Upper Cervical Flashcards
What are the effects of a hyperlordotic curve
posterior disc compression
tensile stress anteriorly to the disc and myofascial structures
Shortening of posterior musculature
possible predisposition to facet syndrome
What are the effects of a hypolordotic curve
compression of the anterior disc
prolonged stress on the posterior ligaments
shortening of anterior cervical muscles
protective splinting
What is the degrees of flexion in the cervical spine
60˚
What is the GROM for extension in the cervicals spine
75˚
What is the GROM for lateral flexion in the cervical spine
45˚ to each side
What is the GROM for rotation in the cervical spine
80˚ chin to shoulder
What are the big trends for flexion extension in the cervical
Most in CO-C1
Least C2-3, and C7-T1
What is the combined range for flexion/extension of C0-1
25˚
What is the IAR for flexion/extension CO-C1
just above odontoid
What is the paradoxical movement of the occiput for flexion/extension
during cervical flexion a large percentage of the population will extend at CO-C1 at end range of cervical flexion
During flexion what direction is the roll? What direction is the slide?
Roll: Anteriorly
Slides: Posteriorly
What is the SROM for lateral flexion at CO-C1
5˚ each side
What limits the lateral flexion of CO-1
Alar ligaments
What is the IAR for lateral flexion of C1-0
located midway between odontoid tip and EOP
What is occuring on the articular surface of CO-1 during lateral flexion
C0 is gliding down the ipsilateral articular surface while the contralateral side glides up
What are the two patterns of motion of lateral flexion in C0 - C1
Predominately a movement in the coronal plane
coupled with contralateral rotation
What is the SROM of rotation of CO-1
5˚ to each side
What occurs at the articular surface during rotation of CO-1
C0 articular surface slides posterior and superior on the ipsilateral articular surface of C1. On the contralateral side it slides anterior and superior
What is the main feature of the C1-2 joint articulation besides the odontoid
That the facets of both bones are convex
What is the type of cartilage lines the posterior portion of the ondontoid
fibrocartilage
What is the SROM for flexion/extension at C1-2
Combined motion of 20˚
What is the IAR for flexion/extension C1-2
middle third of dens
What is the pattern of motion for C1-2
angular sagittal plane motion coupled with sagittal plane translation
What happens in flexion at the joint articulation of C1-C2
posterior jt surfaces and posterior arches separate while C1 articular surface slides posteriorly
What is the SROM of lateral flexion of C1-2
limited
5˚ to each side
What happens at the articular surfaces during lateral flexion at C1-2
C1 translates on the C2 articular surfaces toward the side of lateral flexion
What is the SROM of rotation at C1-2
Huge!
40˚ to each side
How much of cervical rotation occurs at the C1-2 articulation
~1/2
How degrees of rotation occur exclusively at C1-2
The first 25˚
What is the IAR of rotation for C1-2
vertical axis in dens
What occurs to the joint articulations during rotation of C1-2
C1 articular surface slides posterior on ipsilateral side and anterior on contralateral side
What is the pattern of motion of C1-2 during rotation
vertical translation of 2-3mm due to convex surfaces of both facets. -y translation from neutral to full rotation
What muscles coordinate upper cervical movements into global movements
suboccipital muscles
What muscles initiate upper cervical flexion
bilateral anterior concentric activity of:
Rectus Capitis Anterior
Longus Capitis
What muscles guide flexion of upper cervical spine
Bilateral posterior eccentric activity of suboccipitals
What limits the Flexion of the upper cervicals
eccentric activity of suboccipital mm joint capsules PLL Nuchal ligament cruciate ligament chin hitting sternum
What muscles initiate extension in the upper cervicals
bilateral concentric activity of suboccipitals
What guides extension of upper cervicals
bilateral eccentric activity of rectus capitis anterior and longus capitis
What limits extension of the upper cervicals
eccentric activity of anterior mm ALL Anterior atlanto occipital membrane capsular ligaments cruciate ligaments impact of occiput on C1 impact of C1 on C2
What initiates lateral flexion of the upper cervicals
contraction of the ipsilateral rectus capitis lateralis
What guides lateral flexion of the upper cervicals
eccentric contraction of the contralateral rectus capitis lateralis
What limits lateral flexion of the upper cervicals
eccentric activity or lengthening of contralateral rectus capitis lateralis
capsular ligaments
alar ligaments
occipital ligaments
How is rotation of the upper cervicals created
concentric activity on the side of rotation balanced by eccentric activity on the side opposite of rotation
What limits rotation of upper cervicals
contralateral eccentric activity
alar ligaments
cruciate ligaments
articular design
