Exam #3 - Cervical Spine Flashcards
Characteristics of cervical vertebrae (3)
- Smallest
- Most mobile
- Transverse foramen
“Typical” cervical vertebrae
C3-6
“Atypical” cervical vertebrae
C1-2 and C7
What 2 muscle groups makeup the posterior craniocervical region
Splenius & Suboccipital muscles
Splenius muscles (2)
- Splenius cervicis
- Splenius capitis
Suboccipital muscles (4)
- Rectus capitis posterior major
- Rectus capitis posterior minor
- Obliquus capitis superior
- Obliquus capitis inferior
Muscles of the Anterolateral Craniocervical region
- SCM
- Scalenes
- Longus coli
- Longus capitis
- Rectus capitis anterior
- Rectus capitis lateralis
What are the 3 scalene muscles apart of the anterolateral craniocervical region
- Scaleneus anterior
- Scalenus medius
- Scalenus posterior
- Considered the lower cervical spine
- Superior surfaces CC side to side with uncinate processes (“hooks”)
- Inferior surfaces CC anterior-posterior, with elongated posterior & anterior margins
- Wider side to side
- Uncovertebral joints (“joints of Luschka”)
Typical cervical vertebrae (C3-6)
- Form between uncinate processes & adjacent superior vertebrae
- Exists between C3 & C7
Uncovertebral joints (“joints of luschka”)
The triangular vertebral column of C3-6 is to accommodate
thickening of the spinal cord
Superior articular facets face what direction
posterior & superior
Inferior articular facets face what direction
anterior & inferior
Transverse processes are short lateral extensions that terminate as
anterior & posterior tubercles
What is the function of C1 (atlas)
Support the head
What “Atypical” cervical vertebrae has - no body, pedicle, lamina, or spinous process
Atlas (C1)
2 large lateral masses of C1 are joined by
anterior & posterior arches
C1 anterior arch has anterior tubercle for attachment of the
anterior longitudinal ligament
Atlas (C1)
CC superior articular facets face ____ to accept the CV occipital condyles
CC superior articular facets face cranially to accept the CV occipital condyles
Atlas (c1)
Inferior articular facets face ____ with the lateral edges facing 20° from the ____ plane
Inferior articular facets face inferiorly with the lateral edges facing 20° from the horizontal plane
Characteristics of…
- Large & tall body base of dens (odontoid process)
- Stout pedicles & short transverse processes
- Spinous process of the axis is bifid & very broad serving as muscles attachment site
Axis (C2)
Axis (C2)
What structure provides a rigid vertical axis of rotation for the atlas and head
Dens (odontoid process)
Axis (C2)
A pair of superior articular processes project ____ from the body
laterally
Articular processes are slightly CV & oriented 20° from the ____ plane
horizontal plane
Inferior articular processes of C2 project in what direction
anteriorly & inferiorly
- Largest of all cervical vertebrae
- Resembles thoracic vertebrae
- Large transverse processes
- May sprout an extra cervical rib
- Large spinous process
Vertebra Prominens (C7)
Atypical
Atlantooccipital Joint
Anteriorly the capsule of each joint blends with the
Anterior atlantooccipital membrane
Atlantooccipital Joint
Posteriorly the capsule is covered by a thin, broad
Posterior atlantooccipital membrane
Atlantooccipital Joint
What artery pierces the posterior atlanto-occipital membrane in order to enter the foramen magnum
Vertebral Artery
The vertebral artery enters where on the vertebrae
foramen magnum
What 2 synovial cavities of the atlantoaxial joint make up the median joint
anterior & posterior cavity
What cavity of the atlantoaxial joint is - smaller, bw anterior dens & posterior border of anterior arch of atlas
Anterior cavity
What cavity of the atlantoaxial joint is - large, seperates posterior side of dens & cartilage lined section of the transverse ligament of the atlas
Posterior cavity
Essential horizontal plane stability of the atlantoaxial articulation
Transverse Ligament of the Atlas
What could happen if the transverse lig of the atlas is damaged?
Atlas could slip anteriorly & cause damage to axis and spinal cord
- Posterior to transverse ligament
- Continuation of posterior longitudinal ligament
- Attaches on basilar part of occipital bone anterior to foramen magnum
Tectoral membrane
Tectoral membrane function
Provides generalized multidirectional stability to the ____ junction
craniocervical junction
- Passes laterally & slightly upward from the apex of the dens to the medial sides of occipital condyles
- “check ligaments”
- Contralateral to the side of rotation resists the rotation
Alar ligaments
Why is alar ligaments referred to as “check ligaments”
resist (check) axial rotation of thehead & atlas relative to the dens
When is the Alar ligaments loose and taut
Loose in neutral & becomes taut during axial rotation
Alar ligaments function
Limits ____ & extremes of all other potential motions at the ____ joints
Limits rotation & extremes of all other potential motions at the atlantooccipital joints
Upper Cervical Spine Coupling
- Right occiput moves medial, inferior, & anterior (MIA)
- Left occiput moves lateral, posterior, & superior (LPS)
- Results in a conjunct LEFT rotation
Right lateral flexion
Upper Cervical Spine Coupling
- Left occiput moves medial, inferior, & anterior (MIA)
- Right occiput moves lateral, posterior, & superior (LPS)
- Results in a conjunct RIGHT rotation
Left lateral flexion
Lower Cervical Spine: Intervertebral Disc
IVD height-to-vertebral body height ratio
2:5
25% of the superior-to-inferior height of the
Cervical spine
Absence of the annulus fibrosus at the uncovertebral region
enabling or resulting from rotary movements of the c-spine
Axial rotation of a “typical” cervical verterae occurs around an ____ axis perpendicular to the plane of its facets
Oblique axis
Posterolaterally, the nucleus pulposus is contained only by the ____ fibers of the ____ ____ ligament
Posterolaterally, the nucleus pulposus is contained only by the alar fibers of the posterior longitudinal ligament
- Diarthrodial joints from C3-T1
- Maintains a synovial compartment
- Formed bw an uncinate process & inferolateral superior vertebra
- Creates the posterolateral border of intervertebral disc
Uncovertebral Joints
- C1-7
- Synovial joints, covered with hyaline cartilage
- Superior facet face up & posteriorly
- Inferior facet faces down & anteriorly
Zygapophyseal Joints
Zygapophyseal Joints
C5-6 contributes the greatest to
Segmental mobility
Zygapophyseal Joints
Major constraints & support for ZAJ are the ____ & the ____
ligaments & IVD
Zygapophyseal Joints Angulation
Clinically: the orientation of the ZAJ planes can be imagined as passing through the patient’s
nose
Lower Level Coupling
Lower level cervical spine exhibits ____ coupling
ipsilateral
Lower cervical coupling between movements in what planes of motion
frontal & horizontal planes
What is this an example of?
Lateral flexion to the right occurs with slight axial rotation to the right
Lower cervical ipsilateral coupling
