Mid-Lower Cervical Flashcards
Uncinate Processes
- what
- where
- clinical significance
lateral "hooks" -superior aspect of vertebral body uncovertebral joints -pseudo joints -limits lateral flexion significance -degenerative changes and compressive forces may lead to nerve root impingement
articular processes
- other name
- what type of joint
- formed by
- orientation
- function
facet joints type -flat plane synovial facet joints formed by -superior and inferior articular processes of adjacent vertebrae oblique orientation guides vertebral motion
C2 facet orientation
20 degree orientation to the horizontal plane
C3-C7 facet orientation
45 degrees to the horizontal and frontal plane
flexion C2-C7
- how much
- motion follows _____ plane created by _____
- facets slide ____
- limited by
35-40 motion follows oblique plane created by facets in the apophyseal joints facets slide "open" limited by -posterior structures --PLL --ligamentum nuchae --interspinous ligaments --muscles
extension C2-C7
- how much
- facets _____ in the _____ direction
- limited by
55-60 facets "close" in the posterior direction limited by -anterior structures --ALL -approximation of apophyseal joints -muscles
lateral flexion C2-C7
- how much
- superior facet movement
35-40
superior facet arthrokinematics
-ipsilateral side slide inferior and posteriorly
-contralateral side slide superior and anteriorly
axial rotation C2-C7
- how much
- inferior facet movement ipsilateral and contralateral
30-35
ipsilateral
-inferior facet slides posteriorlyand slightly inferior the ipsilateral side of rotation
contralateral
-inferior facet slides anteriorly and slightly superior
spinal coupling C2-C7
-what happens
lateral flexion and axial rotation are coupled ipsilaterally
example
-right lateral flexion occurs with a small amount of right axial rotation
controversial topic
how many degrees of lordosis should you have in the cervical spine
30-35
interbody joints
- location
- types of joints
located from C2C3 to L5S1
synarthrodial joints
-cartilaginous
-permit slight to no amount of movement
interbody joints
- each joint is composed of…
- function
composed of -intervertebral disc -vertebral endplates -adjacent vertebral bodies function -optimizes function of the spine
facet joint surfaces C2-C7
45 degrees between the horizontal and frontal planes
“shingles on a roof”
allows for motion in all 3 planes
arthrokinematics of C2-C7 flexion/extension
-total amount of movement
flexion
-inferior facts of the superior vertebrae slide superiorly and anteriorly
-35-40
extension
-inferion facts of the superior vertebrae slide posteriorly and inferiorly
-55-60
what prevents hyperflexion in the C-spine
ligaments -ligamentum nuchae -PLL -interspinous muscles
what prevents hyperextension in the C-spine
ALL
muscles
trachea
arthrokinematics during protraction
- what happens acutely
- what happens if you are there for an extended period of time
sagittal plane motion head translates forward -mid-lower cervical spine flexes -upper cervical spine extends extended time -leads to forward head posture -stress/strain on joints and muscles
arthrokinematics during retraction
head translates posteriorly
- mid-lower cervical spine extends
- upper cervical spine flexes
arthrokinematics of lateral flexion
frontal plane motion 30-35 degrees each side inferior facet of superior vertebrae slides inferior and slightly posteriorly on the ipsilateral side and superior and slightly anteriorly on the contralateral side the ipsilateral side -facets downslide aka close contralateral side -facets upslide aka gap
arthrokinematics of rotation
horizontal plane motion
30-35 degrees on each side
total ROM 65-75 degrees on each side
inferior facet on the superior vertebrae slides posteriorly and slightly inferiorly on the same side as the rotation and anteriorly and slightly superiorly on the opposite side of rotation
rotation is greatest in the most cranial segments
-facet orientation changes as you reach the T-spine
what position at the AO joint creates a posterior glide
flexion
what position would you place the AO joint in to create a maximal anterior glide of the left occipital condyle
extension
ipsilateral lateral flexion
cervical musculature deep muscles
-functions
local stabilizers of the spine
attach directly to vertebrae
control intersegmental motion (stiffens)
control the position of the vertebrae
longus capitis and colli functions
“dynamic” anterior longitudinal ligament
vertical stability
key muscles in cervical rehabilitation
cervical spine superficial muscles functions
global muscles
larger torque producing muscles
transfer and balance external loads during movements
with forward head posture, what happens at the
- TMJ
- upper cervical spine
- mid-lower cervical spine
TMJ
-
effects of aging
recurrent loads over time change morphology vertebral bone changes -reduction in trabeculae -challenges system to withstand loads vertebral disc changes -loss of proteoglycans --> reduced water content -l;oss of elastin osteophytes long term effects from diseases
