Lecture 26 - Cervical and Thoracic Spine Flashcards

1
Q

Cervical spine is composed of

A

7 cervical vertebrae divided into upper (C0-C2) and lower (C3-C7) cervical spine

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2
Q

C0-C1 is called

A

Occiput-Atlas

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3
Q

How does the occiput-atlas articulate

A

Articulates with condyles of occiput and superior facets of atlas

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4
Q

T or F: Atlas lacks a vertebral body and spinous process

A

T

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5
Q

3 movements of occiput-atlas

A

1) extension (10-15 deg)
2) Side bending (8 degree)
3) Minimal rotation

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6
Q

C1-C2 is also called

A

Atlantoaxial

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7
Q

How are the facets of the atlantoaxial aligned

A

Horizontally

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8
Q

What 4 movements is atlantoaxial responsible for

A
  1. 50% cervical rotation
  2. 10 degrees of flexion/extension
  3. 45 degrees of rotation
  4. Little to no side bending
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9
Q

What allows for increased mobility of C3-C7 compared to thoracic and lumber spine

A

Zygapophyseal (facet joints) are angulated at 45 degrees to the vertical in sagittal plane

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10
Q

What are the 4 movements of C3-C7

A
  1. Flexion (64 deg)
  2. Extension (24 deg)
    3) Side bending (40 deg)
    4) Rotation (40 deg)
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11
Q

T or F: The cervical spine (C3-C7) are not victims of wear and tear due to increased motion

A

F, they are

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12
Q

What joints make up the C3-C7 and their function

A
  1. 2 zygapophyseal (facet) joints for rotation and side bending
  2. 2 uncinate (Van Luschka/uncovertebral) joints that prevent posterior translation and some bending. Also acts as gliding mechanism for flexion and extension
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13
Q

What 3 components make up the intervertebral disc

A
  1. Annulus fibrosis
  2. Nucleus Pulposis
  3. End-plate
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14
Q

The cervical spine is reinforced by

A

Uncovertebral joints for posterior-lateral stability and protection against disc herniation

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15
Q

What is unique to the cervical spine in regards to the vertebral artery?

A

There is a foramen in C1-C6 to allow for passage of vertebral artery vertically

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16
Q

What does the vertebral artery arise from and turn into?

A

Arises from subclavian artery and turns into basilar artery

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17
Q

Where does the alar craniovertebral ligaments attach to?

A

The dens and occipital condyles of the cranium

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18
Q

What is the pathway of the alar craniovertebral ligaments (arise from and goes to)?

A

Arises from odontoid process and passes superiorly and laterally to inside of foramen magnum

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19
Q

What does the transverse craniovertebral ligament cover and attach to?

A

Covers dens and attaches horizontally to C1

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20
Q

T or F the transverse ligament forms part of the cruciform ligament

A

T

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21
Q

What 2 ligaments are important for keeping the dens in close approximation to C1 and away from the spinal cord

A
  1. Alar ligament
  2. Cruciform Ligament
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22
Q

Where does the ligamentum nuchae craniovertebral ligament extend to and from

A

Extends from spinous process of C7 to external occipital protuberance

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23
Q

What is the function of the ligamentum nuchae craniovertebral ligament?

A

Increases depth of cervical spinous process allowing for muscular attachment that helps limit cervical flexion

24
Q

What are the 5 muscles that make up the posterior upper C-spine?

A
  1. Suboccipitals (cross 1-2 vertebrae levels)
  2. Rectus capitis posterior major
  3. Rectus capitis posterior minor
  4. Obliquus capitis inferior
  5. Obliquus capitis superior
25
Q

What are the 3 muscles of the anterior upper c-spine

A
  1. Rectus capitis anterior
  2. Rectus capitis lateralis
  3. Longus colli cervicis
26
Q

What are 8 muscles that make up the anterior lower cervical spine

A
  1. Sternocleidomastoideus (SCM)
  2. Long capitis
  3. Longus colli
  4. Anterior scalene
  5. Middle scalene
  6. Posterior scalene
  7. Splenius capitis
  8. Cervicis
27
Q

Function of the longus capitis

A

Ventral flexor of c-spine and stabilizer

28
Q

Function of longus colli

A

Stabilizer of mid c-spine and provides dynamic tension of anterior longitudinal ligament

29
Q

What are the 9 muscles that make up the posterior lower cervical spine

A
  1. Splenius capitis
  2. Splenius cervicis
  3. Semispinalis capitis
  4. Semispinalis cervices
  5. Longissimus capitis
  6. Longissimus cervicis
  7. Levator scapulae
  8. Uppper trapezius
  9. Spinalis cervicis
30
Q

Importance of superficial muscles of the neck in regards to biomechanics

A

Exert more torque by acting like large lever arms

31
Q

Importance of deep muscles of the neck in regards to biomechanics

A

Segmentally arranged to guide and support cervical motion

32
Q

Why does there need to be coordination between deep and superficial muscles of the neck?

A

Deep muscles cannot support the load of the head and the superficial segments cannot support cervical segments

33
Q

What 2 muscles have the largest density of muscle spindles in the body

A

Suboccipital muscle and deep cervical muscles:
1. Multifidus
2. Longus colli

34
Q

Occipital-Atlas Joint Shape

A

Simple, synovial, ellipsoid

35
Q

Atlantoaxial joint complex shape

A

Made of 3 separate articulations (2 lateral and 1 median)

36
Q

What are the 3 laws of fryettes laws of spinal motion (dont need to know)

A

Law 1 (Neutral Mechanics): When a spine is in neutral, sidebending to one side will be accompanied by horizontal rotation to opposite side (coupled relationship)

Law 2 (Non-Neutral Mechanics): When spine is flexed or extended, side-bending and rotation will occur on same side

Law 3: When motion is introduced in one plane it will reduce or modify motion in other planes of movements. (Sums up other 2 laws by stating that dysfunction in one plane will negatively affect all other planes of movement)

37
Q

Describe the 3 principles of arthrokinematics of the C-spine (dont need to know)

A

1) Upper c-spine (neutral position) will side bend and rotate in opposite directions
2. Upper c-spine (flex or ext) will side bend and rotate in the same side
3. Lower c-spine will always side bend and rotate in the same direction

38
Q

Vertebrae of the thoracic spine vary by region with superior segments sharing commonalities with the [blank] and inferior segments becoming more like [blank]

A

c-spine and l-spine

39
Q

Vertebral bodies become..

A

larger and denser from superior to inferior to support increased body mass

40
Q

Facet joints of the thoracic spine are

A

synovial and planar

41
Q

What plane is the thoracic spine orientated in

A

Frontal plane (60 deg)

42
Q

T or F: Thoracic discs are thicker compared to cervical and lumbar spine

A

F, thinner

43
Q

What 2 factors contributes to lower mobility of thoracic spine

A
  1. Thin thoracic discs
  2. Attachment of thoracic spine to ribs
44
Q

T or F: Transverse processes correlate to the same level as spinous processes

A

F, they do not

45
Q

Do any ligaments arise from the thoracic spine

A

No, they only run through

46
Q

What 3 ligaments attach thoracic vertebrae to ribs

A
  1. Superior costovertebral ligament
  2. Medial costovertebral ligament
  3. Lateral costovertebral ligament
47
Q

What is the biggest function of the muscles in the thoracic spine?

A

Support segments from being exaggerated further into kyphotic predisposition

48
Q

What 3 muscles attach t-spine to c-spine?

A
  1. Upper trap
  2. Splenius capitis
  3. Splenius cervicis
49
Q

What 4 muscles attach t-spine to scapula?

A
  1. Rhomboid Major
  2. Rhomboid Minor
  3. Middle Trap
  4. Lower Trap
50
Q

ROM of the thoracic spine is affected by

A

Rib cage and rib articulations

51
Q

T or F: ROM is greater in the t-spine than the c and l-spine

A

F, it is less

52
Q

Can the thoracic spine move independently of the rib cage

A

Yes they can, but the rib cage increases stability of the thoracic spine

53
Q

Describe the clinical significance of end range of shoulder flexion coupled with end range thoracic extension

A

Patients with limited thoracic extension can contribute to shoulder elevation and shoulder abduction mobility impairments

54
Q

Describe the 2 consensus that make up the arthrokinematics of the thoracic spine

A
  1. Side-bending of t-spine leads to approximation of ribs on ipsilateral side and separation of ribs on other side
  2. Rotation results in posterior rotation of rib on ipsilateral side and anterior rotation of rib on opposite side
55
Q

What 2 motions does the arthrokinematics of rib motion undergo

A
  1. Pump-handle motion: anterior and superior migration of ribs at costovertebral and costotransverse joints
  2. Bucket Handle Motion: Lateral and superior migration of ribs
56
Q

T or F: Neck pain is one of the most prevalent musculoskeletal conditions

A

T