Exam 2: Cervical Spine Flashcards
More ___ associated with this region than any other region
Muscles
Cervical spine is the most ___ of vertebral column
Mobile
Cervical curve is ____ of spinal curves
Least distinct
Cervical curve is considered a
Secondary (compensatory) curve
Upper cervical spine consists of
Occiput
Atlas
Axis
Upper cervical spine does not contain any ___
IVD
Occiput—C1 combined thetaX = ___degrees
25
Occiput—C1 one sided thetaZ _ = ____ degrees
5
Occiput—C1 one sided thetaY = ___ degrees
5
C1–C2 combined thetaX = ___ degrees
20
C1–C2 one sided thetaZ = ___ degrees
5
C1–C2 one sided thetaY = ____ degrees
40
Occiput—C1 greatest motion
ThetaX (flex/exten)
C1–C2 greatest motion
ThetaY (rotation)
Superior articular facet of atlas is ___ shaped
Peanut
Superior articular facet is ___ and faces slightly ___
Concave; medial
Anatomical structure at occiput—C1 is “cuplike” in ___ and ____ planes
Sagittal and frontal
Peanut shaped lateral mass of C1 allows for little
Rotation
Shape of articulation favors ____ axis
ThetaX
Flexion of occiput—C1
Rotates P and S
+thetaX
DOES NOT TRANSLATE
Extension of occiput—C1
Rotates A and S
-thetaX
DOES NOT TRANSLATE
Flexion at occiput—C1 is limited by
Posterior neck muscular tension
Extension of occiput-C1 is limited by
Suboccipital muscle compression against occiput
Occiput—C1 thetaY rotation is limited by
A and P walls of C1 sockets
Joint capsule tension
Alar lig tension
Major limiter of of thetaY rotation at Occ-C1
Alar lig
Z axis rotation of occiput-C1: one condyle ____ while the other ____
Elevates out of its socket; serves as a pivot
____ lig limits Z axis rotation
Alar
Z axis rotation to one side is associated w/
Coupled motion in opposite direction
Why chin rotates away
C1 inferior articular process characteristics
Oval
Flat/slightly concave
Face slightly medial
Even though C1 inferior articular facets are flat, cartilage creates
Biconvex articulation
Instant axis of rotation
Path identifies where one body will rotate relative to another body
X axis rotation of C1-C2
Biconvexity: combined thetaX = 20 degrees
Inc in dens curvature ___ amount of thetaX
Increases
____ lig restrain thetaY rotation at C1-C2
Alar
C1-C2 is responsible for over ___ of rotation of neck
50%
Intraarticular meniscoids location within C1-C2 articulation
A and P
Intraarticular meniscoids function
Keep film of synovial fluid applied to those surfaces
Intraarticular meniscoids are displaced with
Y axis rotation
C1-C2 thetaY rotation is coupled with
-Y translation
ThetaZ at C1-C2 is limited by
Alar ligs and bony anatomy
Which lig of upper cervical spine serves as main limiter of motion
Alar lig
There is only ___ x axis translation at C1-C2
Apparent
There is little Z axis translation at C1-C2 because of
Tight articulation of C1 ring around dens
C1-C2: as head is laterally flexed to one side, ____ articular process takes on greater load
Ipsilateral
Lateral bend at C1-C2 results in rotation of spinous toward ____
Convexity of lateral bend (opposite)
At C1-C2, if lateral bend to R, spinous goes
L
Most cervical flexion/extension occurs at
C4/5 and C5/6
13-29 degrees (about 20)
Most y axis rotation of cervical spine occurs at
C3/4
C4/5
C5/6
About 7 degrees
Most Z axis rotation of cervical spine occurs at
C2/3
C3/4
C4/5
About 10-11 degrees
Lower cervical: lateral bending to one side, spinous rotates
Contralateral
During flexion/extension of cervical spine, there is associated ____ in sagittal plane
Translation
+ thetaX is coupled with _____ translation
+Z
- thetaX is coupled with _____ translation
-Z
More translation occurs in
Upper Cervical spine
Total “normal” translation is approximately
3.5mm
Lateral bending of cervical spine causes spinouses to move toward
Convexity of curve (contralateral)
Positive thetaZ is coupled with ____
- thetaY
- thetaZ is coupled with ____
+ thetaY
____ rotation w/ lateral bending in lower cervicals
Less
Steepness of arch at C2
Flat (more translation)
Steepest arches are at
C6 and C7
The acuity of arc decreases w/ ____
Degeneration
ALL limits what motion
Negative thetaX (extension)
PLL limits what movement
Positive thetaX (flexion)
Ligamentum flavum slows what motion
Last few degrees of + thetaX
Interspinous lig limits what motion
Positive thetaX
Ligamentum nuchae limits what motion
Positive thetaX
Intertransverse lig limits what motion
Contralateral lateral flexion (thetaZ)
X axis translation of cervicals is reduced because of
Uncinates
X axis rotation is ____
Promoted
Uncinate processes also limit
Pure lateral flexion
Uncinates act as guides to couple
Lateral flexion w/ axial rotation
Degeneration of uncovertebral joints results in
Bony outgrowth (osteophytosis)
Osteophytosis may impinge the
Vertebral artery
Cervical nerves
Cervical IVD have strong ___ annulus and are lacking in ____ and ____
Anterior; lateral and posterior
Facets of cervical spine are angled ____ degrees between _____ and ____ planes
45 degrees; coronal and transverse
Inferior facet orientation for C, T, L
AIL
AIM
AIL
Changes to Z joint w/ age
Thin articular cart
Thicken subarticular bone
Osteophytes
Osteophyte formation always occurs at
Edge of articular cartilage
Proprioception in cervical spine
IVD
Facet joints
Cervical muscles
IVD likely senses peripheral
Compression/tension
Deformation
Alignment
Facet mechanoreceptors are responsive to ____ of joint motion
Extremes
Only small # of receptors in cervical facets so they likely ____
Responsible for large receptive field
Muscle spindles primarily detect
Changes in length
Muscles in cervical region contain ____ of muscle spindles
High density
**especially suboccipital
Which suboccipital muscles contains most muscle spindles
RCP minor
Gate theory
Proprioceptive input into dorsal horn modulates nociceptive input to CNS
The more open the gates, the more
Pain messages— High levels of pain
More closed the gates, the fewer
Pain messages — person experiences less pain
Sensitization is the change in stimulus-response profile so that they respond to
Mehanoreceptive afferents as if they were nociceptors
Sensitization occurs when
CNS becomes facilitated
Hurt may not equal harm
Direction of orientation of superior facets in cervical spine
Posterior, superior, medial
Muscular changes in patients w/ chronic neck pain
Atrophy
Fatty infiltration/degen
Cervical curve develops when
Prior to birth
Cervical lordosis aids in
Absorbing spinal loads
Angle of cervical lordosis should be
30-45 degrees
Upper cervical curve (occiput-C2) is
Kyphotic
Lower cervical curve (c2-C7) is
Classical lordosis
Primary load on cervical spine is
Compression
Compressive loads ___ during flexion or extension
Increase
Cervical spine units can withstand at least _____N in compression w/out damage
2000
The ___ load induces bending and the ___ load minimizes bending moments and shear
Vertical load; follower load
Follower load remains ___ to spinal curve
Tangential
Follower load allows cervical spine to
Bear larger compressive loads
Inc stability that comes from added compression is due to
Muscular action
The co-activation of muscles produces a ____ load
Follower load
NOT vertical load
