Mid-Cervical Flashcards
The mid-lower cervical spine segments are all oriented…
45 degrees to the horizontal and frontal planes
Interbody joints are located between
each vertebral body
interbody joints are located from C2/3 to
L5/S1
each interbody joint contains:
- intervertabral disc
- vertebral endplates
- adjacent vertebral bodies
the intervertebral disc contains
the annulus fibrosus and nucleus pulposus
annulus fibrosis
concentric rings of fibrocartilage tissues with each layer oriented about 90 degrees differently to optimize strength
the annulus fibrosis is thicker..
anteriorly
it is easier to herniate the disc to the posterior or anterior direction?
posteriorly because of the crescent shaped annulus fibrosis and weaker posterior longitudinal ligaments
Nucleus pulposis
- 70-90% water for shock absorption and dissipation of forces across the vertebrae
- as you get older the water in the disc is greatly reduced
Vertebral endplates
cartilaginous caps made up of connective tissue that covers a majority of the superior and inferior surfaces of the vertebral bodies
changing vertebral endplates with age
- thick at brith
- during childhood they serve as growth plates for the vertebrae
- in childhood they become thinner and only occupy about 5% of the height of each intervertebral space
another name for facet joint
apophyseal joint
facet joints in the mid-lower cervical spine
- inferior facets of the superior vertebrae face anteriorly and inferiorly
- superior facets of the inferior vertebrae face posteriorly and superiorly
Facet surfaces between C2-7
- 45 degrees between horizontal and frontal planes
- allows for motion in all 3 planes
Arthrokinematics flexion
- sagittal plane
- inferior facets of superior vertebrae slide superiorly and anteriorly
arthrokinematics extension
sagittal plane
- inferior facets of superior vertebrae slide posteriorly and inferiorly
ROM values flexion mid cervical
35-40 degrees
ROM values extension mid cervical
55-60 degrees
arthrokinematics Protraction
- sagittal plane motion
- head translates forward
- mid-lower cervical spine flexes
- upper cervical spine extends
with prolonged cervical extension
this leads to forward head postures; stress and strain on the joints and muscles
arthrokinematics of retraction
sagittal plane motion
- head translates posteriorly - mid-lower cervical spine extends and upper cervical spine flexes
Arthrokinematics lateral flexion
- frontal plane motion
- ipsilateral downslide with contralateral upslide
ROM values with lateral flexion
30-35 degrees on each side
ROM values for rotation
30-35 degrees each side (total is 65-75 degrees)
Arthrokinematics of rotation
inferior facet of superior vertebrae slides posterior and slightly inferior on the ipsilateral side; anterior and slightly superior on contralateral side
what position at the AO joint creates a posterior glide at the occipital condyles?
Flexion
what position would you put the AO joint in to create max anterior glide of L occipital condyle
Extension with L lateral flexion (side-bend) and coupled right rotation
What 2 positions could you place the OA joint in to test max posterior glide of L occipital condyle?
- flexion with R lateral flexion and couples left rotation
- flexion with L rotation and coupled right lateral rotation
what 2 positions could you place the OA joint in to test max anterior glide of the R occipital condlye?
- extension with R lateral flexion and L rotation
- Extension with L rotation and coupled right lateral flexion
Cranial cervical flexor test
assesses the strength of the deep cervical muscles (local stabilizers of the spine)
- normal is able to generate 28-30mmHg of pressure for 10 seconds without compensation
if someone has neck pain what is the normal range with the Cranial cervical flexor test
Superficial neck muscles
global muscles; larger torque producing; they transfer balance and loads during movements
with forward head posture for extended periods of time
this could result in “re-posturing” of the cervical spine
- puts a lot of stress on joints and muscles in craniocervical region
what is the median pressure achieved in individuals without and with neck pain using cranial cervical flexion test?
28mmhg without pain and 24 with pain
QQ: someone with forward head posture will exhibit all of the following EXCEPT
a) excessive protraction of craniocervical region
b) excessive retraction of craniocervical region
c) excessive flexion in mid-lower cervical region
d) excessive extension in upper cervical region
B- exscessive retraction of craniocervical region
QQ: T/F the uncovertebral joints are sites for degenerative changes in the cervical spine
True
uncovertebral joints limit
lateral flexion in the cervical spine
they permit flexion and extension
QQ: the articular facets of the cervical vertebrae (C3-7) are oriented
45 degrees to the frontal and horizontal plane
QQ: what spinal coupled motion occurs with left rotation of C3 and C4`
Left lateral flexion
QQ: T/F a tear in the transverse cruciate ligament has the potential to move the dens anteriorly and compress the spinal cord
FALSE
