Cervical + Thoracic Spine Flashcards by Emily Stephens

Number of cervical vertebra

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Number of cervical spinal nerves

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Number of thoracic vertebra

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What vertebrae are atypical?

C1, C2 + C7

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Function of the cervical vertebrae transverse foramen

C1-C6 transmit the vertebral artery, vein and sympathetic nerve plexus
C7 transmits accessory vertebral vein only

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Describe the cervical vertebrae

Anatomical features of lumbar spine vertebrae

Bifid spinous NOT C7
Small + broad body
Contain transverse foramen

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Cervical vertebrae orientation

45°

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What is the name for the C1 vertebra?

Atlas

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What is the name for the C2 vertebrae?

Axis

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How is the C1 vertebra atypical?

No spinous process
No vertebral body
Has anterior and posterior arch

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Describe the C1vertebra

Anterior + posterior arch
No spinous process
No vertebral body
Largest lateral masses
Transverse foramen in transverse processes
Articulate facet for dens in middle of anterior arch
Widest cervical vertebrae foramen

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Why are the lateral masses on the C1 vertebra the biggest?

Supports head
Spreads out the weight

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What attaches to the anterior arch of C1?

Anterior longitudinal ligament

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What attaches to the posterior arch of C1?

Ligamentum nuchae

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What is the atlanto-occipitial joint between?

Between the occiput of skull + atlas vertebrae

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What does the atlanto-occipital joint permit?

Flexion + extension
Head nodding

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What is the atlanto-axis joint between?

Between atlas + axis vertebrae

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Why is the C2 vertebra atypical?

Dens/Odontoid process

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Describe the C2 vertebra

Largest spinous process
Dens/Odontoceti process
Other features of cervical spine

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What holds the dens in place?

Transverse ligament of atlas

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What does the atlanto-axis joint permit?

Rotation
Shaking head

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What does the transverse ligament of atlas permit?

Rotation
‘no’

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What is the function of the odontoid process?

Acts as a pivot joint
Allows rotation

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What is atantoaxial instability?

Excessive movement between C1 + C2 vertebrae

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What causes atlantoaxial instability?

Due to damage of transverse ligament Causes - acute trauma *e.g. C1 fracture* - erosion from inflammatory conditions *e.g RA*

What happens in atlantoaxial instability?

- C1 vertebra moves forwards when head moves forwards - Compression of spinal cord

Why is the C7 vertebra atypical?

- Longest spinous process - not bifid - Small transverse foramen - only transmits accessory vertebral veins

Name for the C7 vertebrae

Vertebrae prominens

List nerve roots and where the exit in relation to their corresponding vertebrae

**C1-C7** - exit **above** corresponding vertebrae **C8** - **between C7 + T1** vertebrae **T1-L5** - exit **below** corresponding vertebrae

Cervical spine nerves exit more horizontally to lumbar spine - what does this mean clinically?

- No transversing nerve roots in cervical spine - Exiting nerve root compressed by intervertebral disc prolapse

List the ligaments in the spine

6 Anterior longitudinal ligament Posterior longitudinal ligament Intertransverse ligament Ligamentum flavum Interspinous ligament Supraspinous ligament

Location of the anterior longitudinal ligament

Anterior vertebral body C1 to sacrum Broader than PLL - stronger

Function of anterior longitudinal ligament

Prevent hyperextension of vertebral column

Location of posterior longitudinal ligament Clinical relevance

Posterior to vertebral body C2 to sacral canal Intervertebral disc prolapse often occurs laterally

Function of posterior longitudinal ligament

Prevent hyperflexion of vertebral column

Location of the intertransverse ligament

Between transverse processes

Location of the ligamentum flavum

Connect to lamina of vertebrae

What colour is ligamentum flavum?

Yellow

What does the ligamentum flavum contain a lot of?

Elastin

Location of the interspinous ligaments

Between spinous processes

Location of supraspinous ligament

Along tips of spinous processes

What is ligamentum nuchae?

Thickening of supraspinous ligament

Where is the ligamentum nuchae attached to?

Midline of external occipital protuberance Spinous processes of all C vertebrae (ends at C7)

Function of ligamentum nuchae

Maintains secondary curvature of cervical spine Helps cervical spine support head Major site of attachment of neck + trunk muscles

Movements of cervical spine

Flexion 85° Extension 70° Rotation 80° Lateral flexion 45°

Where does nodding the head take place and how?

Flexion and extension 50% atlanto-occipital joint 50% facet joints between C vertebrae

Where does shaking the head occur and how?

Rotation 50% atlanto-axial joint 50% facet joints of C vertebrae

Describe the thoracic vertebrae

Heart shaped vertebral bodies Small + circular vertebral foramen Spinous process angled inferiorly No transverse foramen

Clinical relevance of small circular vertebral foramen in vertebral body

Increased likelihood of neurology in leg Weakness + numbness

Why does the thoracic vertebrae have limited flexibility?

Ribcage is connected

List + describe the facets in the thoracic vertebrae

T2-T8 - demifacets on sides of vertebral bodies T9-T10 - whole facets on sides of vertebral bodies T11-T12 - whole facets on pedicles

Which head of rib does the superior demifacet articulate?

Adjacent ribs Vertebral number = rib number *e.g. T5 superior demifacet articulates 5th rib head*

Which head of rib does the inferior demifacet articulate?

Head of rib below Vertebral number + 1 = rib number *e.g. T5 inferior demifacet articulates 6th rib*

What lies within the costal groove?

Neurovascular bundle

Where does the neurovascular bundle of the rib lie?

The coastal groove Below the rib

Location of rib articulation with vertebra

Head with vertebral body Neck with transverse process - NOT T11+T12

Thoracic facet joint function What does it permit and prevent?

Permits lateral flexion + rotation Prevents flexion + extension

Function of the ribcage + sternum

Provide stability Protect heart, lungs, liver + other vital organs

Function of T11+T12 ribs

Protection for kidneys posteriorly

What protects the kidneys?

T11+T12 ribs

Where do the ribs meet at?

1-7 attach to sternum 8-10 attach to costal cartilage 11-2 no attachment

How does CSF appear in a T2 weighted MRI?

T2 weighted - fluid is bright

Outline the attachment of the ribs

- 1-7 attach to sternum via costal cartilages - 8-10 attach to costal cartilage of 7th rib - 11-12 are floating ribs **TRUE RIB**: 7 letters > 1-7 true ribs **FLASE RIB**: 8 letters > 8-10 false ribs **FLOATING RIB**: 11 letters > 11-12 floating ribs