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Anatomy II > UNIT 1 - CERVICAL SPINE > Flashcards

UNIT 1 - CERVICAL SPINE Flashcards

1
Q

What are the properties of a typical cervical vertebra? (3)

A
  • Bifid spinous and transverse processes (except C7)
  • Vertebra prominens (C7)
  • Transverse foramen for vertebral artery and vein
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2
Q

What are the properties of the Atlas (C1)?

A
  • Ring of bone
  • No vertebral body
  • Large superior concave articular facets
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3
Q

What are the properties of the Axis (C2)?

A
  • Odontoid process (dens) projects upwards into atlas

* Forms a pivot joint allowing rotation

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4
Q

Describe the atlanto-occipital articulation:
Joint classification
Articulations
Axis of movement and movements available

A

Joint classification:
• Synovial ellipsoid joint
Articulations
• Concave facets on upper surface of atlas
• Reciprocal convex occipital condyles on base of skull

Axis of Movement
•  Biplanar
•  20° total flexion/extension
•  ~8° lateral flexion 
• Minimal rotation
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5
Q 
Describe the atlanto-axial articulation: 
Joint classification
Axis of movement
Articulations
Joint capsule
Ligaments
Movements available
A

Joint classification: 3 synovial joint complex
• Middle pivot joint
• Two lateral plane joints

Axis of movement:
Complex

Joint capsule:
• Thick and loose

Ligaments

  1. Transverse ligament of atlas
    • Together with the longitudinal bands, forms the “cruciform” ligament
    • Attaches to a small tubercle on the medial side of each lateral mass of the atlas.
    • Attaches superiorly to the foramen magnum
    • Attaches inferiorly to the body of the axis.
    • Holds dens in place against atlas
  2. Alar ligaments
    • Project from dens up to occipital condyles

Movements
• Rotation: 15°
• Minimal flexion and extension.

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6
Q

Describe the cervical intervertebral joints:
Joint types (2)
Ligaments (5)
Movements available

A

a) Facet Joints (Zygapophyseal)
• Facets sloped AP, which allow a large amount of F/E

b) Intervertebral discs
• Secondary cartilaginous joint (symphysis)
• Thick relative to height of vertebral body

Ligaments
1.	Ligamentum nuchae
•  From Skull – C7 
•  Continuation of the supraspinous ligament
•  Principle role is to increase surface area for muscle attachments
2.	Supraspinous ligament
3.	Ligamentum flavum 
4.	Interspinous ligaments
5.	Intertransverse ligaments
Movements available
•  Flexion = 25° 
•  Extension = 85°
•  Lateral flexion = 40° 
•  Rotation = 50°
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7
Q

What are the properties of a typical thoracic vertebra?

A
  • Costal facets on the body and on the transverse process for articulation with the ribs
  • Sloping spinous processes
  • Heart shaped vertebral bodies
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8
Q

Describe the two types of thoracic intervertebral joints, and the movements available.

A 
1. Facet (zygapophyseal) 
•  Facets almost vertically A-P to allow large amount of rotation. 
Flexion/Extension = 50-70° 
Lateral flexion = 20-25°
Rotation = 35° 
2. Intervertebral discs
• Secondary cartilaginous joint
•  Thin relative to height of vertebral body
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9
Q

What are the characteristics of a typical rib? (6)

A
  • Shaft – costal groove on internal surface for transmission of nerves, arteries
  • Tubercle
  • Articular facets
  • Neck
  • Costal cartilage anteriorly for articulation with sternum
  • Enlarged head posteriorly

STANCE

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10
Q

The sternum is made up of what 3 parts?

A

a) Manubrium - Clavicular notches either side for articulation w/clavicle (SC joint)
b) Body
c) Xiphoid process

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11
Q

List the cervical flexors

A
  1. Longus colli
  2. Sternocleidomastoid
  3. Scalenus anterior
  4. Longus capitis
  5. Rectus capitis anterior
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12
Q

List the cervical extensors

A 
Levator scapulae
Splenius capitis 
Splenius cervicis 
Erector spinae
Rectus capitis 
Obliquus capitis superior
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13
Q

List the cervical lateral flexors

A 
Levator scapulae
Splenius capitis 
Sternocleidomastoid
Scalenus anterior, medius, posterior
Erector spinae
Rectus capitis 
Trapezius
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14
Q

List the cervical rotators

A 
Multifidus
Sternocleidomastoid
Splenius capitis 
Splenius cervicis 
Scalenus anterior
Semispinalis cervicis
Rectus capitis posterior major (RCPM)
Obliquus capitis inferior
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15
Q

ORIANS OF ILIOCOSTALIS THORACIS/CERVICIS?

A 
Iliocostalis thoracis/cervicis
O: 
Iliac crest and tuberosity 
Sacrum 
Spinous processes T11-L5
Supraspinous ligaments
R: 
Up and out via slips
I: 
Thoracis: 
•  Upper 6 ribs (T1-T6) and transverse process of C7
Cervicis
•  Posterior tubercles of the transverse processes of C4-C7
A: 
Unilateral: Ipsilateral side flexion / rotation
Bilateral: Trunk/neck extension
NS: 
Adjacent posterior primary rami
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16
Q

ORIANS LONGISSIMUS CERVICIS/CAPITIS?

A 
Longissimus cervicis/capitis
O: 
Cervicis: 
•  Transverse processes T1-T6
Capitis: 
•  Transverse processes of T1-T5
•  Articular processes of C4-C7
R; 
Up and out
I
Cervicis: 
•  Posterior tubercles of transverse processes C2-C6
Capitis: 
•  Posterior aspect of mastoid process 
A: 
Unilateral: Ipsilateral rotation/side flexion
Bilateral: Trunk/neck extension. 
NS: 
Adjacent posterior primary rami
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17
Q

ORIANS OF SPINALIS CERVICIS/CAPITIS?

A 
Spinalis Cervicis / Capitis
O: 
General: 
•  Spinous process to spinous process  (spinalis thoracis T11-T12) 
Cervicis and capitis:
•  Poorly developed and blend with other muscles
R: 
Upwards
I: 
Cervicis and capitis
•  Poorly developed and blends with other muscles
Spinalis thoracis (T1-T6)
A: 
Unilateral: Ipsilateral side flexion / rotation 
Bilateral – trunk extension
NS: 
Adjacent posterior primary rami
18
Q

ORIANS OF SEMISPINALIS CERVICIS/CAPITIS?

A

A) Semispinalis cervisis/capitis

O: 
Cervicis
• Transverse processes T1-T6
Capitis
•  Transverse processes T1-T6
•  Articular processes C4-C7

R: Up and in

I: 
Cervicis
•  Spinous processes C2-C6
Capitis
•  Medial impression between the superior and inferior nuchal lines of base of the skull

A:
• Unilateral action: Contralateral rotation
• Bilateral action: Trunk extension

NS:
Adjacent posterior primary rami

19
Q

What are the muscles of the

1) Antero-lateral neck?
2) Posterior neck?

A
  1. Muscles of the antero-lateral neck.
    a) Longus colli and longus capitis
    b) Scalenus anterior, medius, and posterior
    c) Sternocleidomastoid

Muscles of the posterior neck

a) Suboccipitals
- Rectus capitis posterior major / minor
- Obliquus capitis superior / inferior
b) Splenius cervicis and capitis

20
Q

ORIANS Longus Colli?

A

Longus Colli
• Thin, strap-like muscle on anterior aspect of cervical spine (posterior to trachea)
O&I:
Upper section
• From transverse processes below to anterior tubercle of atlas
Middle section
• From vertebral bodies below to vertebral bodies above
Lower section
• From vertebral bodies below to transverse processes above

R:
Vertically

A:
Cervical flexion

NS:
• Ventral rami C3-C6

21
Q

ORIANS Longus Capitis?

A

Longus Capitis
• Thin strap-like muscle running vertically on anterior aspect of cervical spine (posterior to trachea)

O:
• Transverse processes of cervical spine.

R:
• Upwards and medially

I:
• Anterolateral occipital bone

A:
Bilateral neck flexion

NS: 
Ventral rami (C1-C3/C4)
22
Q

ORIANS SCALENES?

A

Scalenes

O (common)
• Transverse processes of the cervical spine

R:
• Downwards and laterally

I:
• Anterior and middle: 1st rib
• Posterior : 2nd rib

*Brachial plexus and axillary artery emerge between anterior and middle scalene
A:
All 3 assist with respiration
Anterior
Unilateral: Ipsilateral side flexion and contralateral rotation
Bilateral: Neck flexion

Middle and posterior:
• Unilateral: Ipsilateral side flexion

NS:
• Ventral rami (C3-C8)

23
Q

ORIANS SCM?

A 
Sternocleidomastoid
O: 
TWO HEADS
Sternal: Upper surface of manubrium 
Clavicular: Upper surface of medial 1/3 clavicle

R:
Upwards

I:
• Mastoid process of the skull

A:
Assists with respiration
Unilateral: Ipsilateral side flexion and contralateral rotation
Bilateral: Cervical flexion.
Posterior fibers may extend head on neck at AO joint

NS:
Motor: Spinal part of accessory nerve (CN XI)
Sensory: Ventral rami C2-C3

24
Q

ORIANS of Suboccipitals (4)?

A

Suboccipitals

O & I:

1.	Rectus capitis posterior minor
•  From C1 to skull
2.	Rectus capitis posterior major
•  From C2 to skull
3.	Obliquus capitis superior 
• From C1 transverse process to skull 
4.	Obliquus capitis inferior 
•  From C2 spinous process to C1 transverse process

A:
Ipsilateral rotation
Bilateral: Neck extension

NS:
Dorsal rami of C1

25
Q

ORIANS Splenius Cervicis?

A 
Splenius Cervicis
O: 
Spinous processes of T3-T6 
R: 
Upwards
I: 
 Transverse processes C1-C4
A: 
Unilateral: Ipsilateral side flexion / rotation
Bilateral: Neck extension
NS: 
Dorsal rami C5-C7
26
Q

ORIANS Splenius Capitis?

A 
Splenius Capitis
O: 
•  Spinous processes C7 – T4
•  Lower half of ligamentum nuchae
R: 
Upwards
I: 
•  Mastoid process
•  Lateral 1/3 superior nuchal line
A: 
Unilateral: Ipsilateral side flexion / rotation
Bilateral: Neck extension
NS: 
Dorsal rami (C3-C5)
27
Q

What creates the anterior and posterior triangles of the neck, and what are their contents?

A

SCM separates neck into anterior and posterior triangles

Anterior triangle contents:
• Hyoid muscles

Posterior triangle contents: 
•  Scalenes
•  Levator scapulae
•  Splenius 
•  Nerves
•  Veins
28
Q

Describe the pathway of the arteries in the upper limb?

A
  1. Subclavian artery
    • Descends until the lateral border of the 1st rib.
  2. Axillary artery
    • Reaches the inferior border of teres major
  3. Brachial artery
    • Gives off deep branch (brachial artery profunda brachii)
    • Divides into radial and ulnar arteries at the elbow
29
Q

List the roots, trunks, divisions, cords, and nerve roots of the brachial plexus

A

Roots
• C5 - T1

Trunks
•Upper
•Middle
•Lower

Divisions
• Anterior
• Posterior

Cords
• Medial
• Lateral
• Posterior

Nerve roots
• Axillary 
• Musculocutanous
•  Radian
•  Ulnar 
•  Median
30
Q

Musculocutaneous nerve:

Roots to cords in brachial plexus?

A 
Musculocutaneous
Roots: C5-C7
Trunks: Upper and middle
Divisions: Anterior
Cords: Lateral
31
Q

Axillary Nerve:

Roots to cords in brachial plexus?

A 
Axillary 
Roots: C5-C6
Trunks: Upper
Division: Posterior 
Cord: Posterior
32
Q

Radial Nerve:

Roots to cords in brachial plexus?

A 
Radial Nerve: 
Roots: C5-T1
Trunks: Upper, middle, lower
Division: Posterior 
Cord: Posterior
33
Q

Median Nerve:

Roots to cords in brachial plexus

A 
Median nerve: 
Roots: C5-T1
Trunks: Upper, middle, and lower
Division: Anterior 
Cords: Medial and lateral
34
Q

Ulnar nerve:

Roots to cords in brachial plexus?

A 
Ulnar nerve:
Roots: C7-T1
Trunk: Lower
Division: Anterior
Cords: Medial
35
Q

Name two nerves that branch off the roots of the brachial plexus, and their root levels

A

Dorsal Scapular nerve (C5)

Long thoracic nerve (C5-C7 )

36
Q

Name two nerves that branch off the trunks of the brachial plexus, and their root levels

A 
Nerve to subclavius (C5-C6)
Suprascapular nerve (C4-C6)
37
Q

Name two nerves that branch off the medial cord, and their root levels

A

Medial Pectoral nerve (C8-T1)

Medial Cutaneous nerves (C8-T1)

38
Q

Name 3 nerves that branch off the posterior cord of the brachial plexus and their root levels

A 
Upper and lower subscapular nerves (C5-C6) 
Thoracodorsal nerve (C6-C8)
39
Q

What is the nerve branching off the lateral cord?

A

Lateral pectoral nerve (C5-C7)

40
Q

How do you palpate the axillary pulse on your model?

A

Feel the pulse on the lateral wall of the inferior axilla.

Anatomy II (4 decks)

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