Lecture - Cervical Spine Flashcards
How many cervical vertebrae
7
Atypical cervical vertebrae
C1
C2
C7
5 features of typical cervical vertebrae
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
Atlas
c1
Bony ring consists of anterior and posterior arch connected by 2 lateral masses
Wildest cervical vertebra
No vertebral body or spinous process
What does the Atlanta-occipital joint permit
Noddding of the head
50% of the total range of flexion and extension of the head and neck
Atlanta-axial joint
Between C1 and C2
Responsible for 50% of the total rotation of the head and neck
Axis
C2
Provides the pivot on which the atlas rotates
Strongest cervical vertebrae
Large spinous process
Odontoid process
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
Apical ligament
Attaches between the odontoid process and the base of the skull superiorly
Odontoid process and transverse ligament
Prevent horizontal displacement of the atlas and axis
Atlantoaxial instability
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
Vertebra prominens
C7
Largest spinous process
Not bifid
Transverse process large but the foramen transversarium is small - on,y transmits accessory vertebral veins
Cervical groove
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
Spinal nerve exit
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
Cervical effects of intervertebral disc prolapse
No traversing nerve root in the cervical spine
Therefore exiting nerve root tends to be compresses by the disc
Ligamentum nuchae
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
Function of ligamentum nuchae
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
Which ligaments link the posterior elements of the vertebrae (spines and laminae)
Supraspinous ligament
Interspinous ligament
Ligamentum flavum
Anterior longitudinal ligament
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
Posterior longitudinal ligament
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
Facet joints of their cervical spine
50% flexion and extension - nodding
50% rotation - side to side
45 degree angle of lateral flexion - ear to shoulder
