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Anatomy LE > Cervical spine arthrology upper and lower > Flashcards

Cervical spine arthrology upper and lower Flashcards

1
Q

Cervical Intervertebral Disc size

A

Relatively small
Transversely broad

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2
Q

where are there no IV-disc in the c-spine

A

No disc between A/O and A/A joints

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3
Q

the joint that the Intervertebral Disc creates

A

Forms symphysis between 2 vertebral bodies

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4
Q

Nucleus Pulposus in the c-spine

A

Constitutes less than 25% of disc volume at birth (lumbar about 50%)

Gel-like until adolescence – becomes fibrous at about 20 yrs of age

Penetrated by uncovertebral clefts

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5
Q

Annulus Fibrosis anterior portion c-spine

A

Fibers interweave & have angled orientation
No separate laminae

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6
Q

Annulus Fibrosis posterior portion c-spine

A

Smaller posterior portion

Fibers oriented vertically

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7
Q

Annulus Fibrosis posterior-lateral portion c-spine

A

Lacking posterolaterally where uncovertebral jts are located

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8
Q

Annulus Fibrosis anterior properties

A

Anterior annulus fibrosis is major stabilizer in cervical spine
Can be torn with whiplash injuries

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9
Q

Annulus fibrous innervation

A

Outer 1/3 of annulus fibrosis has sensory innervation
Can be a ​source of pain

(all AF have sensory innervation)

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10
Q

Uncovertebral Joints other name

A

Joints of VonLuschka

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11
Q

Uncovertebral Joints are what kind of joint

A

Synovial jts

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12
Q

location of Uncovertebral Joints

A

between uncinate processes of vertebra below and body of vertebra above

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13
Q

Uncovertebral Joints bordered by

A

Bounded anteromedially by IV disc, & posterolaterally by IVF

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14
Q

Uncovertebral Joints and arthritic changes

A

can impact the intervertebral​ foreman - Can impact the spinal nerve traveling through the intervertebral foramen

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15
Q

Uncovertebral clefts

A

Cleft can be thought at continuation of the uncovertebral space into the disc

  • These clefts can complete transect the posterior portion of the disc and if they do – this allows for more movement into the rotation at the interverbal disc
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16
Q

Intervertebral Joint are like what kind of joint

A

Resemble saddle joints

included Symphysis & U/V jts

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17
Q

Intervertebral Joint Movement types

A

Flexion/Extension in sagittal plane
Lateral flexion coupled with (isp) rotation in plane of facet jts

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18
Q

Intervertebral Joint Movement - Flexion/Extension in sagittal plane

A

Narrow Anterior/posterior dimension of disc allows greater sagittal plane motion
Uncovertebral joints guide sagittal plane motion

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19
Q

Intervertebral Joint Movement - Lateral flexion coupled with rotation in plane of facet jts

A

Broad transverse dimension of disc allows for limited lateral flexion

Uncinate processes provide lateral stability by limiting lat flexion

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20
Q

Typical Cervical Facet Joints

A

C2/3-C6/7

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21
Q

Typical Cervical Facet Joints types of joints

A

Synovial joints

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22
Q

Typical Cervical Facet Joints orientation

A

Orientation in oblique plane (roof shingles)

Inferior articular facets
Slightly concave
Face inf’ly & ant’ly

Superior articular facets
Slightly convex
Face sup’ly & post’ly

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23
Q

Facet orientation in the c-spine allow for what kind of motion

A

facilitates sagittal plane motion and requires that axial rotation and lateral flexion are always coupled

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24
Q

Facet Orientation also provides for

A

some weight-bearing capability

impediment to forward translation

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25
Q

Typical Cervical Facet Joints - joint capsule

A

Enveloped in baggy capsules which are lax in neutral position and taut in extremes of motion

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26
Q

intra-articular inclusions in the c-spine

A

Fat pads, fibroadipose menisci

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27
Q

Anterior longitudinal ligament runs to

A

the occiput​

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28
Q

ALL function

A

Reinforce interver-tebral joints

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29
Q

ALL and pain fibers

A

Heavily innervated with pain fibers

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30
Q

ALL and cervical discs

A

May or may not have attachments into cervical discs

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31
Q

Longitudinal Ligaments extends to

A

Extends only to posterior body of C2

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32
Q

Posterior longitudinal ligament changes into the

A

Tectorial membrane is cranial extension of PLL

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33
Q

Ligamentum Flavum found between

A

connect the laminae of adjacent vertebrae

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34
Q

Ligamentum Flavum extend to

A

Extends to C1/2

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35
Q

Ligamentum Flavum made out of

A

elastic fibers

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36
Q

vertebral canal and the Ligamentum Flavum

A

Provides smooth post wall for vertebral canal

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37
Q

Ligamentum Flavum and movement

A

Too distensible to limit movement

Accommodates large changes in intralaminar distance with flexion/extension

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38
Q

what is the Ligamentum Nuchae

A

In the cervical region, homologous to interspinous and supraspinous ligaments

39
Q

Ligamentum Nuchae two parts

A

midline raphe and midline fascial septum

40
Q

midline raphe

A

for origins of upper trapezius, splenius capitis, & rhomboid minor

41
Q

midline fascial septum

A

separates semispinalis capitis

42
Q

Movement in Lower Cervical Segments is determined by

A

by orientation of facets

43
Q

facet joints what kind of joint surface

A

planar -synoivial joints

44
Q

Sagittal Plane Motion - felxion, movement seen

A

Both upper facets move sup’ly & ant’ly on lower facets

45
Q

Sagittal Plane Motion - felxion, movement limited by

A

Limited by tension in PLL, artic capsule & ligamentum nuchae

46
Q

In full flexion what does facet contact look like

A

minimal facetal contact - opening-up

47
Q

Sagittal Plane Motion - extension, movement seen

A

Both upper facets move inf’ly & post’ly

48
Q

In full extension what does facet contact look like

A

Facetal approximation - closing down

49
Q

Sagittal Plane Motion - extension, movement limited by

A

Limited by tension in ALL and impact of SPs, and sup articular processes of vertebra below with TPs of vertebra above

50
Q

what side do Combined Lateral Flexion with Rotation occur on

A

Both occur to same side

51
Q

example Combined Lateral Flexion with Rotation to the right

A

Right upper facet glides inferiorly and posteriorly (closing down)
Left upper facet glides superiorly and anteriorly (opening up)

52
Q

two Upper Cervical Joints

A

Atlanto-Occipital Joints

Atlanto-Axial Joints
Lateral atlanto-axial joints
Median atlanto-axial joint

53
Q

Atlanto-Occipital (A/O) Jointswhat kind of jt

A

Synovial ellipsoid jts

54
Q

Atlantal facets properties

A

Concave, tilted medially
Constricted in middle
Long axes run obliquely ant & med

55
Q

Occipital condyles

A

convex

56
Q

Ligaments of A/O Joints

A

Fibrous capsule
Anterior Atlanto-Occipital Membrane
Posterior Atlanto-Occipital Membrane

57
Q

Fibrous capsule of A/O joint

A

Thickened posterolaterally

Thin & sometimes lacking medially where joint may communicate with bursa between dens & transverse ligament

58
Q

Anterior Atlanto-Occipital Membrane

A

Broad, dense membrane between foramen magnum and anterior arch of atlas

Strengthened by ALL

59
Q

Posterior Atlanto-Occipital Membrane

A

Broad, thin membrane between foramen magnum & posterior arch of atlas

Arches over groove for vertebral artery forming opening for artery

60
Q

Movement at A/O Joints

A

The two joints act as one

Movement may occur around transverse axis (nodding), and A/P axis (slight lateral flexion)

61
Q

Flexion – nodding at the A/O joint

A

Occipital condyles roll ant’ly & glide post’ly
About 10-degree range

62
Q

Extension at the A/O joint

A

Occipital condyles roll post’ly & glide ant’ly
About 25-degree range

63
Q

Lateral flexion

A

Ipsilateral occipital condyle glides ant’ly, med’ly & inf’ly

Contralateral occipital condyle glides post’ly, lat’ly & sup’ly

So some conjunct rotation occurs to opposite side
About 5 deg range

64
Q

Lateral Atlanto-Axial Joints formed by

A

Articulations between:
inferior articular surface of thelateral mass of atlas(C1) - the superior articular surface of thelateral mass of axis(C2)

65
Q

Lateral Atlanto-Axial Joints what kind of joint

A

Synovial joints

66
Q

Lateral Atlanto-Axial Joints capsule type

A

Capsules are thin & loose

67
Q

Lateral Atlanto-Axial Joints facet shapes

A

Facet surface shapes are debatable

The kinematic remain the same

68
Q

Median Atlanto-Axial Joint

A

between dens & ring formed by ant arch of atlas & transverse ligament

69
Q

Median Atlanto-Axial Joint type of joint

A

Synovial pivot joint

70
Q

Median Atlanto-Axial Joint anterior

A

Ant’ly, capsule encloses space bet ant arch & dens

71
Q

Median Atlanto-Axial Joint posteriorly

A

Post’ly, larger synovial cavity lies between transverse ligament & dens

72
Q

what is the Transverse Ligament

A

Thick strong band dividing ring of atlas into 2 unequal parts

73
Q

Transverse Ligament attaches to

A

Attached on each side to tubercle on lateral mass

74
Q

median portion of the transverse ligament

A

Median portion lined with cartilage for articulation with dens

75
Q

Transverse Ligament function

A

Function: Retains dens in contact with anterior arch of atlas during movement

76
Q

cruciform ligament

A

cross

made out of the:
transverse ligament
small band - extends up to the O (
large band - extends down to the body of the axis (sometimes absent)

77
Q

where does the small band of the cruciform liagment lie

A

lies between tectorial membrane & apical ligament

78
Q

Movement at A/A Joints in general

A

Occurs simultaneously at all 3 joints

Lateral joints support weight of head via atlas, while medial joint guides rotation

Consists primarily of rotation with minimal degree of flexion/extension

79
Q

Rotation at A/A Joints dens momvement

A

During rotation dens should not move, but act as pivot around which movement occurs

80
Q

facet movement with Rotation at A/A Joints

A

Inferior facet of atlas glides forward with contralateral rotation and backward with ipsilateral rotation (reform)

81
Q

rotation at the A/A joint is limited by what

A

Limited by alar ligs

82
Q

range of Rotation at A/A Joints

A

Total range: ~45 degrees
- 20ish on each side

83
Q

Flexion/Extension at A/A Jts - during flexion

A

inferior facets of atlas roll ant’ly & glide post’ly
Anterior arch of atlas glides inf’ly

84
Q

Flexion/Extension at A/A Jts -During extension

A

inferior facets of atlas roll post’ly & glide ant’ly
ant arch glides sup’ly

85
Q

Flexion/Extension at A/A Jts - dens movement

A

Regardless of the facet surface shapes, the dens will retain contact with the anterior arch of the atlas and the atlanto-odontoid interval will not open out

Transverse Ligament is keeping dens in place

86
Q

range of motion during Flexion/Extension at A/A Jts

A

10 degrees of movement

87
Q

Ligaments Connecting Axis and Occipital Bone

A

Tectorial Membrane
Alar Ligaments
Apical Ligament

88
Q

Tectorial Membrane

A

Lies within vertebral canal

Extension of PLL

Broad, strong

Runs from body of axis to occipital bone in front of foramen magnum

89
Q

Alar Ligaments

A

2 strong cords run from dens obliquely up and lat’ly to condyles of occiput

90
Q

Alar Ligaments resitriction of movement

A

Primary restraints- for contralateral rotation & lateral flexion
2ndary restraint for flexion

91
Q

alar ligament are most taut with

A

Flexion
Extension combined with rotation

92
Q

Apical Ligament of Dens

A

Runs from tip of dens to anterior margin of foramen magnum

Very thin

More reinforcement

93
Q

Apical Ligament of Dens lie where

A

Lies between upper band of cruciform ligament & anterior atlanto-occipital membrane

Anatomy LE (13 decks)

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