Module 9, Year 1, 2, 3 - Scott Rosa's Material Flashcards
Describe Grabb-Oakes
Distance between the front of the spinal canal and the line drawn between the clivus angle and posterior inferior C2 body
9mm or more could either be ventral brainstem compression or transverse ligament instability
This is especially valuable in the age of upright MRI and flexion/extension MRI
Describe Harris’ Line
The distance between the basion and the posterior axial line. 12mm or more denotes instability. This measurement is also valuable with flexion and extension view.
Describe clivo-axial angle
Varies between 150 to 165 degrees at neutral and no more than 140 degrees in flexion.
Neutral 130 degrees or less indicates medullary kyphosis due to retroflexion of the odontoid, causing basilar invagination or ventral brainstem compression. Flexion will further exacerbate this, 120 degrees.
Ventral brainstem compression due to instability may also be called _________. Symptoms include…
Cervicomedullary syndrome
Heavy headache Chiari-type pressure headache aggravated by Valsalva's maneuver Dysautonomia Neck pain (often severe) Sleep apnea Facial pain or numbness (Trigeminal Neuralgia at worst) Balance and coordination impairment Muscle weakness Dizziness and vertigo Vision problems, double vision, and downward nystagmus Reduced gag reflex Dysphagia Tinnitus Nausea/vomiting Paralysis
Structures innervated by C1-C3 dorsal roots
Dura mater of the posterior cranial fossa
Inferior surface of the tentorium cerebelli
Anterior and posterior upper cervical and cervical-occiput muscles
C0-C1, C1-C2, and C2-C3 joints
Skin of occiput
Vertebral arteries
Carotid arteries
Alar ligaments
Transverse ligaments
Traps
Segmental angulation greater than _____ degrees is considered unstable, and between _______ degrees abnormal.
> 11 degrees unstable
7-11 degrees abnormal
Segmental translation between ________ mm is considered abnormal and ______ mm or more unstable
1-3mm ab
> 3mm unstable
Name the static stabilizers of the CCJ
Alar ligaments Transverse ligament Anterior atlanto-occipital membrane Anterior antlanto-axial membran Apical ligament Tectorial membrane Posterior atlanto-occipital membrane Posterior atlanto-axial membrane
T or F: Seat belts save lives, but increase the risk of cervical spine injuries by 268%.
True
