Lecture - Cervical Spine

Question 1

How many cervical vertebrae

Answer 1

7

Question 2

Atypical cervical vertebrae

Answer 2

C1
C2
C7

Question 3

5 features of typical cervical vertebrae

Answer 3

Body is small and broad 
Large triangular vertebral foramen 
Bifid spinous process (except C7)
Transverse foramen - conduit for the vertebral artery and vein 
Articular facets in the coronal place

Question 4

Atlas

Answer 4

c1
Bony ring consists of anterior and posterior arch connected by 2 lateral masses
Wildest cervical vertebra
No vertebral body or spinous process

Question 5

What does the Atlanta-occipital joint permit

Answer 5

Noddding of the head

50% of the total range of flexion and extension of the head and neck

Question 6

Atlanta-axial joint

Answer 6

Between C1 and C2

Responsible for 50% of the total rotation of the head and neck

Question 7

Axis

Answer 7

C2
Provides the pivot on which the atlas rotates
Strongest cervical vertebrae
Large spinous process

Question 8

Odontoid process

Answer 8

Dens or odontoid peg
Projects vertical upwards from the body of the axis
Vestigial remnant of C1 body
Held by transverse ligament of the atlas
Pivot joint

Question 9

Apical ligament

Answer 9

Attaches between the odontoid process and the base of the skull superiorly

Question 10

Odontoid process and transverse ligament

Answer 10

Prevent horizontal displacement of the atlas and axis

Question 11

Atlantoaxial instability

Answer 11

Excessive movement of C1 and C2 vertebrae
Can be congenital
More likely- acute trauma or degenerative changes in rheumatoid arthritis

If spinal cord/ adjacent nerve roots compressed, neurological symptoms

Question 12

Vertebra prominens

Answer 12

C7
Largest spinous process
Not bifid
Transverse process large but the foramen transversarium is small - on,y transmits accessory vertebral veins

Question 13

Cervical groove

Answer 13

Groove for Spinal nerve runs across the superior aspect of the vertebral pedicle between the anterior and posterior tubercles of the transverse process

Spinal nerve passes posterior to vertebral artery

Vertebral artery ascends through the foramina transversaria in C1- C6

Question 14

Spinal nerve exit

Answer 14

Each spinal nerve exits above its respective vertebral body until C7/T1 junction

Spinal nerve roots leave the cord more horizontal to pass through the intervertebral foramina

Question 15

Cervical effects of intervertebral disc prolapse

Answer 15

No traversing nerve root in the cervical spine

Therefore exiting nerve root tends to be compresses by the disc

Question 16

Ligamentum nuchae

Answer 16

Thickening of the supraspinous ligament

Extends from the external occipital protuberance of the skull and the median of the unchallenged line to the spinal process of C7

Anterior border -fibrous lamina attaches to the posterior tubercle of the atlas and cervical spinous processes

Continuous inferiorly with the supraspinous ligament

Question 17

Function of ligamentum nuchae

Answer 17

Maintain secondary curvature of the cervical spine

Assist the cervical spine to support the weight of the head

Major site of attachment of the muscles in the neck and trunk I.e trapezius, rhomboids

Question 18

Which ligaments link the posterior elements of the vertebrae (spines and laminae)

Answer 18

Supraspinous ligament
Interspinous ligament
Ligamentum flavum

Question 19

Anterior longitudinal ligament

Answer 19

Stronger than posterior longitudinal ligament

Runs continuously from tubercle of the atlas to the sacrum

Loosely attached to intervertebral discs and mobile

Prevents hyperextension of the vertebral column

Question 20

Posterior longitudinal ligament

Answer 20

Posterior tovertebral body

From axis C2 to sacral canal

Superior to axis - tectorial membrane of the Atlanto-axis joint

Prevents hyperflexion of the vertebral column

Intervertebral disc prolapse tends to occur lateral to it - parade trail disc herniation

Question 21

Facet joints of their cervical spine

Answer 21

50% flexion and extension - nodding
50% rotation - side to side
45 degree angle of lateral flexion - ear to shoulder