Cervical Spine Anatomy Flashcards by Nicole Nelson

Upper cervical spine levels

Occiput-C2

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Lower cervical spine levels

C2-C7

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Orientation of Atlas

Anterior, medial, superior

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What allows more atlanto-occipital extension?

oprientation of superior facets (ant, med, sup)

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What is the first palpable midline structure below occiput

Axis spinous process

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Structure that extends just superiorly above axis

Dens

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What makes the dens susceptible to frx?

hypodense below dens

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What type of joint– occipito-Atlantal

condyloid synovial joint

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Occipito-atlantal joint CC/CV rules…

CC superior facets of C1 articulate with CV occipital condyles

Roll and slide opposite (CV on CC)

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where is the OA joint capsule thick?

posterior lateral

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What type of joint is the AA joint

Median (atlanto-odontoid) joint
-pivot synovial joint
-odontoid (dens) rotates in an osteoligamentous ring

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2 lateral synovial joints AA CC/CV

C1 CV
C2 CV

gives a lot of mobility / rotation (50% occurs here) NOT congruent

large loose capsule

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Which ligaments prevent anterior displacement of vertebral body of C1 on C2

Transverse and cruciform

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Which ligaments limit AA flexion

transverse and cruciform

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Which ligament holds the dens of the axis to the atlas?

transverse

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Which cervical ligaments provide sagittal plane stability

transverse/cruciform

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Which cervical lig. hold dens to the medial aspect of the occipital condyles

Alar

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Orientation of the Alar Lig

sup, post, lateral (varies)

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What does Alar ligament limit?

flexion, CL rotation and SB
prevents distraction of C1 on C2

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Continuation of ALL lig
From C2 to the occiput (ant foramen magnum)
Anterior surface of C1 and C2

Ant atlantooccipital membrane (btwn OA) & ant atlantoaxial ligament (btwn AA)

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– within the spinal canal on the posterior surface of the C1 and C2
– continuation of the PLL lig

tectoral membrane

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What does the tectorial membrane limit?

– limits upper cervical flexion and holds the occiput off the atlas

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continuation of the ligament flava
from C2 to the occiput (posterior foramen magnum)

post atlanto-occipital membrane and post atlanto-axial ligament

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Rectus Capitus Post Major
actions:

capital ext
ipsilateral lateral flexion

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Rectus Capitus Posterior Minor actions:

Capital (AO) extension ipsilateral lateral flexion (minimum)

Oblique capitus superior actions:

capital AO extension ipsilateral lateral flexion and rotation

Oblique capitus inferior actions:

capital AA extension ipsilateral lateral flexion and rotation

segmental stabilizer and provide proprioception

Rectus Capitus Anterior is deep to.... OI? Action?

deep to longus capitus anterior C1 lat mass to base of occiput CV flexion

Rectus Capitus Lateralis OI? Action

C1 TP to occiput CV lateral flexion a weak CV flexor when contracts BILAT

what does the uncinate process limit

rotation

Uncinate process is where?

Cervical PL VB

C2-C7 spine VB transverse diameter is _____ than AP diameter and height sellar sup surface: ____ med-lat and ____ ant-post

greater CC CV

Most commonly involved nerves

C5-6

Cervical TP has foramen for

vertebral a, vertebral v, and venous plexus

TP of Vertebral Arch ANT tubercle:

longus capitus, longus colli, and scalenus anterior

TP of vertebral arch POST tubercle

Splenius, longissimus cervicis, iliocostalis cervisis, levator scpaulae, scalenus medius/posterior

What joint bears most of axial loading

Zygapophyseal joint

C2-C7 ___degrees above horizontal C7-T1 ___degrees above horizontal

45 10

Z joint Superior Facets face... inferior facets face...

superior and lateral inferior and medial

Ant vs post cervical joint capsule

anterior is strong, post is weak

what does the cervical joint capsule limit?

extreme intervertebral motions

what is the cerv. joint capsule reinforced by?

MF, lig flavum (ant capsule)

Ligament -sacrum to C2 -Narrow in upper cervical and wider in lower cervical -Limits extension or excessive lordosis

ALL

Ligament? -Within vertebral canal -sacrum to C2 -broader and thicker in cervical region -limits flexion and prevents disc protrusion

PLL

Ligament? - btwn laminas -sacrum to C2 -Extends laterally to cover z joint -limits flexion -maintains tension when head and neck are in neutral

Ligament Flavum

thickening of this ligament increases the liklihood of spinal nerve/root impingement

lig flavum (spinal stenosis more common in c spine, disc more common in l spine)

where is lig flavum weakest?

mid cervical

Ligament? -SP to SP posteriorly -continuation of supraspinous lig, C7 to external occipital protuberance

Lig Nuchae

which lig pulls the vertebrae posteriorly during cervical flexion, limiting ant translation (limiting cervical flexion)

nuchae

ligament? -btwn adj spinous processes -not well developed in c region limits flexion

interspinous lig

height of cervical disc disc to body height ratio central/peripheral portions are called

5-6mm 1:3 nucleus pulposis, annulus fibrosis

Degeneration of disc -- characterized by... newborns % h2o child 14 yrs % h2o 70 yrs % h2

decline of hydrophilic properties 88 80 70

Splitting along the post aspect of the disc (horizontal, disc is degenerated)

cervical cleft

Function cervical vs lumbar

axial rotation weight bearing

Nucleus ar birth cervical vs lumbar

25% disc 50% disc

annular layers cervical vs lumbar

indistinct distinct, 65 deg to vertical

Cleft cervical vs lumbar

posterolateral disc, horizontal circumferential and radial

Height cervical vs lumbar

thin thick

nerve supply cervical vs lumbar

outer 1/3 (> lumbar spine) outer 1/3

Trapezius: contracting unilaterally: Contracting bilaterally:

produces extension, ipsilateral lateral flexion and contralateral rotation extension

Splenius cervicis and capitis contracting unilaterally: Contracting bilaterally:

ipsilateral lateral flexion and rotation extension (travels med to lat)

SCM sternal and clavicular head Unilaterally- Bilaterally-

ipsilateral lateral flexion and CL rotation Flexes lower cervical and extends upper cervical spine

Scalenes attachments ant, med posterior

1 rib 2 rib

scalenes if c spine is stabilized if ribs are stabilized (contracting unilaterally / bilaterally)

raise the ribs, assisting breathing Unilateral: ipsilateral flexors and weak CL rotators Bilateral: weak lower cervical flexors

Longus capitis and colli (stabilizers)

lateral/anterior VB attachment! (function: nodding) CV & cervical flexion resist to compression of head Often injured during hyperextension whiplash injury