Cervical spine

Question 1

What are the atypical cervical vertebrae + what are the typical?

Answer 1

Atypical = C1, C2, C7
Typical = C3-6

Question 2

What are the 5 key characteristics of cervical vertebrae?

Answer 2

Small, broad vertebral body
Large triangular vertebral foramen
Bifid spinous process (NOT C7)
Transverse foramen in transverse process (NOT C7)
Articular facets in coronal plane, 45 degrees to axial plane (allows 45 degrees of lateral flexion @ facet joints)

Question 3

Describe C1

Answer 3

Atlas
Anterior + posterior arch connected by 2 lateral masses
Widest C vertebra
No vertebral body or spinous process

Question 4

Where are the articular facets in C1 and what do the inferior/superior articular facets articulate with?

Answer 4

On lateral masses
Superior = occipital condyles of skull
Inferior = superior articular facets of C2

Question 5

What is the joint between the occiput of the skull + atlas vertebra?

Answer 5

Atlanto-occipital joint
Nodding of head + neck (flexion + extension 50%)

Question 6

What is the joint between C1 + C2?

Answer 6

Atlanto-axial joint
Rotation of head + neck (50%)

Question 7

Describe C2

Answer 7

Axis
Strongest C vertebra
Rugged lateral mass
Large spinous process

Question 8

What is the odontoid process/peg or the dens?

Answer 8

Projects vertically upwards from axis body
Vestigial remnant of body of C1

Question 9

What ligament holds the dens in place?

Answer 9

Transverse ligament of the atlas = pivot joint
Together prevent horizontal displacement of atlas on axis

Question 10

What ligament attaches between the dens + base of skull superiorly?

Answer 10

Apical ligament

Question 11

What is excessive movement between C1 + C2 called? Causes?

Answer 11

Atlantoaxial instability
Congenital, acute trauma, degenerative from RA
Compress spinal cord/nerve roots

Question 12

Describe C7

Answer 12

Vertebra prominens
Longest spinous process (not bifid)
Large transverse process, small transverse foramen (only transmits accessory vertebral veins)

Question 13

Where does the spinal nerve run in the cervical spine?

Answer 13

Superior aspect of pedicle, between anterior + posterior tubercles of transverse process

Question 14

Where does the vertebral artery run?

Answer 14

Through transverse foramen in C1-6

Question 15

When comparing the effect of disc prolapse in the cervical spine compared to the lumbar, what is of importance?

Answer 15

No traversing root in C spine = exiting root compressed by disc (spinal nerves exit above its vertebral body)
Lumbar = traversing root compressed as exiting nerve root exits below vertebra

Question 16

What is the ligamentum nuchae?

Answer 16

Thickening of supraspinous ligament from external occipital protuberance to spinous process of C7
Fibrous lamina @ its anterior border connected to atlas posterior tubercle + spinous processes of C vertebrae

Question 17

What are the 3 roles of the ligamentum nuchae?

Answer 17

Maintain lordosis in C spine
Assist C spine to support weight of head
Site of attachment for neck + trunk muscles

Question 18

What is the clinical relevance of the posterior longitudinal ligament?

Answer 18

Disc prolapse occur lateral to it