Exam 2 (Don’t forget to study Exam 1 cards) Flashcards
Steel’s Rule of Thirds applies to which structures of the atlas?
1/3 odontoid (anterior)
1/3 spinal cord
1/3 free space: adipose, vessels, ligaments, meninges, subarachnoid space
What are the 3 ossification centers of atlas?
anterior arch lateral masses (2)
There are 5 primary and 5 secondary ossification centers of axis, what are they?
Primary:
Body (1)
Arches (2)
Lateral base of odontoid (2)
Secondary: Tip of odontoid (1) Inferior vert body (1) TPs (2) SP (1)
There are 3 primary and 7 secondary ossification centers in C7, what are they?
Primary:
Body (1)
Secondary (2)
Secondary: TPs (2) Superior body (1) Inferior body (1) SP (1) Costal elements (2)
What ossification centers are distinctly different between typical cervical vertebrae and C7?
Separate secondary ossification centers for costal processes
Which vertebral structures have an articular facet?
Dens
Anterior arch
Superior articular process
Inferior articular process
What structures form the IVF?
Pedicles
Articular pillar
vert bodies and IVDs
Uncinate processes
Anterior and posterior roots in the cervical spine are found as part of which structure?
TPs
The atlanto-occipital joints would be considered what type of joint?
Condylar
Which part of the vertebral artery runs from C6 to C1 TP?
2nd part
What percentage of the height of the cervical spine is from the cervical disc?
25%
The EOP is found at the midpoint of which nuchal line?
Superior nuchal line
The condylar fossae are found ____ to the occipital condules?
Posterior
Which part of the vert artery runs superior of axis?
3rd part
Cervical lordotic curvature is characterized as appearing ____.
Convex anteriorly
Development of cervical curve begins when?
Around 9 weeks with initial fetal movements
Lordosis becomes more prominent when infant begins lifting head at ____.
3-4 months of age
Infant begins sitting upright around ____ months of age further establishing lordosis of c spine.
9
In males, cervical lordosis increases gradually until age ____, when a dramatic increase in lordosis occurs.
70
In females, lordosis increases gradually until age ____, before rapid increase for several years and then slowing down again.
50
Do males or females have greater lordosis throughout life?
Females
Identify the location of the upper cervical and lower cervical curve.
UC:
primary curve CO-C1, kyphotic
LC:
Secondary curve C2-C7, lordotic
How many curves are found in the cervical spine?
2 curves
During flexion of lower cervical spine, upper cervical spine moves dependently or independently?
Independently (flex/extend both possible)
Lack of a cervical lordotic curve is acceptable for what age group?
Under 17
Lack of cervical curve in adults is indicative of what?
Ligamentous injury and/or anterior neck muscle hypertonicity
Which muscles of the neck could contribute to a lack of cervical lordosis?
Hyoid muscles, longus colli (anterior hypertonicity)
What boney abnormality can contribute to lack of cervical lordosis?
Hyperplastic articular pillars
Loss of cervical curve in an adult is found often times to be a(n) ____.
Insignificant finding
The theory behind why lack of cervical lordosis is significant by some is that ____.
There is an increased pressure on the brainstem and spinal cord
Females have more rapid shortening of height during what age range?
50-60 (menopause)
Degenerative changes of the spine begin around what age range in males?
31-40
Rapid degenerative changes of the spine in females happens in what age range?
51-60
Which vertebrae are considered typical?
C3-C6
Typical cervical VBs are small, ____ shaped.
Rectangularly
Typical cervical VBs transverse diameter ____ AP diameter.
Greater
Width and height of the typical cervical VBs are present at which portion of the c spine?
Inferior portion
Which ligament attaches along ridges of the anterior VB of the typical cervical vertebrae?
ALL
Ridges of the typical cervical vertebrae create a concave or convex surface for the ALL to attach?
Concave
What boney structure creates the concave surface of the superior portion of the typical cervical VBs?
Uncinate processes
Is the inferior surface of the typical cervical VB larger or smaller than the superior surface?
Larger
Raised lips of the VB are found where on the typical cervical vertebrae?
Superior aspect of VB Uncovertebral joints (Luschka’s joints, neurocentral joints) of the uncinate processes
How many uncinate processes are found on either side of the typical cervical vertebrae?
1 on each side
Which boney structure of the typical cervical vertebrae functions to allow flex/extend and limiting some lateral flexion?
Uncinate processes
Uncinate processes may help prevent IVD protrusion in which directions?
Posterior and lateral
What type of joint are the uncovertebral joints (Luschka joints, neurocentral joints)?
Synovial joints
At what age do uncovertebral joints (Lushka’s joints, neurocentral joints) form?
9-10 years of age
What pathology may encroach on the vert artery and/or spinal nerves?
Degeneration with osteophytes
Which region of the typical cervical vertebrae has the highest incidence of neural compression syndromes?
C4-C6
Which nerve roots would C4-C6 neural compression syndromes affect most often?
C5-C7
What sign may present at the typical cervical vertebrae when there has been trauma to the area?
Prevertebral soft tissue swelling
Typical cervical vertebrae pedicles project ____.
Posterolaterally
The medial border of transverse foramen is formed by which boney structure?
Pedicles
Where do the pedicles lie in relation to the superior and inferior VB endplates?
Midway
The spinal nerve runs ____ to its corresponding pedicle.
Superior
In the c spine, the spinal nerve exits ____ its corresponding vertebrae.
Above
____ of TPs of typical cervical vertebrae originate from the spine as 2 roots or bars.
Tubercles
Tubercles of typical cervical are joined by what boney structure?
Intertubercular lamella (costotransverse lamella)
Groove or gutter for the spinal nerve and anterior ramus is located ____.
Between anterior and posterior roots
Dural sleeve of the spinal nerve is adhered to ____ by fibrous tissue.
Gutter of TP
The dural sleeve of the spinal nerve is especially strong at what region of the cervical spine?
C4-C6
Dural root sleeves in the c spine has ____ sensory innervation than other regions.
More
The dural root sleeves in the c spine originate from ____ instead of recurrent meningeal nerves.
Dorsal root ganglion
Traction of nerve roots registers as ____.
Pain
Dorsal ramus leaves each ____ nerve shortly after it exits the IVF.
Spinal
Dorsal ramus courses along z joint and supplies joint with ____ innervation.
Sensory
Dorsal ramus provides what types of sensory information to cervical parts deep back muscles?
Motor, nociception, proprioception
Dorsal ramus provides information from what layers of the skin of the back?
Dermis and epidermis
What muscles attach to the anterior tubercles of the cervical TPs?
Anterior scalene
Longus colli
Longus capitis
What muscles attach to the posterior tubercles of the cervical TPs?
Splenius cervicis Longissimus cervicis Iliocostalis cervicis Levator scapulae Scalenius medius and posterior
Posterior tubercles of the TPs of the c spine extend further ____ than ____.
Laterally and inferiorly than anterior
Transverse foramen of all C spine vertebrae are bound by what structures?
Pedicle
Anterior root of TP
Posterior root of TP
Intertuberuclar lamella
After the vert artery travels through C1 transverse foramen, it loops ___ and ___ over the superior articular process to enter foramen magnum.
Superiorly and medially
Ventral rami pass ____ to vert artery.
Posterior
____ veins descend through transverse foramen.
Vertebral
Vertebral veins dump into ____ veins.
Subclavian
Vertebral veins begin in which region of the c spine?
Atlanto-occipital region
Vert artery is accompanied by plexus of ____ nerves through the transverse foramen.
Sympathetic
Cervical ribs have the following AKAs for attachment sites:
Costal elements
Costal processes
Pleurapophyses
What boney structure arises from the mesenchymal stage of vert development of the costal process?
TPs
Where in the c spine does compression of the brachial plexus or subclavian artery appear most often?
C7 ribs
The fibrous band of tissue usually connecting the tip of the cervical rib to the manubrium or the 1st true rib is seen on plain films. True/False
False
Facet joint (z joint) angles in the c spine are at what degrees?
45 degrees
What cardinal plane do the s spine facet (z) joint angles appear in?
Horizontal
Upper cervical vert are closer to what degree of facet joint angle?
35 degrees
Lower cervical vert are closer to what degree of facet joint angle?
65 degrees
Superior articular processes and facets of c spine face what direction?
Posterior, superior and slightly medial
Articular processes become more ____ as a child reaches 10 years of age.
Vertical
Asymmetry in facet joint angles and articular process orientation is especially common in what region of the c spine?
Transition areas (C6-T1)
Height of superior articular processes of c spine ____ while width ____ from C2-C7.
Decreases and increases
Prior to what age do you maintain smooth, thick articular cartilage with regular subarticular bone?
20 years old
Subchondral bone ____ with age.
Thickens
2 signs of degeneration of facet joints/articular pillars are?
Osteophytes and sclerosis
Z joint capsules limit what movement?
Hyperextension
Which aspect of z joint capsules are thickest?
Anterolateral
Z joint capsules of s pine are thinner, longer, and looser than T spine and L spine. True/False
True
Z joint synovial folds AKA:
Menisci
Z joint synovial folds (menisci) project into the joint from what directions?
Anterior and posterior
Z joint synovial folds (menisci) cover about ____ of the articular surface?
1/3
Z joint synovial folds (menisci) cover larger area at what region of the c spine?
C1-C2