Cervical , Thoracic Spine

Question 1

describe the cervical spine

Answer 1

C1-C7

from occipital bone to C7

C1 = atlas

C2 = axis

Question 2

which cervical vertebrae arent typical and which are?

Answer 2

C1 C2 C3 are all atypical

the rest are typical

Question 3

draw a typical cervical vertebrae and describe its structure

Answer 3

image

• articular facet angles are 45degree in coronal plane to the axial plane [superior facet faces upwards and backwards, inferrior face downwards and forwards]
• bifid spinous except C7
• large triangular vertebral foramen
• transverse foramen where vertebral veins and artery and sympathetic plexus can pass through except C7
  
  • body is small and broad from side to side

Question 4

describe C1 and draw it

Answer 4

• atlas
• anterior and posterior lateral masses
• widest cervical vertebra and doesnt have a ventral body or a spinous process
• vertebral arches are thick and strong and form 2 lateral masses (side masses) wc are powerful
  
  • anterior arch occupies 20% of the circumference of the ring and is attachment site of the anterior longitudinal ligament
• posterior arch frms 40% of the cirumference and contains the posterior tubercule which is site of attachment of ligamentum nuchae
• articualr facters are positioned on the lateral mass

Question 5

describe the lateral mass atlas

Answer 5

the articular facets are positioned on the lateral masses

• superior articular facet articulates with the occipital condyle of the skull - its hsape is bean shaped and concave
  
  • inferior articular facets articulate with C2 adn are flat and rounded in shape

Question 6

does C1 have a vertebral body

Answer 6

no, its vertebral body fused with C2 to form dens of C2

Question 7

C2 describe it

Answer 7

atlas

• no intervertebral space between C1 and C2
• provides a pivot allowing C1 to rotatefrom side to side
• its also the strongest cervical vertebra and has a rugged lateral mass and large spinous process
• the posterior aspect of the anterior arch of C1 articulates with the dens of C2, wc projects superiorly from the vertebral body of C2
• its this dens that acts as pivot
• it is held C1 via a transverse ligament of the atlas wc acts as a pivot joint
• theres also an apical ligament wc attatches between odonoid process(dens) and base of skull superiorly
  
  • transvere process sit more laterally and are larger than the other cervical lateral masses as they act as levers for muscle action, particualrly for the muscles that move thehead at the atlanto-axial joint

Question 8

whats the joint associated with atlas and skull and its function

Answer 8

atlano-occipital joint

50% of total head extension adn flexion

Question 9

what joint is associated with C1 and C2 and its function

Answer 9

atlanto-axial joint responisble for 50% of heead rotation

Question 10

describe the dens

Answer 10

project superiroly from the ertebral body of C2, they articular with the posterior aspect of the anterior arch of C1 and is held in place by a transverse ligament

Question 11

function of the tranverse ligament

Answer 11

prevent horizontal displacement of the atlas on the axis

Question 12

why is c7 different

Answer 12

because it doesnt have bifid spinous adn has the longst spinous of the cervical

its transverse process is also large but the foramen transversian i small and only allows the passage of accessory vertebral veins

Question 13

foramen transversium

Answer 13

passage way for vertebral veins and arteries and behind teh vertebral artery is spinal nerve adn ascend supwards wwithteh sympathetic plexus and vertebral veins

Question 14

whats the difference between the exiting roots of Cevical vs lumbar

Answer 14

lumbar below the vertebra,

cervical above and no traversing root , but between th C7t! junction is C8 rotts wc is exiting

Question 15

due to the differences in root exiting what does this mean for injury

Answer 15

theres no traversing root in the cervial region adn so it is the exiting roots that will be compressed in disc herniation

whilst in lumbar its the traversing root that tend to be compressed

Question 16

ligamentum nuchae

Answer 16

tickening of the supraspinous ligament

extends form the ocipital proturdence and median nuchae line of spinous process of C7

its anterior boarder attatcehs to the posterior tubercule of atlas adn then to the spinous process of all 7 vertebrae and is continous with the supraspinous ligaemnt

Question 17

function of the ligamentum nuchae

Answer 17

maintain secondary curvature fo teh cervical spine

assist cervical spine to support weight of the head

major site of muscle attacthment of muscles in thoracic and chest sice it is continous with the supraspinous ligaemnt

Question 18

anterior longitudinal igamnt

Answer 18

runs from the anterior tubercule of atlas to the sacrum

stronger than posterior

attatches loosely over the intervertebral discs

fucntion is to prevent hyperextenstion of the vertebral coloumn

Question 19

posterior longituidanla ligament

Answer 19

weaker than anterior

runs posterior tto the vertebral body from axis c2 to sacral canal

superior to C2 it continues as tectorial membrane of the atlano-axial joint

prevents hyperflexion

clincially important is that disc prolapses occur lateral to it(paracentral herniation)

Question 20

what are the movements of the cervical spine and what allows for this

Answer 20

extension (head backwards - ALL prvents hyperextension)

flexion (head forwards - PLL prevents hyperflexion)

50% of flexion and extension both take place at the atlano-occipital joint , remainer takes place inbetween facets

50% of rotation takes pace at the atlanto-axial joint where remainder occurs between facets

these movements are permissible due to the articualting facets orientating in the coronal plane 45 to the axial plane

Question 21

thoracic spine made up what? and what are the key characteristics of it?

Answer 21

made up of 12 vertebrae

• medium sized- heart shaped vertebral bodies
• vertebral foramen that is small and circular
• prominent transverse process with transverse costal facets that allow articulation with the ribs
• demi facets on T2-T8,
• whole facets on T9 and T10
• T11 T12 have facets on their pedicles
• long spinous process that angulate inferiorly
  
  • articular facets that are orientatedat 20 degree to the coronal plane and 60 to the axial

Question 22

describe the facets of the thoracic vertebra

Answer 22

• articular facets that face 20 in coronal to the 60 axial plane - this means that the superior faets face posteriolaterally adn the inferior facets face anteromedially , this means that theres rotation and lateral flexion but no flexion but prevents extension
• transverse costal facets that articualt with ribs
• demi facets T2-T8 wc are superior and inferior
• whole acets T9-T10
• facetson their pedicles = T11 T12

Question 23

why does thoracic spine have limited movement compared to the cervial adn lumbar spine

Answer 23

• facets 20 in coronal and 60 in axial permitting alteral flexion adn rotation but no flexion and extention

vertebra are connected to ribs

Question 24

describe rib attatchment to the vertbrae

Answer 24

• ribs curve to meet at front in T1-T10 and meet at the sternum
• T7-T10 attatch to the costal cartilageof the rib above
  
  • T11 T12 terminate in the abdominal musculature
    *

Question 25

whats the function of the ribs

Answer 25

provide stability and protection for heart, lungs, liver and other vital organs

ribs T11 and T12 provide protetion for kidneys in the retroperitoneum

Question 26

with T1 describe its facets

Answer 26

theres no superior demi-facet but the infeiror is demi and normal like the rest

Question 27

what are the mytomes of the upper limb

Answer 27

C5 = shoulder abduction and external rotation

C6 = elbw flexion/ wrist extension /supination

C7 = elbow extension/wrsist felxion/ pronation

C8 = finger extension / finger flexion

T1 = finger abduction / finger adduction

Question 28

what are the dermatomes of the upper limb

Answer 28