Part 1 (bone, lig disc) Flashcards
What unique functions does the cervical spine have?
- most mobile area of the spine
- Provides protection for vital structures such as spinal cord, sympathetic nerves, esophagus, trachea, arteries
- Supports and balances the head
- Extensive sensory function in support of positioning for eyes, ears and nose
- Upper cervical spine has the capacity to move independent of the rest of the spine
What anatomical features of the cervical spine are similar to the rest of the spine?
- body
- pedicales
- transverse processes
- neural foramina
- articular facets
- meniscoids
- lamina
- spinous processes
How are the neural foramina oriented in the cervical spine?
oriented anteriorly and inferiorly 10-15 degrees
How do the foraminal openings in the cervical spine vary?
- C1 adn C2 don’t have them
- C3 is the largest
- C7 is the smallest
What are the variations in the cervical vertebrae anatomy from the rest of the spine?
- foramen transversarium
- uncinate process
- bifid spinous process
- smaller vertebral bodies
- triangular vertebral canal
- short transverse process with foraminal gutter
- C1 and C2 are completely different
What is in the foramen transversarium?
- vertebral artery
- plexus of veins
- sympathetic nerve fibers
What is the foramen traversarium?
- Foramen through the transverse process in all cervical bodies except C7
- formed by an isthmus of bone extending from the body to the anterior tubercle
- located 3-6 mm from uncinate process and 2-3 mm from the facet
What are the characteristics of the cervical TPs?
- Shorter
- have a foraminal gutter
- have an anterior orientation pf about 1-=15 degrees
- Anterior and posterior tubercles
- anterior is actually a rudimentary rib
- Posterior is actually the true transverse process
How do the vertebrae differ as you transition into the thoracic spine from the cervical spine?
- Uncovertebrals disappear
- ribs appear
- body and pedicales become thicker
- spinous processes lengthen
- spinous process angle inferiorly
- transverse processes are longer and thicker
- facets become more vertically oriented
What does the articulating surface of the occiput look like?
- condyles- kidney pattern, but can be wasp shaped or have separate anterior and posterior facets
-Convex laterally, oriented inferior and lateral with long axes converging anteriomedially - condylar fossa located behind the condyle
accommodating the posterior margin of the super facet of the the atlas
How is the atlas different?
- No vertebral body
- No vertebral foramen
- Odontoid of C2 serves as its body
- Slim anterior and posterior arch
- Facet on the posterior part of the anterior arch for the articulation with the dens
- Wedge shaped lateral masses resembling a meniscus
- Biconcave superior articular surfaces above the lateral mass with shape patters like condyle
- foramen transversarium is loacated lateral to the articulating surface
- No pedicales
- No spinous process or Nutrient foramen
- Inferior articulating surface is biconvex
How is the axis different?
- small body with the dens on it
- Articular surface on the anterior part of the den with C1 anterior arch
- Lateral mass are wing shaped
- Superior articulating surface sits on the lateral mass
- Bi convex superior articulating surface
- Inferior articulating facet is located behind superior and is the first “normal” cervical facet
- No intervertebal foramen so nerve sits in sulcus behind lateral masses
- Largest spinous process of cervical spine
What are the attachments of the ALL?
1Basilar aspect of occipital bone 2anterior tubercle of C1 3anterior C2 body 4skips boney rim 5disc 6continues down to the sacrum
What are the different parts of the ALL?
- Superficial layer- cross several segments to attach to the body
- intermediate layer- cross only one segment to attach only half way up or down the body
- deep layer- one segment from superior to inferior margin
- fourth layer- travels inferior and lateral like the alars
What are the attachments of the AAOM?
base of the occiput to the anterior arch of the atlas covering the anterior margin of the
What does the AAOM blend with?
- laterally with capsular ligaments
2. anteriorly with the ALL
What are the attachments of the apical ligament?
tip of the dens to the base of the occiput
What does the apical ligament blend with
- AAOM
2. cruciform ligament
How is the apical ligament oriented and how long is it?
- 20 degrees anterior tilt
2. about 23.5 mm
What are the attachments of the alar ligament?
odontoid to the occiput as well as lateral masses of C1
How is are the alar ligaments oriented?
- They run down and in and their angle can vary depending on the height of the dens
- Panjabi indicates they are angulated about 70 degrees in the transverse plane and there is considerable variation