Upper Cervical Spine Flashcards
What feature is unique to the cervical vertebrae?
Transverse foramina
What passes through the transverse foramina?
Vertebral arteries
How many cervical vertebrae are there?
7
Which cervical vertebrae are “typical”?
C3-C6
What is another name for C1?
Atlas
What is another name for C2?
Axis
What is the primary function of the atlas?
Hold up the head
What arthrokinematic rule holds true for the AO joint?
Convex on concave
In the spine, when we discuss movements, we refer to the (1) superior/inferior vertebrae moving on the (2) superior/inferior vertebrae.
(1) Superior
(2) Inferior
What joins the 2 lateral masses of the atlas?
Anterior and posterior arches
What is the orientation of the inferior articular facet of the atlas?
Sloped downwards by 20º
What does the inferior facet of the atlas articulate with?
The superior articular facet of C2
What is the orientation of the superior articular facet of the axis?
20º below the horizontal plane
What is the shape of the superior articular facet of the axis?
Slightly convex
What is the arthrokinematic rule at the AO joint?
Convex on concave
What is the primary movement at the AO joint?
Flexion/extension
Do we have more flexion or extension at the AO joint?
Extension
What is the arthrokinematic rule at the AA joint?
SLIGHTLY concave on convex
What is the primary movement at the AA joint?
Rotation
What articulates with the anterior arch of the atlas?
Dens of the axis
How much of the rotation in the cervical spine comes from the AA joint?
50%
What are the arthrokinematics of cervical right lateral flexion at the AO joint?
Right roll
Left slide
What is spinal coupling?
One motion around one plane is associated with another motion around a different plane
What is the spinal coupled motion hat occurs during right lateral flexion?
Left rotation
What is the spinal coupled motion that occurs during right rotation?
Left lateral flexion
Which direction does longus capitis rotate the head?
Same side rotation
What are the functions of longus colli?
Nodding and support of cervical lordosis
Which muscles provide vertical stability to the cervical region?
Longus colli and longus capitis
What is the nickname for the longus colli and longus capitis?
“Dynamic” anterior longitudinal ligament
What are the 4 suboccipital muscles?
Rectus capitis posterior minor
Rectus capitis posterior major
Obliquus capitis superior
Obliquus capitis inferior
What motion does the alar ligament prevent?
Contralateral head rotation
Contralateral lateral flexion
Where does the alar ligament originate?
Lateral side of the apex of the dens
Where is the transverse ligament located?
On the posterior aspect of the dens
What will happen if the transverse ligament is compromised?
The atlas will move anteriorly
Which test to you use to test the integrity of the transverse ligament?
Sharp purser test
What is a positive result of the sharp purser test?
Cardinal signs occur during flexion but go away when you applly posterior pressure
What membrane is the continuation of the posterior longitudinal ligament?
Tectorial membrane
What motion does the tectorial membrane limit?
Flexion of the upper cervical spine
When is the tectorial membrane injured?
During forceful flexion injuries
What are the 5 cardinal signs/symptoms?
Nystagmus Facial paraesthesias Profuse sweating Nausea, vomiting Difficulty swallowing
In what direction do the occipital condyles move during flexion?
Anterior roll
Posterior glide
To assess maximum posterior glide of the left occipital condyle, what 2 movements could you ask the patient to do?
Flexion with left rotation
OR
Flexion with right lateral flexion
In what direction do the occipital condyles move during extension?
Posterior roll
Anterior glide
To assess maximum anterior glide of the right occipital condyle, what 2 movements could you ask the patient to do?
Extension with right lateral flexion
OR
Extension with left rotation
