Cervical Spine I Flashcards
fucntions/ goal of cervical spine
goal: keep the eyes level - compensates for SD in other areas of the body
- Transfers weight from a 2-column (occipital condyles) to a 3-column system (body of cervical vertebrae + two facet joints)
- protection
- support an dmobility
curve of cervical spine
lordotic
cervical - level where are problems most common
C5-C6
superior facets of cervical face:
backwards, upwards, and medial (BUM)
bifid cervical vertebrae?
C3-C6
C3-C6 info:
- Saddle shaped bodies
- Short, bifid spinous processes
- Short, modified bifid transverse processes with transverse foramen for the vertebral arteries
- Superior facets face BUM
large non-bifid spinous process?
C7
C7 info
- Thick, long non-bifid spinous process
- Vertebral Prominens
- Large, non bifid transverse processes
- Vertebral artery does not pass through the transverse foramen (the vertebrae vein however)
Atlas C1 info
- No vertebral body…
- No spinous process
- Concave superior facets
- Palpable transverse processes=not bifid
- No disc between the occiput & the atlas (Occipital-Atlantal [OA] joint)
Axis C2 info
- Modified Vertebral body
- Odontoid process (dens)serves as the body of C1
- No disc between atlas & axis (Atlanto-Axial [AA] joint)
- Superior facet articulations are convex and articulate with convex cartilage covering the inferior facets of C1
- Convex on convex apposition (AA joint)
Zygapophyseal Joints
- Facet joints
- Located between
a) Inferior articular facet of the superior vertebra &
b) Superior articular facet of the inferior vertebra - Superior facet at an angle: BUM
In contrast to the thoracic and lumbar spine, we are palpating
the facets rather than transverse processes for diagnosis
Joints of Luschka (Uncovertebral Joints) - functions
- Located at the lateral/posterior surface of the cervical vertebral bodies
- Guides cervical motion
- Supports lateral side of cervical discs
- Protects cervical nerves from pressure
Classic area for degeneration & spur formation
Joints of Luschka (Uncovertebral Joints) -
Anterior Longitudinal Ligament prevents
hyperextension
Posterior Longitudinal Ligament prevents
hyperflexion
Ligamentum Flavum - prevents
separation of the vertebral lamina, stopping abrupt flexion of the vertebral column (whiplash
Nuchal Ligament provides muscular attachment for which muscles?
splenius cervicis
splenius capitis
upper trap
Alar Ligament
- goes from C2 to the occiput:
- Two strong bands that extend from the side of the dens to the lateral margins of the foramen magnum of the occiput
- Limits rotation
Transverse ligament
- goes from C1 across the dens to C1
- Holds the dens of C2 against the anterior arch of C1
- Anterior surface of the spinal cord lies immediately posterior to the dens
down syndrome or rheumatoid arthritis patients have issues with which ligaments?
- increased laxity of the Alar ligaments and the Transverse ligaments
- can pinch the spinal cord
find C1 landmark
– Between the angle of the mandible & mastoid process
find C2 landmark
angle of mandible
find C3 landmark
hyoid bone
find C4 landmark
superior thyroid cartilage
find C5 landmark
inf thyroid cartilage
find C6 landmark
cricoid cartilage
find C7 landmark
vertebral prominens
muscles that span a few vertebrae
-Suboccipital Triangle: Rectus Capitis post major; Obliquus capitis superior; Obliquus capitis inferior
-Rectus Capitis Posterior Minor
-Short Restrictors: Rotatores
Intertransversarii; Interspinales
muscles that span entire cervical spine anteriorly
-SCM
-scaene (ant, middle, posterior)
omohyoid
-platysma
Occipital-Atlanto Joint
- “Yes” joint
- Flexion & extension greatest at the OA joint
- Two articulations are formed by the occipital condyles & the superior articular facets of the atlas (C1)
- Occipital condyles are convex
- Superior articular facets of the atlas (C1) are concave
- No disc between joint
Occipital-Atlanto Joint - primary movements
- Flexion & Extension (Type II mechanics)
- Due to the condyles of the occiput
during flexion of the head
occipital condyle slides posterior
during extension of the head
occipital condyle slides anterior
Occipital-Atlanto Joint - secondary movements
Coupled sidebending & rotation to opposite sides (Type I mechanics)
Multiple reasons for motion coupling
Sidebending
One occipital condyle slides upward on one side of the atlas and downward on the other (~5° in each direction)
Rotation
Coupled with sidebending
Atlanto-Axial Joint - 4 articulations
- —Right & Left zygapophyseal joints (facet joints)
- Convex inferior cartilage of the atlas articulates with the convex superior facets of the axis
- —Dens articulation
- Anterior surface of the dens articulates with the atlas
- Posterior surface of the dens articulates with the transverse ligament
Atlanto-Axial Joint - primary motion
Primary Motion = Rotation
**“No” joint **
50% of cervical rotation occurs at the AA joint
Secondary motion = small
amounts of flexion & extension
