iRA/tRA- C-Spine Anatomy and Biomechanics Review

Question 1

What are the typical cervical vertebrae?

Answer 1

C3-C7

Question 2

Describe each of these structures of the cervical vertebrae:

• Body
• Uncinate Processes
• Pedicles
• Transverse Processes

Answer 2

• Body- small, broad
• Uncinate Processes- prominence on lateral discal surfaces of superior body; saddle shape (uncoverteral joints)
• Pedicles- posterolateral projection
• Transverse Processes- transverse foramen (except C7), anterior and posterior tubercles located on processes

Question 3

The cervical spinous process is bifid except for which vertebrae?

Answer 3

-C7 and commonly C6

Question 4

What are the foramen of the cervical vertebrae?

Answer 4

• spinal
• intervertebral
• foramen transversarium

Question 5

C1 is known as the ______ and is divided into what 2 portions?

Answer 5

• Atlas (bony ring)

- anterior and posterior arch

Question 6

The anterior arch of C1 has a posterior surface that articulates with the _______ from C2. The anterior arch also has an anterior tubercle.

Answer 6

dens

Question 7

The posterior arch of C1 has a groove for the _________ artery. It also has a posterior tubercle which is the attachment for ____________.

Answer 7

• vertebral

- ligamenta flava

Question 8

What part of C1 articulates with the occipital condyles?

Answer 8

lateral masses

Question 9

The transverse processes of C1 are ______ than C2-C6 and are palpable between mastoid processes and ramus of mandible.

Answer 9

longer

Question 10

• C2 articular pillars superior facets are slightly _______.

- C2 articular pillars inferior facets are oriented ________ and __________.

Answer 10

• convex

- inferiorly and anteriorly

Question 11

What protrudes from the body of C2 and is the axle for head rotation?

Answer 11

dens

Question 12

What are the stabilizing ligaments of the dens?

Answer 12

• transverse ligament
• apical ligament
• alar ligaments

Question 13

What is the intervertebral disc made up of?

Answer 13

• nucleus pulposus
• annulus fibrosis
• vertebral endplates

Question 14

The nucleus pulposus is a semifluid, mucoid material that can be _______, but not compressed.

Answer 14

deformed

Question 15

The vertebral endplate has what 2 layers?

Answer 15

• hyaline cartilage- towards vertebral body

- fibrocartilage- towards nucleus

Question 16

The vertebral endplate is _______ attached to the vertebral bodies and ________ attached to the IV disc.

Answer 16

• weakly

- strongly

Question 17

How do the vertebral discs get nutrients?

Answer 17

Since they are not vascularized, they rely on diffusion from the end plates compression.

Question 18

Is the annulus fibrosis thicker anteriorly or posteriorly?

Answer 18

anteriorly

Question 19

The posterior annulus has a ________ fissure that allows for swinging motion of cervical vertebral bodies.

Answer 19

transverse

Question 20

The zygopophyseal joint is synonymous with _____ joints and ________ joints.

Answer 20

• facet

- apophyseal

Question 21

What type of joint is the z-joint and what is its function?

Answer 21

• synovial joint (lining surrounded by capsule)

- guide and limit movement of spine

Question 22

• -What is the leaf-like fold of synovium that encloses fat, collagen, and blood vessels. It projects up to 5mm into the joint cavity of the z-joints.
• What is the function of the fibro-adipose meniscoid of the z-joints?

Answer 22

-Fibro-adipose meniscoid

Transmits loads and protects articular cartilage that would otherwise be exposed during motion.

Question 23

-Is the fibro-adipose meniscoid of the z-joints innervated?

Answer 23

Yes, highly innervated

Question 24

Can we feel pain in the vertebral disc?

Answer 24

Only when it gets to the outer layers where the sinuvertebral nerve is located.

Question 25

Where are the joints of Luschka located?

Answer 25

Between the uncinate process of vertebrae below and inferolateral border of superior vertebrae.

Question 26

What type of joint is the joint of Luschka?

Answer 26

synovial

Question 27

The multifidi are important in cervical spine ________.

Answer 27

stabilization

Question 28

What are the 4 suboccipital muscles?

Answer 28

- Obliquus Capitis Inferior - Obliquus Capitis Superior - Rectus Capitis Posterior Major - Rectus Capitis Posterior Minor

Question 29

The scalenes can act to ________ the lordotic curve of the cervical spine when the longus colli isn't active.

Answer 29

increase

Question 30

What are the 3 parts of the cruciate ligament?

Answer 30

- Transverse - Transverso-occipital - Transverso-axial

Question 31

What movement does the cruciate ligament check?

Answer 31

cervical flexion

Question 32

The alar ligaments go from the _____ to the occipital condyles and limit C1-C2 ________.

Answer 32

- dens | - rotation

Question 33

The apical ligament goes from the apex of the dens to the anterior ________________.

Answer 33

foramen magnum

Question 34

The tectoral membrane goes from the posterior body of ____ to above foramen magnum.

Answer 34

C2

Question 35

The posterior longitudinal ligament blends with the tectoral membrane and spans from the posterior body of C2 to the ______.

Answer 35

sacrum

Question 36

The ________________ ligament blends with the anterior bodies and anulus/end-plate.

Answer 36

ALL (anterior longitudinal ligament)

Question 37

The ligamenta flava connects adjacent _________ and check cervical ________.

Answer 37

- laminae | - flexion

Question 38

The ligamentum nuchae is continuous with the ____________ ligament.

Answer 38

supraspinous

Question 39

What are the clinical implications of compression of nerve roots PRIOR to convergence?

Answer 39

We could have possible sensory OR motor impairment

Question 40

The brachial plexus passes between the _______ and ________ scalene muscles. The _________ sheath surrounds the plexus. The cords pass deep to the clavicle and pec minor.

Answer 40

- anterior and middle | - axillary

Question 41

What are some reasons for differing normative values for the c-spine?

Answer 41

- differences in studied populations - differences in measurement tools - confusion between PROM vs. AROM