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OPPII: Test 1 > Functional Anatomy of the C-Spine 3/25 > Flashcards

Functional Anatomy of the C-Spine 3/25 Flashcards

1
Q

how does the cervical spine have the greatest motion and variety of movement

which portion has foramen and what foramen is it

A

thicker discs
more horizontal facets
less body mass

only vertebrae with transverse foramen–> C1-C6 transmit vertebral arteries

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2
Q

what are the atypical cervical spine vertebrae

A

C1
C2

C7–> semi-atypical

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3
Q

why is C1 atypical

what are the lateral masses

A

no body
no spinous process (just a small posterior tubercle)
widest cervical vertebra

lateral masses–> act like body, articulate with occipital condyle

has a groove for the vertebral artery

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4
Q

why is C2 atypical

A

strongest cervical vertebra

has an odontoid process

  • “the dens”
  • ANTERIOR to the spinal cord
  • pivot point for head

bifid spinous process-> can feel this in the nuchal groove

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5
Q

which cervical vertebrae have bifid spinous processes

A

C2-C6

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6
Q

what are the typical vertebrae

what are the components
what is different about the superior and inferior aspects of the bodies of the vertebrae
what direction are the superior facets facing ?

A

C3-C6

superior aspect of body (concave)
inferior aspect of body (convex)

transverse foramen

superior facets
=directed superoposteriorly at 45 degrees

Bifid spinous process

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7
Q

what is significant about C7

A

most prominent spinous process (in 70% of people)

S-process not bifid

Smaller transverse foramen -does NOT transmit vertebral artery

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8
Q

how do you find cervical transverse processes

A 
Step 1: Find the EOM 
Step 2: Drop inferior from EOM, just posterior to the angle of the mandible 
Step 3: That’s C1
Step 4: Now just work your way down
Step 5: Stay Posterior to SCM
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9
Q

landmarks for C1

A

first TRANSVERSE process palpated

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10
Q

landmarks for C2

A

first SPINOUS process palpated

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11
Q

C3 landmarks

A

C3 is at the level of the hyoid bone

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12
Q

C4/C5 landmarks

A

at the level of thyroid cartilage

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13
Q

C6 landmarks

A

at the level of the cricoid cartilage

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14
Q

C7 landmarks

A

most prominent spinous process

each vertebrae is about a finger width thick

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15
Q

what is the OA joint
what are the major motions

what is the minor motion and in what directions

in which motions are the somatic dysfunctions FOUND

A

occiput moving on the atlas

major–> flexion and extension

minor –> rotation and sidebending
must occur in opposite directions due to the anterior convergence of occipital condyles

rotation and sidebending are the motions where somatic dysfunction are found

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16
Q

what is the AA
what is the major motion
what is the minor motion

A

atlas (C1) moving on the axis (C2)

Major motion = Rotation
40-50% of all rotation of c-spine

Minor motions = F/E/SB
Don’t contribute to somatic dysfxn of C1

17
Q

what are the typical joints

A

C2 moving on C3 to C7 moving on T1

18
Q

why does the OA have to have opposite motions ?

A

anterior and inferior convergence of the occipital condyles… the lateral aspect of the condyle is more cephalid than the medial aspects

the superior facets of the atlas slope inferiorly as they converge anteriorly

19
Q

how do you diagnose the OA

A

Step 1: Contact the occipital condyles with middle fingers
Contact C1 with index fingers to stabilize and isolate motion to OA
Cradle head with rest of hands
Step 2: Translate head to induce sidebending to opposite side
which way does it sidebend more freely?
Step 3: Push anterior on one condyle, then the other
which way does it rotate more freely?

Step 4: Move fingers slightly to superior aspect of condyles (inducing flexion) and rotate in restricted direction
Does it now rotate freely to the restricted side?
Step 5: Move fingers slightly to inferior aspect of condyles (inducing extension) and rotate in restricted direction
Does it now rotate freely to the restricted side?
Step 6: Put it all together (are R & SB opposite?)
OA is ____ (F/E), rotated ____ (R/L), and sidebends ____ (R/L).

20
Q

how do you diagnosis C1 (AA joint–> C1 moving on C2)

A

Step 1: Find the transverse processes of C1
Step 2: Drop just slightly posterior to transverse processes of C1
this is the articular pillar
Step 3: Flex C-spine up to C1 in order to lock out the uncinate processes
that’s a lot of flexion (you may want to stand)
Step 4: Rotate head + C1 as a unit
which way does it rotate more freely?
Step 5: Put it all together
C1 rotated ____ (R/L)

21
Q

what are the uncinate processes?

A

the joints of Luschka

small lips on superior surface of vertebral bodies

improve the stability during movement

22
Q

what is the motion of the typical C-spine

A

rotation and SB occur to the same side due to the orientation of the articular facets

23
Q

what planes do the somatic dysfunction of the typical C-spine joints involve

A

all three planes!!

F/E, sidebending , rotation

24
Q

open vs. closed facet joints cause speed bumps . what are these?

A

vertebrae usually rotates around closed facet

but open facet irritates tissues and can produce speed bumps

typical C - spine joints have rotation and SB to the same side

25
Q

how do you diagnose the typical cervicals

A

Step 1: Screen neck for TART changes
Step 2: Find the transverse processes
Step 3: Translate (push) to one side and then the other
Which way does it like to sidebend?
Remember, translation left = right SB
Step 4: Drop just posterior to transverse processes (this is the articular pillar), push anterior on one side, then the other
Which way does it like to rotate?

Step 5: Move fingers slightly to superior aspect of transverse processes (inducing flexion) and rotate in restricted direction
Does it now rotate freely to the restricted side?
Step 6: Move fingers slightly to inferior aspect of transverse processes (inducing extension) and rotate in restricted direction
Does it now rotate freely to the restricted side?
Step 7: Put it all together
C? is ____ (F/E), rotated ____ (R/L), and sidebends ____ (R/L).

26
Q

when you push on a transverse process from the back to incur rotation, what are you acutally pushing on?

A

articular pillar

27
Q

what are the major muscles that can affect my treatment of the C-spine

A 
suboccipital muscles 
trapezius
SCM
Scalenes
paraspinal muscles 
levator scapulae
28
Q

subocciptial muscles attach what to what

A

attach occiput to C1 and C2

29
Q

scalene muscles attach what to what

A

attach C3-C7 to 1st and 2nd ribs

30
Q

paraspinal muscles attach what to what

A

attach occiput and C-spine to thorax

31
Q

levator scapulae attaches to what

A

Origin at t-processes of C1-C4 b/l

Insertion at superior angle of scapula

32
Q

where are all the important superficial neovascular structures of the neck

A

anterior and medial to the SCM

the carotid triangle is anterior to the border of the SCM

33
Q

what pages in my manual should i read for this lecture?

A

76-78

OPPII: Test 1 (13 decks)

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