Exam 2: Cervical Flashcards
how many joints does the cervical spine consist of
37, which allow for more motion than any other region of the spne
when you increase mobility
you decrease stability (more vulnerable to both direct and indirect trauma)
a complete examination of the cervical spine requires
that the patient unless to the waist exposing the neck area as well as the entire upper extremeity
what do surgical scars on the anterior portion of the neck most often indicate
previous thyroid surgery
what do irregular, pitted scars in the anterior triangle could be
previous tuberculous adenitis
what articulations is each pair of vertebrae in the cervicals connected by
a pair of zygzapophyseal joints
uncovertebral joints
IVD
the structure of the cervcial vertebrae combined with orientation of the zygapophyseal facets provide
very little bony stability
the lax soft tissue restraints permit
large excursions or motions
what kind of curve is in the cervical spine
lordotic curve that develops secondary to the response of an upright posture, which initially occurs when the child begins to lift the head at 3-4 months
what does the presence of the curve allow
allows the head and eyes to remain oriented forward, and provides a shock absorbing mechanism to counteract the axial compressive force produced by the weight of the head (how many pounds?)
where is the weight of the head
directly above the center of gravity
what happens in forward head translation
if the head is 3 inches in front of the COG an estimated 30 pounds of weight is produced in structures of the c-spine
what is palpation performed
- check for any vasomotor changes such as an increase in skin temperature
- localize specific sites of swelling
- identify specific anatomical structures and their relationship to one another
- identify sites of point tenderness
- indentify soft tissue texture changes or myofascial restriction
- locate changes in muscle tone resulting from, trigger points, muscle spasm, hypertonicity, or hypotonicity
where is the hyoid bone located
opposite of C3
where is the thyroid cartilage located
“adams apple” level of the C4/C5 vertebral body
where is the first cricoid ring located
opposite C6 vertebral body
where is the carotid tubercle located
C6- used as an anatomical landmark for anterior surgery
common bony growths on the front of the spine
anterior cervical osteophytes
- most patients have no symptoms from the osteophytes
- these small bony lumps push against the back of the throat and make swallowing difficult
occiput is located
on the back of the skull
the inion is located
on the center of the superior nuchal line
the mastoid process is located
lateral to the superior nuchal line
which spinous process is the first palpable
C2
which vertebrae is considered typical and which one is considered atypical
sixth cervical= typical
seventh= atypical
what happens if the vertebra shift
can result in unilateral facet dislocation or spinous fracutre
how does the superior facet of the contralateral side move
anterior-superior and over the tip of the inferior particular facet of the involved side, resulting in placement in the intervertebral foramen anterior to they inferior facet
what injuries are associated with a unilateral facet dislocation
- disruption of the non dislocated joint
- concomitant fracture of either facet or the complete lateral mass
- partial tearing of the PLL
- additional bony fractures of the remaining cervical spine
how many zygapophyseal joints are there
14- from C0-T1
what kind of joints are the zygapophyseal joints
typical synovial joints and are covered with hyaline cartilage
what is the average horizontal angle of the zygapophyseal joints
approximately 45 degrees
where do the uncovertebral joints extend from
C3-T1
how many uncovertebral joints are there
10 saddle-shaped, diarthrodial articulations
how are the uncovertebral joints fromed
between the incinerate process found on the lateral aspect of the superior surface of the inferior vertebrae, and the beveled inferior-lateral aspect of the superior vertebra
what did Penning and Wilmink highlight
a possible correlation between uncovertebral joint configuration and the coupled cervical segmental motion of side bending and axial rotation
a more recent study of C5-6 segment level by Clausen et al. found that both the z joints and Luschka joints are
the major contributors to coupled motion in the lower c spine, and that the uncinate processes effectively reduce motion coupling and primary cervical motion
what serves as the principal routes of entry and exit of the neurovascular systems to and from the vertebral canal
intervertebral foramina
intervertebral region is vulnerable to
narrowing with certain motions or with osteophyte growth
what happens to the intervertebral foramen with full extension and ipsilateral side bending of the cervical spine
decrease
what may compress the nerve root and cervical cord posteriorly
osteophytes
what is the most common area for pathology in C-spine
c5/c6
what does the cervicothoracic junction comprise
the C7-T1 segment, although functionally it includes the C7 vertebra, T1 and T2 vertebrae, ribs 1+2, and the manubrium
the CTJ also forms
the thoracic outlet
-through which the neruovascular structures of the upper extremities pass
