Cspine anatomy/biomechanics review Flashcards
What processes do you find on the typical cervical vertebrae (3-7) on the lateral discal surfaces of the superior body?
Uncinate processes
Within the uncovertebral joints, what herniations are more common than posterior lateral?
Just posterior because of uncinate processes
What are the posteriolateral projections off the body?
Pedicles
What runs through the foramen transversarium? What is the one exception?
Vertebral artery, except C7
Describe the spinous process on the typical cervical vertebrae (3-7)? Except what vert?
Bifid (except 6,7)
What travels through the intervertebral foramen?
Nerve roots
What part of the atlas articulates with the dens of C2?
The posterior surface of the anterior arch
The groove on the superior surface of the posterior arch of the atlas holds what?
The VA
What ligament attaches to the posterior tubercle of the atlas?
Ligamenta flava
Where can you palpate the transverse process of the atlas?
Between mastoid process and ramus of mandible
The superior facets of the articular pillars on the axis are what shape?
Slightly convex
The inferior facets of the articular pillars on the axis are what shape?
oriented inferiorly and anteriorly
The pedicles of the axis are grooved for what structure?
VA
The transverse processes of the axis are projected which direction?
Inferiolaterally
What are the stabilizing ligamentous structures of the dens on the axis?
- Transverse ligament
- Apical ligament
- Alar ligaments
The intervertebral discs are composed of what 3 structures?
– Nucleus pulposus
– Annulus fibrosus
– Vertebral endplates
T/F there is no clear boundary between the nucleus and annulus
True
The nucleus pulposus is made up of what material?
Cartilage cells and irregularly arranged collagen fibers in semifluid ground matrix
T/f the nucleus pulposus can not be compressed
True, deformed, but not compressed
- Transmits pressure in all directions if deformed
What are the layers of the vertebral endplate toward the vertebral body and toward the nucleus?
the vertebral body - hyaline cartilage
toward the nucleus - fibrocartilage
The vertebral endplate is weakly attached to ____ and strongly attached to ____
vertebral bodies
disc
What are the 3 primary functions of the c-spine disc?
- Allows motion
- transmit forces
- attenuation of forces
What part of the cspine annulus is thick/strong and lambdoid orientation?
Anterior annulus
What part of the cspine annulus is thin with longitudinal fibers and a transverse fissure?
posterior annulus
The transverse fissure of the posterior annulus allows for what?
Allows for swinging motion of cervical vertebral bodies
What is the function of ZYGAPOPHYSIAL JOINTS?
Function: Guide & limit movement of spine
What type of joints is the ZYGAPOPHYSIAL JOINT?
Type: Synovial joint (Synovial lining, surrounded by capsule)
The ZYGAPOPHYSIAL JOINTS have a fibro-adipose meniscoid that projects up to 5 mm into joint cavity (superior & inferior) for what purpose?
Transmit loads & Protects articular cartilage that would otherwise be exposed during motion
T/F the fibro-adipose meniscoid of the ZYGAPOPHYSIAL JOINT is highly innervated
True
The medial branch of the dorsal rami innervates what?
ZYGAPOPHYSIAL JOINT
The sinuvertebral nerve off the ventral rami moves posterior and anteriorly and crosses midline to innervate what?
Innervates annulus fibrosus 1/3 deep
Why don’t we feel degeneration of the disk until it gets into the outer 1/3?
the sinuvertebral nerve innervates 1/3 deep
Describe the articulating surfaces of the joints of luschka.
Articulating surfaces:
Medial border of uncinate processes
Articulates with the inferiolateral border of the superior vertebra
You can get formations in the joints of luschka which will do what?
Project out where nerve roots pass through and impinge and cause radiculopathy
Obliquus Capitis inferior action -
Rotates the head ipsilaterally (Transverse process c1 to spinous process c2)
Obliquus Capitis Superior action -
Capital extension, ipsilateral lateral flexion (skull to transverse process c1)
Rectus Capitis Posterior major action -
Capital extension, ipsilateral rotation (skull to spinous process c2)
Rectus Capitis Posterior Minor action -
Extends the head (skull to posterior arch of c1)
Bilateral contraction of the longus coli does what?
straightens cervical curvature and flexes neck
What muscle plays a role in static position of the neck?
longus coli
Which scalene muscle attaches to the 2nd rib?
posterior (ant/middle attach to 1st rib)
Scalenes will do what to the cpine lordosis when the longus coli is not active?
Increase lordosis
Transverse ligament of atlas does what?
Retains dens against anterior arch of C1
What are 3 parts of the cruciate ligament?
- Transverse
- Superior longitudinal
- Inferior longitudinal
The Superior longitudinal ligament attaches to what?
(attaches to occipital bone)
The inferior longitudinal ligament attaches to what?
(attaches to posterior surface of body of axis)
The alar ligament’s origin and insertion are?
origin - apex of dens
insertion - occipital condyles
The alar ligament limits what?
C1-C2 rotation
When is the alar ligament taut?
with contralateral rotation (right taut with left rotation)
The apical ligament’s origin and insertion are?
origin - Apex of dens
insertion - anterior foramen magnum
The posterior longitudinal ligament continues on to be what ligament?
tectoral ligament
The tectoral ligament’s origin and insertion are?
Posterior body of C2 to above foramen magnum
The posterior longitudinal ligament spans from the posterior body of C2 to where?
The sacrum
The anterior longitudinal ligament spans what part of the spine and blends with what?
Anterior spine, blending with the anterior bodies and annulus/end plates
What ligament attaches adjacent laminae?
Ligamenta Flava
The ligamentum nuchae is continuous with what ligament?
supraspinous ligament
What are the clinical implications if there is a compression on the nerve root prior to convergence?
Clinical Implications: possible sensory or motor impairment (or both)
If the nerve compression if more proximal, what impairments will you see?
either sensory or motor
What muscle does the brachial plexus pass between from the cervical spine?
the anterior and middle scalene muscles
What surrounds the brachial plexus?
The axillary sheath
The cords pass deep to what structures?
Clavicle and pec minor
What is the primary function of the Convex occipital condyle sitting in a concave superior surface of the lateral mass of C1?
transmit forces from head to cervical spine
What is the function of the superior and posteriorly facing articular facets of the mid/lower cervical spine?
Superior = bear weight of pillar above Posterior = stabilizes vertebra by impeding anterior translation
Describe the arthrokinematic motion that occurs with the head nodding forward
With head nodding forward = occipital condyles roll forward coupled with a downward and posterior slide to keep condyles against C1 floor
What limits neck flexion?
limited by post neck muscles and impaction of submandibular tissues against throat
Describe the arthrokinematic motion that occurs with the head extension/.
occipital condyles roll posterior coupled with downward and anterior slide
What limits neck extension?
limited by compression of suboccipital muscles against occiput
Describe the arthrokinematic motion that occurs with the head rotation
not a true movement but can be induced if sufficient torque applied
What limits head rotation?
limited by tension of capsule and alar lig
T/F Lateral flexion at the occiput and C1 is not a true movement.
True
Describe axial rotation around the atlas.
anterior displacement of 1 lateral mass and posterior displacement of opposite coupled with the inferior articular cartilage of atlas sliding down convex superior articular cartilage of axis assuming space previously occupied by intra-articular meniscoids
What limits axial rotation around the atlas?
Alar ligament
T/F First 75% of cervical spine rotation occurs at the atlas/axial
False, first 50%
Describe extension between the atlas and the axis,
dens curved slightly posteriorly allowing for atlas to slide upwards and backwards
Describe Flexion between the atlas and the axis,
anterior translation of atlas where anterior arch separates from dens slightly
Describe Lateral translation between the atlas and the axis,
superior articular facets of axis slope inferiorly and laterally, lateral translation of atlas accompanied by ipsilateral side bending
What limits lateral translation of atlas on axis?
Alar ligament
What limits posterior translation of atlas on axis?
limited by impact of anterior arch and dens
What limits anterior translation of atlas on axis?
limited by transverse and alar lig
Describe lateral flexion between C2 and C1
C2 squeezed into ipsilateral rotation while atlas undergoes contralateral rotation
Describe flexion at the mid and lower cervical spine segments.
long superior articular process = flexion/extension axes closer to intervertebral disc of segment
Describe side bending at the mid and lower cervical spine segments.
impaction of ipsilateral inferior facet against opposing superior articular facet
