Craniovertebral Joints Flashcards

1
Q

Atlas/Axis

Which supports the skull

A

Atlas

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2
Q

Atlas/Axis

Which has no body or no spinous process

A

Atlas

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3
Q

Atlas/Axis

Which has large lateral facets?

A

Atlas

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4
Q

Atlas/Axis

Which has large foramen transversum?

A

Atlas

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5
Q

Atlas/Axis

Which has dens on superior surface?

A

Axis

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6
Q

Atlas/Axis

Which has a bifid spinous process?

A

Axis

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7
Q

What are the 2 main craniovertebral joints

A

atlanto occipital joint

atlanto axial joint

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8
Q

Both the craniovertebral joints (atlanto occipital and atlanto axial) are ___ joints

A

synovial

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9
Q

Atlanto occipital joint movement:

A

“YES”

and tilts head laterally from side to side

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10
Q

Atlanto occipital joint is articulation between __ and __

A

occipital condyles and C1 facets

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11
Q

Atlanto occipital joint is ___ synovial joint

A

condyloid synovial joint

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12
Q

Altanto occipital joint range of motion is ____

A

flexion and extension

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13
Q

Atlanto axial joint movement:

A

“NO”

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14
Q

Atlanto axial joint is ___ synovial joit

A

pivot synovial joint

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15
Q

Atlanto axial range of motion is ____

A

rotation

supplies 50% of cervical rotation

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16
Q

The periosteal dura mater lines ___ and is continuous with ___

A

lines the cranial vailt

continuos with the spinal column

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17
Q

The tectorial membrane is __ to the dura

A

deep

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18
Q

Tectorial membrane is the superior extension of ____

A

posterior longitudinal ligament

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19
Q

The superior extension of the posterior longitudinal ligament is the ____

A

tectorial membrane

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20
Q

What is found deep to the tectorial membrane?

A

deep ligaments and craniovertebral joints

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21
Q

What are the two membranes associated with the atlanto-occipital joint?

A

anterior atlanto-occipital membrane

posterior atlanto-occipital membrane

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22
Q

Anterior atlanto-occipital membrane is the superior extent of ____

A

anterior longitudinal ligament

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23
Q

Anterior atlanto-occipital membrane attaches to the _____

A

base of the occipital bone and the margin of foramen magnum

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24
Q

Anterior altanto-occipital membrane covers what part of the atlas?

A

covers the anterior arch of the atlas INFERIORLY

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25
Q

Posterior atlanto occipital membrane is a superior extent of ____

A

ligamentum flavum

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26
Q

What are ligamentum flavum?

A

fill the gaps between posterior vertebral arches

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27
Q

Superior extension of ligamentum flavum is ____

A

posterior atlanto-occipital membrane

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28
Q

What are the 4 deep ligaments of craniovertebral joint?

A

1 transverse ligament of atlas
2 cruciate ligament (cruciform ligament)
3 alar (check) ligament
4 apical ligament of dens

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29
Q

Transverse ligament of atlas holds __ to __

A

holds dens of axis (C2) tightly to the anterior arch of atlas (C1)

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30
Q

What shape is the transverse ligament of atlas?

A

bow shaped

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31
Q

If the dens is fractured, where would the fracture be and why?

A

the fracture would be at the base because the transverse ligament of the atlas holds dens so tightly to the anterior arch of C1

This fracture will likely not repair, but it is not fatal unless severs spinal cord

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32
Q

What are the components to the cruciate ligament?

A

superior longitudinal band
inferior longitudinal band
transverse ligament of atlas

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33
Q

What are the 2 “bands” in the cruciate (cruciform) ligament?

A

superior longitudinal band

inferior longitudinal band

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34
Q

Both of the bands in the cruciate ligament are __ oriented

A

vertically

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35
Q

The superior longitudinal band attaches to ___

A

the foramen magnum

traverses superiorly from the transverse ligament of the atlas

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36
Q

the inferior longitudinal band attaches to ___

A

the dens of C2 posteriorly

traverses inferiorly from the transverse ligament of the atlas

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37
Q

Why is the cruciate ligament called the cruciate/cruciform ligament?

A

the 2 “bands” or “crura” + the transverse ligament of the atlas = a cross (crucifix)

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38
Q

What are the paired, “check” ligaments of the craniovertebral joints?

A

alar ligaments (check ligaments)

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39
Q

The alar (check) ligaments extend from __ to __

A

from dens to medial portions of occipital condyles

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40
Q

What do the alar ligaments “check”?

A

check lateral rotation of skull/head

owls don’t have this

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41
Q

Describe the apical ligament of the dens

A

slender band ascending from the apex of the dens

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42
Q

The apical ligament of the dens attaches to ____

A

anterior margin of foramen magnum

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43
Q

Apical ligament of dens is located deep to ____ (another ligament)

A

superior longitudinal band of the cruciate ligament

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44
Q

What is the main vein found in the craniovertebral region?

A

internal jugular vein

45
Q

internal jugular vein emerges from ___

A

jugular formamen

46
Q

What is the main artery found in the craniovertebral region?

A

internal carotid artery

47
Q

Internal carotid artery enters ___

A

carotid canal

48
Q

The sympathetic trunk (in the craniovertebral region) gives rise to the ___

A

internal carotid plexus

49
Q

The internal carotid plexus comes from ___

A

sympathetic trunk

50
Q

What main Cranial Nerves are found in the craniovertebral region?

A

7, 9, 10, 11, 12

51
Q

CN 7 emerges from ___

A

stylomastoid foramen

52
Q

CN 9 emerges from ____

A

jugular foramen

53
Q

CN 10 emerges from ___

A

juuglar foramen

54
Q

CN 11 emerges from ____

A

jugular foramen

55
Q

CN 12 emerges from ___

A

hypoglossal canal

56
Q

What are the 3 structures associated with the craniovertebral region?

A

pharynx
carotid sheath
sympathetic trunk

57
Q

The pharynx, carotid sheath, sympathetic.

How are these all related to hte vertebrae?

A

pharynx, carotid sheath and sympathetic trunk are all prevertebral

58
Q

Pharynx hangs off of the ___

A

pharyngeal tubercle at base of the skull

59
Q

Pharynx is continuous with the ___

A

oral cavity

60
Q

Carotid sheath is ___ to the pharynx

A

lateral and posterolateral

61
Q

Sympathetic trunk is ___ to carotid sheath

A

posteromedial

62
Q

What are the main ganglia at the base of the skull?

A

CN 9 inferior/superior ganglia
CN 10 inferior/superior ganglia
Sympathetic trunk gives superior cervical ganglia

63
Q

CN 9 and 10 each have superior/inferior ganglia. These are ___ ganglia within __ foramen.

A

sympathetic ganglia

each within jugular foramen

64
Q

Sympathetic trunk gives rise to ___

A

superior cervical ganglia

65
Q

Superior cervical ganglia sends off ___

A

internal carotid plexus

66
Q

Internal carotid plexus rides along ___

A

internal carotid artery

67
Q

Cn 9 travels with what muscle ___

A

stylopharyngeus muscle

68
Q

CN 9 travels bertween __ and __

A

ICA and ECA

69
Q

CN 9 runs on the __ aspect of the stylopharyngeus muscle

A

lateral

70
Q

CN 9 innervates what muscle

A

stylopharyngeus

71
Q

Cn 9 descneds the back of ___

A

pharynx and tongue

72
Q

CN 10 immediately splits into

A

pharyngeal nerve

superior laryngeal nerve

73
Q

pharyngeal nerve is a branch off of __

A

CN 10

74
Q

superior laryngeal nerve is a branch off of __

A

CN 10

75
Q

Pharyngeal nerve emerges ~__cm inferior to skull base

A

2

76
Q

Pharyngeal nerve travels between __ and __ to innervate __

A

ICA and ECA

to innervate pharynx

77
Q

Superior laryngeal nerve arises __ to pharyngeal nerve

A

inferior

78
Q

What makes up the pharyngeal plexus of nerves?

A

union of pharyngeal branches of CN 9 adn CN 10

79
Q

What does CN 9 contribute to the pharyngeal plexus of nerves?

A

primarily contributes sensory fibers

and motor innervation to stylopharyngeus m

80
Q

What does CN 10 contribute to the pharyngeal plexus of nerves?

A

supplies most of the motor innervation to pharyngeal muscles

also supplies parasympathetics

81
Q

Where do the sympathetics in the pharyngeal plexus of nerves come from?

A

superior cervical ganglion

82
Q

CN 11 runs immediately lateral to ___

A

CN 10

83
Q

CN 11 runs immediately __ to CN 10

A

lateral

84
Q

As CN 11 descends, it travels through ICA, ECA, which makes it appear that ____

A

CN 10 is beneath the carotid sheath

but really CN 10 is within the carotid sheath

85
Q

CN 11 supplies ___

A

trapezius m and SCM m

86
Q

CN 12 runs __ within the __ triangle

A

inferiorly within the subamndibular triangle

87
Q

CN 12 supplies the muscles of the __

A

tongue

88
Q

While removing the head, we use the __ joints, and sever all ____

A

use the craniovertebral joints

sever all ligaments

89
Q

While removing the head, we use the ___ as a long plane for separation. Why?

A

Retropharyngeal space

Because it is full of loose fibrous connective tissue which is easy to rip

90
Q

Retropharyngeal space is between __ fascia and __ fascia

A

buccopharyngeal and alar

91
Q

Retropharyngeal space runs from __ to __

A

base of skull to superior mediastinum

92
Q

Retropharyngeal space is easily accessed posterior to ___

A

carotid sheaths

93
Q

Cervical nerves in craniovertebral region C1-C4 form:

A

cervical plexus

94
Q

Cervical plexus is made up of what cervical levels?

A

C1-C4

95
Q

Where is cervical plexus found?

A

C1-C4

found posterior to longus capitis/colli m

96
Q

Cervical nerves in craniovertebral region C3-C4 make up:

A

phrenic nerve

97
Q

Phrenic nerve is made up of what cervical levels?

A

C3-5

98
Q

Where is phrenic nerve found?

A

descends anteriorly across anterior scalene muscle

99
Q

Cervical nerves in craniovertebral region C5-8 make up:

A

brachila plexus

100
Q

Brachial plexus is made up of what cervical nerves?

A

C5-8

101
Q

Brachial plexus runs between __ and __

A

anterior scalene muscle and middle scalene muscle

102
Q

Vertebral arteries arise from __

A

subclavian artery

103
Q

Vertebral veins drain into __

A

brachiocephalic vein

104
Q

Vertebral aa and vv are located __ to cervical spinal nerves

A

anteiror

105
Q

vertebral aa and vv both enter __ from what vertebral level?

A

transverse foramina of C6 and above

106
Q

What are the 2 pharyngeal plexus of veins?

A

INTERNAL plexus

EXTERNAL plexus

107
Q

Where is the internal pharyngeal plexus of veins found?

A

between pharyngobasilar fascia and constrictor mm

108
Q

Where is the external pharyngeal plexus of veins found?

A

outside of pharygobasilar fascia