Mid cervical

Question 1

I. Structure

Answer 1

a. C3-C6 = typical cervical vertebrae
b. Transverse foramina for vertebral artery
c. Uncinate processes on either side of body
i. Uncovertebral joints/Joints of Luschka
1. No synovial sheath
2. Articulate with adjacent superior vertebra
3. Dengenerative changes = osteophytes, nerve root impingement

Question 2

a. Articular processes/pillars

Answer 2

i. Stacks formed by superior & inferior articular facets
ii. Plane joints, enclosed in synovial capsule
iii. Superior articular facets
1. Face posterior & superior
iv. Inferior articular facets
1. Face anterior & inferior

Question 3

a. Facets

Answer 3

i. Mid-lower C-spine facets have a 45° orientation flex/ext, rotation, lat flex
ii. C4-C5-C6 have highest ROM and have highest risk of spondylosis (degeneration of IV discs) & hyperflexion fractures

Question 4

I. Kinematics (C2-C7)

a. Flexion: 35-40°

Answer 4

i. Facets slide ‘open’
ii. Inferior face of superior vertebrae slide anteriorly & superiorly
iii. Limited by posterior structures (PLL, ligamentum nuchae, interspinous ligaments, mm)

Question 5

a. Extension: 55-60°

Answer 5

i. Facets ‘close’ in posterior direction
1. Inferior face on superior vertebra slides down, moves posterior & inferior
ii. Limited by anterior structures (ALL, mm)
iii. *Closed-packed position

Question 6

a. Lateral Flexion (35-40° each side)

Answer 6

i. Right lateral flexion: right facets ‘close down’ while left facets ‘open up’

Question 7

a. Axial Rotation: (30-35° each side)

Answer 7

i. Ipsilateral inferior facets slide posteriorly & inferiorly
ii. Contralateral inferior facets slide anteriorly & superiorly

Question 8

a. Spinal Coupling

Answer 8

i. Lateral flexion & axial rotation are coupled ipsilaterally
1. Right lateral flexion with small right axial rotation