Module 1

Question 1

Stability from ligament throughout range in cervical spine

Answer 1

20% of stability supplied by ligament and this occurs at end of range, the other 80% is supplied by muscular system

Question 2

What are the names of C1 and C2

Answer 2

Atlas above axis

Question 3

What guides ROM at different level in the cervical spine

Answer 3

These ranges are guided by the discs, uncinate processes (these are either side of the vertebra) and shape of the articular facets.

Question 4

Where does 50% of cervical rotation occur

Answer 4

50% of cervical rotation occurs at C1-2 (axis)

Question 5

Movement coupling in cervical spine

Answer 5

C0-C2
- Lateral flexion and axial rotation are coupled contralaterally with medial translation

Cervical

• Lateral flexion and axial rotation are coupled ipsilaterally with medial translation

Question 6

Functional consideration for muscles in the Cx spine

Answer 6

• Superficial muscles are longer and therefore span more joints giving them greater torque capacity
• Deep sleeve have more slow twitch fibres and are arranged so that they have better segmental control of motion and the spinal curve. These are also much physically close to the vertebrae.

However, the key takeaway is that all muscle are required. Need balanced activity between the deep and superficial layers. Deep muscles to avoid segmental buckling and superficial with larger torque to hold the head against gravity.

Question 7

6 Impairments in muscle function in those with neck pain

Answer 7

• Changes in muscle behaviour → motor control strategies (deep and superficial)
• Loss of feed forward response
• Morphological changes (slow to fast twitch ect)
• Loss of muscle support in posture and movement (remember ligament only provide support at EOR)
• Loss of endurance
• Loss of strength

These responses do not automatically reverse with the relieve of pain → this is why recurrent episodes are so frequent