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cervical > part 2 (UV > Flashcards

part 2 (UV Flashcards

1
Q

What is the controversy surrounding the uncovertebral joint?

A

There is controversy about whether the UV joint comes from degenerative process or an adaptive process

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2
Q

What are the functions of the uncovertebral joint?

A
  1. guide flexion and extension
  2. allow for greater mobility
  3. prevent lateral displacement of vertebra
  4. prevent lateral disc herniations
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3
Q

What characteristics of the UV joint contribute to its function?

A

1.Joint surfaces have hyaline cartilage
2.capsular ligaments are present
3.definite space between the surfaces
4.articulations satifsy the definition of a synovial joint
5.posterior lateral position at as a barrier to disc (ie posterior lateral lumbar is where the problems are)
6.chondromalacic changes are found in the UV joint
appear to provide greater mobility compared to other areas
7.annulus ends at medial boundaries of UV joint, not the vertebral bodies

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4
Q

Where will you find UV?

A
  1. C3-C6 joints are on the lateral aspect of the body

2. C7-T1 joints are situated dorsolaterally on the body

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5
Q

When does the cleft form?

A
  1. Non uniform size and spinal level that starts as the UV joint begin around age 9-14
  2. by age 20 they have enlarged and are spreading towards mid line
  3. by age 60 the disc has bifurcated
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6
Q

Why are herniation less likely in the cervical spine as we age?

A

There are several histological changes that occur including (1) dehydration of nucleus (2) annulus weakens (3) shearing (4) fissures the disc; therefore, you have less risk for herniation

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7
Q

How can you differentiate injuries to the UV joint?

A
  1. ROM: active and passive painful in the direction of the joint
  2. ROM: SB loss greater than ROT suggestive of mid and lower cervical
  3. ROM: ROT loss greater that SB suggestive of upper cervical
  4. Special Test: compression with FLEX and SB
  5. Joint Mobility: follows the ROM loss
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8
Q

Describe the function of cervical fascia?

A
  1. hold soft tissue together and add support
  2. direct forces from muscle contraction to weight bearing tissues
  3. provide for muscle attachments
  4. divide muscle compartments
  5. divide muscles into different planes
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9
Q

What are the fascial planes of the cervical spine?

A
  1. superficial fascia- outermost layer including the platysma and fatty tissue
  2. investing fascia- surrounds the entire neck and includes the SCM, trapezius and external jugular vein
  3. Middle cervical fascia- sheath around the strap muscles including the sternohyoid, sternothyroid, omohyoid and thyrohyoid
  4. pretracheal fascia- surrounds the phyrnx, larynx, trachea, esophogus and thyroid gland and is continuous with the caroitid sheath laterally
  5. prevertebral fascia- deepest layer, strong and fibrous, covering the pre-vertebral muscles (longus capitus and longus colli) and the scalene muscles
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10
Q

What pathologies tend to have fascial components?

A
  1. Thoracic outlet
  2. forward head can have adaptive shortening
  3. cervical rib
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11
Q

What are the major vascular structures of the cervical spine?

A
  1. carotid artery
  2. jugular vien
  3. vertebral artery
  4. spinal artery
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12
Q

What does the carotid artery come off of and divide into?

A
  1. arises off the brachiocephaleic artery

2. divides at about C4 along the upper border of the thyroid cartilage into internal and external carotid arteries

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13
Q

What does the carotid artery supply?

A
  1. internal supplies ipsalateral hemisphere, the eye, the forehead and the nose
  2. external supplies structures external to the cranium
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14
Q

What does the jugular vein travel with?

A

common carotid artery

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15
Q

Where do the lymph vessels of the head dump?

A

jugular vein

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16
Q

What gives rise to the vertebral artery and what accompanies the VA?

A
  1. subclavian artery

2. plexus of veins and sympathetic nerves fibers from the stellate ganglion

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17
Q

What is the pathway of the vertebral artery in the neutral cervical spine?

A
  1. arises off the subclavian artery to enter the foramen transversarium at C7
  2. travels vertically until C3
  3. at C3 it inclines laterally to C2
  4. at C2 it inclines laterally to C1
  5. at C1 it turns at a right angle posterior and medial around the lateral mass of C1
  6. passes under the mastoid process
  7. from there it pierces the POAM to enter the foramen magnum
  8. then it runs anterior and medial to unite with the opposite VA to form the basilar artery
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18
Q

What anomalies can occur with the vertebral artery’s pathway?

A
  1. it could enter the formamen transversarium about C7
  2. it may exit the FT and reenter
  3. there may be a boney bridge (arcus ponticulus) on the posterior arch of C1
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19
Q

What gives rise to the spinal arterial branches and descried there pathway?

A
  1. vertebral artery gives rise to the spinal arteries
  2. from the VA to SPA travel through the invertebral formamen
  3. anastomoses with spinals arteries above and below to form ascending and descending rami
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20
Q

What does the spinal branches off the vertebral artery supply?

A
  1. Surrounding structures

2. periosteum and vertebral bodies

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21
Q

What path does the posterior spinal artery follow?

A
  1. They typically come off the vertebral artery but can also come off posterior inferior cerebral artery
  2. there are two posterior spinal arteries that run down the back of the spinal cord
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22
Q

What path does the anterior spinal artery follow?

A
  1. they come off the vertebral artery to for a single artery in the middle of the spinal card
  2. also supported by the spinal branches and deep cervical branches
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23
Q

How do the upper cervical structures get their blood?

A
  1. C1-No nutrient foramen so it gets it blood supply from two small arteriols anteriorly and one posteriorly
  2. C2- start to get a small nutrient foramen
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24
Q

What functional roles to the muscle of the cervical spine play?

A
  1. provide mobility
  2. provide stability
  3. provide proprioceptive feed back
  4. provide input to coordinate activity between cervical, TMJ, shoulder and respiratory system
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25
Q

What are the attachments of the splenius capitus?

A
  1. lower six cervical spinous processes, posterior cervical ligament, upper four thoracic spinous process and interspinous ligaments
  2. lateral half of the nuchal line of the occiput and mastoid process
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26
Q

What are the attachments of the splenius cervicis?

A
  1. Lower six cervical spinous processes, posterior cervical ligament, upper four thoracic spinous process and interspinous ligaments
  2. transverse process of the upper three cervical vertebrae
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27
Q

What is the function of RCPMin?

A

center the occiput on C1/atlas

28
Q

What are the attachments of RCPmin?

A
  1. central aspect of the posterior arch of C1

2. medial third of the inferior nuchal line

29
Q

What muscle attaches to the spinal dura?

A

rectus capitus posterior minor

30
Q

What is the function of the muscular attachment to the dura?

A

prevent dura hip the spinal cord with upper cervical extension

31
Q

What are the attachments of the RCPMaj?

A
  1. spinous process C2

2. just lateral to attachment of RCPMin on the inferior nuchal line

32
Q

What are the attachments of OCI?

A
  1. spinous process of C2

2. travels obliquely to attach to the transverse process of C2

33
Q

What are the functions of OCI?

A
  1. moves atlas posteriorly
  2. moves axis anteriorly
  3. decreases tension on the transverse ligament
34
Q

What are the attachments of OCS?

A
  1. transverse process of C1

2. runs superior and posterior to the lateral third of the inferior nuchal line

35
Q

What are the functions of OCS?

A

Most efficient upper cervical side bender of the suboccipitals

36
Q

What muscles make up the erector spinae group?

A
  1. longisssimus cervicis
  2. longissimus capitis
  3. spinalis cervicsl
  4. spinalis capitis
  5. iolocostalis cervicis
37
Q

What are the attachments of longissimus cervicis?

A
  1. upper four or five transverse process

2. posterior tubercles of the transverse process of C2-C6

38
Q

What are the attachments of longissimus capitits?

A
  1. upper four or five transverse process of the thoracic spine and lower three cervcial articular processes
  2. deep mastoid process
39
Q

What is the order of muscular attachments to the mastoid process?

A
  1. SCM
  2. Splenius capitis
  3. longissimus capitis
40
Q

What is the function of the longissimus muscles?

A

side bending

41
Q

What are the attachments of spinalis cervicis?

A
  1. lower ligament nuchae of the seveth cervical vertebra

2. spinous process of the axis

42
Q

What muscle does semispinalis capitis blend with?

A

spinalis capitis

43
Q

What are the attachments of iolocostalis?

A
  1. third to sixth costal angel

2. posterior tubercle of fourth to the sixth transervese process

44
Q

What are the transversospinal muscles?

A
  1. semispinalis cervicis
  2. semispinalis capitis
  3. multifidi
  4. rotators
  5. interspinalis
  6. intertransversarii
45
Q

What are the attachments of semispinalis cervicis?

A
  1. tendonis attachements from upper five or six thoracic transverse processes
  2. spinous process of C5 to C2
46
Q

What are the attachments of semispinalis capitis?

A
  1. upper six or seven thoracic transverse processes the C7 transverse process, occasionallyC4-6 articular process
  2. in between the superior and inferior nuchal lines
47
Q

What are the functions of the semispinalis group?

A
  1. most effective cervical extensor

2. maintain cervical lordosis

48
Q

What are the monosegmental muscles and there attachments?

A
  1. multifidi- lower cervcial articular process to spinous process above (sometimes spanning up to 4 segments)
  2. rotators- deep to multifidi upper posterior transverse process to the lower border and lateral surface and the lamina above
  3. interspinalis- flank the interspinal ligmanet
  4. intertransversarii- anterior and posterior slips connect TPs
49
Q

What structure is found between the two intertransversarii?

A

ventral rami

50
Q

What are the attachments of the levator scapula?

A
  1. superior angle of the scapular

2. transverse process posterior tubercles upper three to four cervcial vertebrae

51
Q

How can arm movements influence the upper cervical spine?

A

via the connection of the levator scapula and the upper cervcial spine

52
Q

What are the attachments of trapezius?

A
  • origins 1- medial third of the superior nucal line 2- external occipital protuberance 3- ligamentum nuchae 4- apies of seventh cervical vertebrae 5- thoracic spinous processes 6- supraspinous ligament
  • insersion 1- lateral third of the clavicular posterior border 2- middle fibers medial margin of the acromium 3- superior lip of the spine of the scapula 4- inferior fibers to the medial border of the scapular spine and its tubercle
53
Q

What role does the trap play in cervical fascial function?

A

strong connection to the investing fascia that surrounds the entire
creates expansion forces to give support to the structures of the neck by tensioning the fascia

54
Q

What are the attachments of rectus capitis lateralis?

A
  1. jugular process of the occiput

2. anterior tubercle of C1

55
Q

How is RCL oriented?

A

parallel to the longitudinal axis therefore is a flexor side bender

56
Q

What are the attachments of rectus capitus anterior and how is it oriented?

A
  1. basi occiput
  2. anterior portion of the C1 lateral mass and anterior tubercles
  3. oriented in an oblique, inferior, and lateral plane
57
Q

What are the attachments of longus colli?

A

three divisions- inferior oblique, superior oblique and vertical

  1. inferior oblique- front of first two or three thoracic bodies -> anterior tubercles of fifth to sixth cervical transverse process
  2. superior oblique- anterior tubercles of third to fifth cervical TPs -> anterolateral anterior tubercle of the atlas
  3. vertical- anterior upper three thoracic and lower three cervical bodies -> anterior bodies of C2-4
58
Q

What important anatomic structures are close to the longus colli?

A
  1. sympathetic chain

2. vertebral artery

59
Q

What are the attachments of longus capitis and what is it also known as?

A

rectus capitus anterior major

60
Q

What are the attachments of the scaleni muscles?

A
  1. transverse processes of C1 to C7 to the first and second rib
  2. Anterior- anterior tubercle C3-C6 -> 1st rib
  3. middle- posterior tubercle C2-C7 -> 1st rib
  4. Posterior- posterior tubercle of C4-C6 -> 2nd rib
61
Q

What are the functions of the scaleni?

A
  1. Side bender
  2. extensor if longus colli is quiet
  3. flexor if longus colli is active
  4. Check shearing forces
62
Q

How does longus colli change scaleni function?

A

an active longus colli with change the scalens form extensors to flexors

63
Q

What are the attachments of SCM?

A
  1. mastoid process

2. inserts with two heads in the the sternum and clavicle at the SC joint

64
Q

What are the functions of SCM?

A
  1. Side bend same, rotate opposite
  2. flexion of cervical spine
  3. extension of upper cervical spine
  4. increases lordosis
  5. anterior movement of the TMJ
65
Q

What muscles does the SCM work in synergy with

A

deep transversospinals

cervical (6 decks)

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