Cervical Spine Adjusting -1

Question 0

What are the four segments of the vertebral artery?

Answer 0

• from subclavian to transverse foramina of c5/c6
• within transverse foramina c5/c6-c2
• from the superior of c2 foramen to the dura
• from the dura forward

Question 1

Vertebral artery arises from what?

Answer 1

Subclavian artery

Question 2

From the subclavian artery the vertebral arteries continue to unite and form the??

Answer 2

Basilar artery

Question 3

Prior to the junction of the right and left vertebral arteries forming the basilar artery the what arises??

Answer 3

Posterior inferior cerebellar artery (PICA)

Question 4

Approx. 10% of patients have some form of anomaly in their vertebral arteries. Compression of VA is seen in what % of the population in neutral and rotational positions?

Answer 4

5%

Question 5

What are the three layers of the vertebral artery?

Answer 5

• tunica intima
• tunica media
• tunica adventitia

Question 6

What is arteriopathy?

Answer 6

Disease of an artery

Question 7

Arteriopathy may arise from what five things?

Answer 7

• Marfan’s disease
• Ehler Danlos syndrome
• polycystic kidney disease
• osteogenesis imperfecta
• fibromuscular hyperplasia

Question 8

What is clotting and thrombus formation

Answer 8

Arterial damage, particularly involving tunica intima will yield the start of increased localised clotting and thereby thrombus formation

Question 9

What is a emboli? And how does it present ?

Answer 9

The thrombus at the site of arterial damage is invariably the source of emboli yielding ischemic stroke from the vertebral artery.
Presents in 3 forms:
- liquid
- solid
- gaseous

Question 10

What is ischemia?

Answer 10

Insufficient supply of blood to an organ. He degree of ischemia resultant from an embolism is the consequence of:

• the size of embolism
• location of embolism
• presence/absence of collateral circulation to affected area

Question 11

Causes of vertebral artery dissection

Answer 11

• spontaneously
• trivial movement
• minor trauma
• major trauma

Question 12

Types of VAD?

Answer 12

• subintimal dissection ( tends to result in stenosis of the artery)
• subadventitia dissection (tents to result in aneurysm formation)

Question 13

Various forms of injury to vertebral artery will yield;

Answer 13

• few of minimal symptoms
• transient ischemia attacks due to altered circulation
• development of thrombi and emboli potentially yielding ischemia and/ or infarction

Question 14

Predisposing factors of VAD

Answer 14

Approx. 5% of patients who have a spontaneous dissection of the carotid of vertebral artery have atleast one family member who has had a spontaneous dissection of the aorta or its main branches

Question 15

Predisposing factors of vertebral artery dissection

Answer 15

Migraine
Respites infection
Other neurological symptoms and family history