferior facet orientation in the cervical spine?

A

Anterior, inferior, lateral (FOLD)

79
Q

What is the “trick” for remembering the inferior facet orientations of the spine?

A

AIL (cervicals)
AIM (thoracics)
AIL (lumbars)

80
Q

What effect does age have on the zygapophyseal joint?

A

1 thinning of articular cartilage
2 thickening of subarticular bone
3 osteophyte formation

81
Q

What is proprioception?

A

Sensory perception of movement or position within the body

82
Q

What 3 things in the cervical spine have proprioceptive function?

A

1 IVD
2 Facet joints
3 Cervical musculature

83
Q

What is the role of facet mechanoreceptors?

A

Responsive to extreme joint motions

84
Q

What do muscle spindles detect?

A

Changes in the length of a muscle

85
Q

Where are muscle spindles located?

A

Belly of a muscle

86
Q

Which specific spinal muscles contain a high density of muscle spindles?

A

Suboccipital muscles

87
Q

What is the primary reason for the high content of muscle spindles in the neck muscles?

A

Proper head-eye coordination

88
Q

What is the gate theory?

A

The idea that proprioceptive input flowing into the dorsal hour serves to disallow or modulate nociceptive input into the CNS therefore impacting pain levels

89
Q

What occurs when there is a change in the stimulus-response profile of dorsal horn neurons so that they respond to mechanoreceptive afferents as if they were nociceptors?

A

Sensitization (hypersensitivity) due to CNS facilitation

90
Q

How can chiropractic adjustments help with hypersensitivity to pain?

A

Decrease the hyperexcitable central state

91
Q

What muscular changes are seen on an MRI of the suboccipital muscles of those with chronic neck pain compared to healthy individuals?

A

Atrophy

Fatty infiltration/degeneration

92
Q

When does the cervical curve begin to develop?

A

Prior to birth

93
Q

What is the purpose of the cervical curve being a lordosis?

A

Absorbs spinal loads

94
Q

What radius of a cervical lordotic curve is considered normal?

A

17 cm

95
Q

What term is used when a normal cervical curve has diminished?

A

Hypolordotic (military neck)

96
Q

Which cervical vertebra is considered the keystone vertebra in forming the cervical curve?

A

C5

97
Q

Why do some suggest breaking the cervical spine into two curvatures?

A

Occiput to axis is concave anteriorly (kyphotic)

C2 to C7 is the classical lordosis

98
Q

What should the normal angle of the cervical lordosis be when measured between lines drawn through C1 and C7? **

A

30-45 degrees

99
Q

What type of deviation from the normal cervical curve is most common?

A

Hypolordosis

100
Q

What types of cervical curve changes are associated with tension headaches?

A

Straightened or reversed cervical curves

101
Q

How did Brieg have success in improving neurological disorders by focusing on the cervical spine?

A

Inducing a lordosis

102
Q

What is the primary load on the cervical spine?

A

Compression

103
Q

Compressive loads in the cervical spine increase during what motion?

A

Flexion-extension

104
Q

What allows the cervical spine to bear large compressive loads? **

A

Appropriate lordotic curve (compressive follower load path)

105
Q

The increased stability of the cervical spine that comes from the added compression is due to what?

A

Muscular action (follower load, NOT vertical load)

Biomechanics Exam II (7 decks)

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