lecture 2A: cervical spine anatomy and biomechanics review Flashcards
what is the purpose of cervical spine
stability allowing full mobility
protect spinal cord
what is in the anterior column of the C spine
- vertebral bodies
-IVD - hydraulic and WB portion providers shock absorption
what is in the posterior column of the C spine
- Articular processes
- Zygapophyseal (facet) joints
- Provides gliding mechanism for movement
each spinal segment consists of ___ joints
3
the anterior spinal segment have ___ vertebral bodies and IVD
2
what is the articulations of the posterior spinal segment in the c spine
superior articular processes of inferior vertebra and inferior articular processes of superior vertebra
in the c spine the _ articular surfaces favor _ rotation
horizontal
axial
in the C spine ___ articular surfaces ___ axial rotation
vertical
block
the C spine starts mostly __ and moves toward ___ in lower segments
horizontal
45°
• Disc-vertebral height ratio
• Compliance of fibrocartilage
• Dimensions and shape of
adjacent vertebral end plates
• Age
• Disease
• Gender
these all effect what in the spine
the amount of available motion
• Shape and orientation of
articulations
• Ligaments and muscles of
segment
• Size and location of segment’s
articulating processes
these affected what kind of motion in the c spine
the type of motion
what is the largest a vascular strucutre in the body
IVD
each disc has 3 parts … what are they
• NP
• AF
• End plate
where are cervical and lumbar IVD thicker ? amd what does it create
thicker in the anterior portion and creates lordosis
does IVD move by itself
no
what are the 5 major stresses that the IVD resist
- Axial compression
- Shearing
- Bending
- Twisting
- Combined motion
what is apart of the CV junction
atlas, axis and head
what is teh CT junction
where the mobile lower c spine meets much stiffer upper t spine
where is the thoracolumbar junction
located between T spine w large ability to rotate and L spine w limited rotation
where is the lumbosacral junction
mobile L spine meets relatively stiff SI joints
what are the 2 types of stability of the spine
mechanical (static) stability
controlled (dynamic) stability
what does the passive system under the controlled stability resist
ability to resist forces of translation , compression and torsion (especially at end range)
what dynamic stability controls the feed forward and feedback control
CNS
what equals function in the spine
local mobility and global stability
what does the cranio vertebral refer to
- Occiput (head … aka C0)
- Atlas (C1)
- Axis (C2)
injuries to the cranio vertebral region can involve what
- brain
- BS
- SC
injuries to the Cranio-vertebral can result in what
- death
- HA
- vertigo
- cognitive and sympathetic system dysfunctions
what attaches to the anterior surface of the forman magnum (C0)
alar ligaments
what is housed posteriorly in the forman magnum (C0)
BS - SC junction
SC comes out of this hole
what is a ring like strucutre where the transverse ligament attaches to the
atlas (C1)
what does C1 not have ??? and what motion is available more
does not have a SP
CV extension is more bc no SP
what joint is th only vertebral level where convex condyle move on concave facet of atlas
occipito atlantal (OA) joint
what serves as transitional vertebra and links CV and c spine
axis (C2)
what is the first palpable midline strucutre after occiput
axis (C2)
what is a unique feature of the axis (C2)
odontoid process (dens)
what ligament passes along the posterior surface of the dens (axis C2)
transverse ligament
where does the dens extend
superiorly until above C1
t/f: the dens are susceptible to fx
TRUE
what is the main function of the atlanto-axial joint (AA) (C1-C2)
rotation
what 2 ligaments do we care about most in the cranio vertebral area
alar and transverse
if there is excessive translation of C1 on C2 then it would lead to what
dens compressing SC, epipharynx, vertebral artery and or superior cervical ganglion
insufficiency of the alar ligaments could lead to ___ potential for ____ instability which may present w clinical findings such as neuro or vascular compromise , pain and deformity
Increase
OA
what ligament gives stability at C0-C1 (OA joint)
alar lig
what ligament gives stability at c1-c2 joint
transverse
what mm are included in the anterior sub occipital mm
- Rectus capitis anterior
- Rectus capitis lateralis
what mm are included in the posterior sub occipital mm
- Rectus capitis posterior major
- Rectus capitis posterior minor
- Obliquus capitis inferior
- Obliquus capitis superior
the posterior ramus of C2 is a large ___ ___ ___ that is easily compression between C1 and C2 during c spine ___
dorsal root ganglion
extension
the posterior ramus of C1 follows what artery
vertebral
what spinal nerves is implacited as a primary cause of cervicogenic HAs
OA, AA and C 2
the c spine cord is supplied by whar 2 arterial systems
• Central
• Peripheral
what artery suplies the central and parts of the peripheral systems
anterior spinal artery
Anterior spinal artery supplies central and parts of peripheral systems, which may what infarctions rare
unilateral SC
what is the SB and rotation relationship in the cranio vertebral region (c spine)
opposite so L SB with R rotation
is the upper or lower c spine responsible for 50% of ROM
upper
what 2 articulations permits PURE AXIAL ROTATION
- AA joint (C1-2)
- T-L junction (T12-L1)
how does the OA (atlanto occipital) move
convex C0 moving on concave C1 facet (roll and slide in opposite direction)
Deep sockets on C1 + no IV disc
= ___ bony congruency
increased
what motion does
the OA joint encourage
flexion/extension
where does 60% of total cervical rotation occur
AA (atlanto axial) joint (C1-C2)
in the AA joint if there is a large arc of rotation what can it cause
compression of vertebral artery
the AA joint is big on ex in nature so what does that mean for the motions
opposite motions occur between lower c spine and atlas
ex: lower c spine flexion w upper c spine extension on
the upper c spine flexion increases space between the atlas (c1) and dens (c2) which can lead to what
exce3ssive gapping can lead to spinal cord compression
what is part of the lower c spine region
C2- C7
the c spine consists of how many joints
37 joints
what spinal region permits the most motion
lower c spine
what is the 3 functions of the lower c spine
- complex, and quick movements for ADLs
- positioning of eyes
- protects vital structures
is there more mobility or stability in the lower c spine
mobility
how are the vertebral bodies in the lower c spine
smaller
in the lower c spine the bifid SPs is at the ___ level as the TPs
same
where is the uncinate processes on the VBs in the lower c spine
on supero lateral portion
uncoverttebral joints limit SB and stabilize IVDs
how are the facet joints in the c spine
at 45° from frontal plane so rotation is aloud
how many IVD are there in the lower c spine and how are they names
6 and it is named for the vertebra above
ex: C4 disc sits between c4 and c5
when does teh NP of the lower c spine fibrose by
3rd decade of life
most 40 y/o have cervical disc degeneration
what is Degenerative disc disease (DDD)
↓’d disc height results in ↑’d load
how many spinal nerve root pairs does the cervical foramina house
8
large nerve roots nearly fill the diameter so if anything make the hole smaller then it will compress the n
what houses 8 spinal cord segments
vertebral canal
what is the vertebral canal and what is common here
narrow space between spinal cord and bony walls
disc hernimation common
what are teh deepest cervical flexors
- Longus Capitis/Longus Colli
- Rectus Capitis Anterior/Lateralis
what is the deeper mm of the c spine
• Splenius capitis/cervicis
• semispinalis capitis/cervicis
• Erector spinae
what is the superficial mm of the c spine
• Trapezius
• SCM
• Levator scapulae
• Rhomboids
• Scalenes
the C spine is the only region that has more __ roots then ____ levels of
nerve roots than vertebral levels
C8 n root but no vertebrae
where does C1-C3 refer pain patterns to
head and neck
where does C4-C8 refer pain patterns to
shoulder
anterior chest
UE
scap
Proprioception influences posture through
____, ____ movements and
accommodation
reflexes and eye
what CN innervated traps and SCM
11
where is the vertebral artery most vulnerable to compression and stretching at
C1-C2
the carotid artery structures sense changes in what
- O2 and CO2 levels
- Blood pressure
how was the facets move for flexion in the lower c spine (C2-C7)
facets move up and forward
how was the facets move for extension in the lower c spine (C2-C7)
facets move down and back
how was the facets move for R sidbending in the lower c spine (C2-C7)
R facet moves down and back,
L facet moves up and forward
how was the facets move for R rotation in the lower c spine (C2-C7)
• R facet moves down and back,
L facet moves up and forward
what is rotation coupled with in the lower c spine (C2-C7)
SB … occurs to same side as rotation
what is restricted with a closing restrictions in the C spine
Restriction of extension, R side bending, R rotation (same side of pain)
what is restricted with a opening restrictions in the C spine
Restriction of flexion, L side bending and L rotation (opposite side of pain)
so R sided problem
what is restricted with a opening restrictions in the C spine
Restriction of flexion, L side bending and L rotation (opposite side of pain)
so R sided problem
