Savarese Ch 2: Cervical Spine Flashcards
What is atypical about C1?
No spinous process
No vertebral body
What is atypical about C2?
It has a dens (projects superiorly from vertebral body).
What are 2 things atypical for C2-C6?
- Bifid spinous processes
- Has a foramen transversarium: foramina in the transverse process of C1-6 that allow for the passage of the vertebral artery.
What are articular pillars/lateral masses
Portions of bone of the cervical vertebral segments that lie between the superior & inferior facets
Origin/insertion of the Scalenes
O: Posterior tubercle of the transverse processes of the cervical vertebrae
I: Anterior/middle = Rib 1
Posterior = Rib 2
Action of the scalenes
Unilateral contraction: SB neck to the ipsilateral side
Bilateral: neck flexion
In forced inhalation: Anterior/middle= elevate 1st rib
Posterior = elevate 2nd rib.
Location and cause of scalene tenderpoint?
posterior to the clavicle at the base of the neck
Cause: 1st/2nd rib inhalation dysfunction
Origin/Insertion of the Sternocleidomastoid (SCM)
O: mastoid process & lateral half of the superior nuchal line
I: Medial 1/3 of the clavicle & sternum
Actions of the SCM
Unilateral: ipsilateral SB, Contralateral rotation
Bilateral: neck flexion
Muscle effected in torticollis:
Sternocleidomastoid –> Shortening/restrictions
What is the alar ligament
Extends from the sides of the dens to the lateral margins of the foramen magnum.
What is the transverse ligament of the atlas
Attaches to the lateral masses of C1 to hold the dens in place.
What are 2 conditions that can weaken/rupture the alar and transverse ligaments?
Rheumatoid arthritis
Down’s Syndrome
What results from weakening/rupture of the alar and transverse ligament of the atlas?
Atlanto-axial subluxation –> catastrophic neurological damage.
What is the most common cause of cervical nerve root pressure?
Degeneration of the joints of Luschka + hypertrophic arthritis on the intervertebral synovial (facet) joints.
What are uncinated processes?
-Superior-lateral projections originating for the posterior-lateral rim of the vertebral bodies of C3-C7.
Explain how the 8 cervical nerves exit in relation to the vertebrae
First 7: exit ABOVE their corresponding vertebrae
C8: Exit below (Between C7-T1)
What nerve roots make up the Brachial Plexus?
C5-T1
OA: Main motion and SB/rotation relation
MM: Flexion/extension
SB/R = Opposite sides
AA: Main motion and SB/Rotation relation
MM: Rotation
SB/R = Opposite sides
C2-C4: Main motion and SB/Rotation relation
MM: Rotation
SB/R: Same sides
C5-C7: Main motion and SB/Rotation relation
MM: Sidebending
SB/R: Same sides
Explain the translation/Sidebending relation:
i.e.: Right translation = ____ Sidebending
Right translation = Force from Left to Right
Right translation = Left sidebending
What is the Dx if the OA is RESTRICTED in right translation in the flexed position?
Extended, Side-bent right, rotated left
page 15
The OA translates easier to the right. Which sulcus is deep?
Right
Describe the findings in an AA that is rotated to the RIGHT.
Restriction in LEFT rotation
Rotates easier to the right.
Describe the Dx of C3 that is restricted in RIGHT translation in the flexed position.
C3 Extended, rotated right, sidebent right
What is the cause/clinical significance of SUBOCCIPITAL or PARAVERTEBRAL MUSCLE SPASMS?
Usually associated with upper thoracic or rib problems on the SAME side.
Treat thoracic area FIRST.
Which (2) techniques are best for an ACUTE injury to the cervical spine?
Indirect fascial techniques –or–
Counterstrain
Pain location/quality in cervical foraminal stenosis?
Dull ache, shooting pain, or paresthesias Neck pain radiating into the upper extremity
Signs and Symptoms of Cervical foraminal stenosis
Increased neck pain with EXTENSION
Postitive Spurlin’s test
Paraspinal muscle spasm
Posterior/anterior cervical tenderpoints
Radiological findings associated with CERVICAL FORAMINAL STENOSIS
AP/Lat: Osteophyte formation and degenerative joint changes
Oblique: narrowing of the IV foramina
