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Spinal Tx 600 > Cervical Spine > Flashcards

Cervical Spine Flashcards

1
Q

In the cervical spine, _______ has been sacrificed for ______.

A

Stability has been sacrificed for mobility.

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2
Q

The cervical spine is divided into what two areas?

A

Cervicoencephalic (C0-2)
and
Cervicobrachial (C3-7)

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3
Q

Injuries to cervicocephalic

A

Often cause headache, fatigue, vertigo, poor concentration, increased SNS and irritability.

May involve brainstem, brain, spinal cord.

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4
Q

Atlas

A

C1

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5
Q

Axis

A

C2

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6
Q

Atlanto-occipital joints

A

C0-C1
Ellipsoid.

Principle motion: flexion/extension (15-20°)

Some side flexion (10°) hardly any rotation.

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7
Q

Vertebral body of C1

A

Doesn’t exist. Develops into odontoid process of C2.

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8
Q

Anterior Atlantic-occipital membrane

A

The fibrous layer that extends from the anterior arch of the atlas to the anterior margin of the foramen magnum of the occipital bone.

Strengthened by anterior longitudinal ligament.

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9
Q

Posterior Atlanto-occipital membrane

A

Replaces ligamentum flavum between atlas and occiput

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10
Q

Tectorial membrane

A

Broad band covering dens and its ligament

Within vertebral canal

Continuation of posterior longitudinal ligament

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11
Q

What ligament is the cervical continuation of the PLL?

A

Tectorial membrane

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12
Q

Which ligament is the cervical continuation of the ligamentum flavum?

A

Posterior Atlanto-occipital membrane.

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13
Q

Alar ligaments

A

Two strong cords found on each side of the upper dens

Pass upward and lateral to attach to medial sides of occipital condyles

Major role in stabilizing C1 and C2, especially in rotation.

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14
Q

What movements are limited by alar ligaments?

A

Flexion and rotation

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15
Q

The most mobile articulation in the spine.

A

C1-C2

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16
Q

Atlanto-axial movements

A

Flex/extend 10°
Side flexion 5°
Rotation 50° (primary movement)

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17
Q

Atlanto-axial joints

A

2 facet joints (plane joints)

Centre pivot joint around odontoid process

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18
Q

Main supporting ligament of C1-C2.

A

Transverse ligament of the atlas

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19
Q

Transverse ligament of the atlas

A

Holds dens of axis against anterior arch of atlas.

Weakens in rheumatoid arthritis.

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20
Q

Cruciform ligament

A

Transverse ligament of atlas
Superior crus
Inferior crus

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21
Q

Cervical spine: resting position

A

Midway between flexion and extension

22
Q

Cervical spine: close packed position

A

Full extension

23
Q

Cervical spine: capsular pattern

A

Side flexion = rotation, then extension

24
Q

Which major blood vessel travels through the TVPs of the Cspine?

A

Vertebral artery

Enters at C6 (sometimes as high as C4)

25
Q

How many pairs of joints in the cervical spine?

A

Seven

26
Q

How many cervical intervertebral discs?

A

Six. No disc between C0/C1 or C1/C2

27
Q

How many cervical spinal nerves?

A

Eight.

Even though only 7 cervical segments (the nerves exit above segments).

28
Q

MFR on acute torticollis?

A

No! (Spasm – don’t passively stretch – Swedish, contract release stretch).

29
Q

Vertebral and internal carotid arteries are stressed mostly by what cervical movements?

A

Rotation
Extension
Traction

Vertebral blood flow can be diminished by as little as 20° of rotation and extension.

30
Q

The greatest stresses on the vertebral artery are in what four places?

A

Where it enters TVP at C6

Within bony canals of vertebral TVP

Between C1 and C2

Between C1 and entry of arteries into the skull.

31
Q

Vertebral artery Sx

A 
Vertigo
Nausea
Tinnitus
"Drop attacks"
Visual disturbances
32
Q

Pain in cervicobrachial referred:

A

Into upper extremity

33
Q

How many apology seal joints in C spine?

A

14.

34
Q

Superior facets in cervical spine face:

A

Backwards
Up
Medial

35
Q

Cervical facet angle facilitates what moves?

A

Flexion
Extension

(Prevents simple rotation or side flexion)

36
Q

Cervical coupled movements

A

Rotation and side flexing.

At C0-C2 and between C7-T1 rotation and flexion contralateral

Rest of c-spine ipsilateral

37
Q

Cervical: most flexion-extension

A

C5-C6

(Followed closely by C4-5 and C6-7)

–> most common location of degeneration.

38
Q

Recurrent meningeal nerve

A

AKA sinuvertebral nerve

Innervates anterior dura, posterior annulus fibrosis, and PLL

39
Q

Joints of Luschka

A

AKA uncinate joints

Costal or uncovertebral processes (inferior) to échancrure/notch (superior)

Limit side flexion

40
Q

IVD make up how much of C-spine height?

A

25%

41
Q

Cervical lordosis results from the shape of:

A

The intervertebral discs

42
Q

Even minimal weight bearing by cervical facet joints can lead to

A

Spondylitic changes

43
Q

Whiplash Grading

A
  1. No Sx
  2. No physical signs. Pain, stiffness, tenderness. Nothing neurological
  3. Neck symptoms, musculoskeletal signs. No neuro.
  4. Neck symptoms. Neurological signs. Sensory deficits. Neg X-ray.
  5. Neck symptoms. Fracture, dislocation, objective neuro signs, possible SC signs.
44
Q

Normal lordotic curvature

A

30-40°

45
Q

Facet joints are what type of joints?

A

Plane joints

46
Q

Which vertebra has the largest TVPs?

A

C1

47
Q

Which SPs can be bifid?

A

C3-5

48
Q

What level is the hyoid?

A

C3

49
Q

What level is the thyroid cartilage?

A

C4-5

50
Q

What level is the first cricoid ring?

A

C6

51
Q

To stretch anterior scalene, place the head and neck:

A

CL side flexion

IL rotation

Spinal Tx 600 (9 decks)

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