Cervical Spine Anatomy Flashcards
What puts the cervical spine at such a high risk for injury
Mobility is greater than stability
Unless you know the EXACT SITE OF LESION what must be assessed when treating the cervical spine
What did Cyriax call this assessment?
Cervical spine occiput/c1- c7
Upper lim or portion there of
Scanning examination
There are ___vertebrae and ___ nerve roots in the cervical spine
7
8
Of which joint in the cervical spine does most of the rotation come from ? Which is more responsible for flexion and extension?
C1-C2 (axis) atlanto-axial joint
CO-C1 atlanto-occipital joint
Rotation past ____ degrees may lead to kinking of the _____ on the contra lateral side; while the ipsilateral side may become kinked at ____degrees.
50
Vertebral artery
45
What are some symptoms of vertebral artery compression
Vertigo Nausea Tinnitus Fainting Visual disturbances
What do the facet joints C4/C5; C5/C6; C6/C7 have in common (2 major things)
Greatest amount of flexion/extension of all facets joints as well as greatest amount of degeneration
Whee does the greatest amount of degeneration occur in the C-spine
C4-C7 (joints between)
Vertebral discs make up___% of cervical spine height however they are absent in which joints?
25%
C0/C1 and C1/C2
MOI in the C-spine: (Sounds like....feels like...is like....) Trauma =..? Burning/stinging might be....? Common overuse could lead to..? Onset was insidious.....?
Whip lash
Brachial plexus compression
Thoracic outlet syndrome
Spondylosis
Myotomal; dermatomal; and decreased reflexes are indicative of what in the cervical spine?
Cervical radiculopathy or nerve root injury
Spinal cord injury presentation in the cervical spine:
Spastic weakness
Paresthesia
Lack of coordination in one or both limbs
Loss of propripception or sphincter dysfunction
List signs that headaches have a cervical origin
Occipital or sub occipital headache Mvmt of neck alters headache Limitation of neck movement is painful Neck/head posture is abnormal Sub occipital/nuchal tenderness C0/C1 abnormal mobility Occipital and sub occipital abnormalities
_____ can occur when pressure is applied to a nerve root
Paresthesia (pins&needles)
Injuries in the cervicoencephalic region lead to symptoms of_____(5-6) and show the relationship between ____.
Headache Fatigue Vertigo Irritability Poor concentration Hypertonia of SNS
C0/C1
Injuries at the cervicocranial region have potential to involve what structures
Brain
Spinal cord
Brain stem (medulla pons midbrain)
Cervicomyelopathy more likely to present as:
What’s another term for this
Spastic weakness(LMN lesion)
Paresthesia
Lack of coordination in one or both limbs
Possible sphincter dysfunction and proprioception loss
Spinal cord injury
Cervico radiculopathy usually appears as:
Is also termed what?
Myotome weakness Dermatomal changes Deceased reflexes Unilateral***** Nerve root injury
What are some clinical signs that a headache is cervical in orgin
Occipital or sub occipital location to headache
Neck mvmt alters headache
Painful and limited neck movement
Abnormal head and neck posture
Occipital and nuchal tenderness
Abnormal mobility in C0/C1
Sensory changes in occipital and suboccipital area
Name for a short neck
Klippel-Feil syndrome
Rom of cervical spine
Flexion 80-90
Extension 70
Lateral flex 20-45
Rotation 70-90
Absolute CIs when treating C-spine
Metastic spinal tumor
Acute anterior disc herniation with cord signs
Actuate brachial neuritis
Positive vertebral artery/carotid occlusion signs
Severe jugular vein distension
Tracheal displacement
Local CIs for C-spine
Bilateral C1/2 instability
Acute fracture or dislocation
Deep suboccipital or cranial traction in alar/transverse ligament instability
Deep suboccipital techniques with vertebral artery insufficiency
Precautions of C-spine
Deep bilateral medial pressure hyoid horns
No bilateral anterior neck work
Reflex test for C6
C5/6?
CNV
C7/8?
Brachioradialis
Biceps
Trigeminal jerk
Triceps
Myotome dance for C-spine
C1/2= neck flexion C3= lateral flexion C4= shoulder shrug C5= abduction C6= elbow flex/wrist extension C7= elbow extension/ wrist flexion C8= thumb ext/ ulnar deviation T1= hand intrinsically abd and add
List the 4 places greatest stress is placed on the vertebral artery
Where it enters tvp at C6
Within bony canals of vertebral tvps
Between C1/2
Between C1 and entry into skull
During coupled movements of rotation and side flexion explain where in the c spine they occur in the same direction and where they occur in opposite directions
C0-C2 and C7/T1 they occur in opposite directions
C2-C7 they occur in the same direction
Regarding facet joint referral:
What facets are said to refer to the scapula and lower shoulder?
C6/C7
Your client comes in complaining of pain around the ear and extending down just below the occiput on the right side which facets would you consider testing to see if they were causing this
C2/3
What facets joints are very similar in refera, both posterior and inferior to the ear and into the upper shoulder region above the scapula?
C3/4 C4/5
Where does C5/6 facet joints radiate pain often
Spine of scapula post shoulder up to the lateral aspect of the SPs of about C2-C7
What is upper crossed syndrome
Deep neck flexors are weak
Rhomboids serratus anterior and lower traps weak
Pec major and minor, Levator scap and upper traps tight
Origin and insertion of rhomboid major
SPs T2-5
Vertebral border of scapula below the spine
Dorsal scapular nerve C5
Rhomboid minor origin and insertion
SPs C7-T1
Vertebral border of scapula spine and above including root
Dorsal scapular nerve C5
Serratus anterior origin and insertion
Ribs 1-9
Anterior vertebral border of scapula and inferior angle
Long thoracic nerve C5-C8
