Cervical Thoracic Anatomy and Pathology Flashcards
At any given time, what percentage of the population reports neck problems?
10-20%
How high did neck pain rank in the 2010 Global Burden of Disease study?
4th
If a patient is reporting high pain intensity in their neck which clinical tool is most recommended?
Numeric Pain Scale (0-10) and consider a score of 6 or greater a useful cut score for prognosis
If a patient has high self-reported disability what clinical tool is recommended for prognosis?
Neck Disability Index, you can use a score of 30% or more as a good cut off score for prognosis
What is considered the ‘upper’ cervical spine?
Joints between occiput, atlas, and axis with C3 being the transitional segment
Which cervical vertebra has no vertebral body?
C1
True or false: the C1 superior and inferior articulating facets are both convex.
False, both are concave
Which vertebrae has the dens as a landmark?
C2
What is considered the lower cervical spine?
Joints between C3 and C7/T1
What forms the joints of luschka?
The uncovertebral joints located on the superior surface of the vertebral body which articulate with the inferior surfaces of the body above
true or false: The C1 and C2 vertebrae do not have uncovertebral joints.
True
What are the functions of the Joints of Luschka?
- limit side bending to protect the cervical nerve roots
- support intervertebral discs from protruding
- form medial wall of the intervertebral foramen/canal
- become weight bearing with age and disc dehydration
What other structure along with the uncovertebral joints helps limit excessive movement and protect the IVD from severe torsion strain?
the zygopophyseal joints (ZPJ)
What symptoms are consistent with the uncovertebral joints?
- very little pain-more of a vague discomfort
- stiffness more than pain
- No referred or neurological symptoms
- Morning stiffness
What physical signs may be present with an injury to the uncovertebral joints?
- loss of extension
- neck in forward flexed position
- limited side bend in flexion, neutral and extension
- decreased rotation
- crepitus/”grinding”
when does the uncus usually grow upward from the lateral edge of the vertebral body? When does uncovertebral clefts appear?
at 8 years old
~12 years old
At what age does the nucleus and posterior annulus usually completely fissure? What remains intact?
By around 35-40 years old
anterior annulus and longitudinal ligaments
True or False: Disc fissuring is normal for patients over 35 years old.
True
True or false: Lower cervical discs are fissured before upper cervical discs, but disc C7-T1 is often spared completely from fissuring
False, upper cervical discs are fissured before lower cervical discs
C7-T1 is often spared from fissuring though
What structures can be compressed as the cervical disc space narrows and uncovertebral osteophytes project into the spinal column?
- nerve roots
- vertebral arteries
- spinal cord
As we age what does sclerosis from the UVJ occlude?
the foramen, which can cause foraminal stenosis
What nerves innervate the cervical IV discs?
cervical sinuvertebral nerves supply the disc at their level of entry and the disc above
Why is fissuring of the upper cervical spine not as harmful as fissuring of the lower cervical spine?
Upper cervical spine has no disc, which contains irritant chemicals that can harm the spinal cord
What is the one main factor related to progression of degeneration of the cervical spine?
Age
