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MSK 2 > Upper Cervical Spine Anatomy & Biomechanics > Flashcards

Upper Cervical Spine Anatomy & Biomechanics Flashcards

1
Q

anatomy of OA Joint

A

-concave articular facets for the articulation with the convex occipital condyles

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2
Q

anatomy of AA joint

A

-inferior articular facets (convex) articulate with the axis (C2)

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3
Q

other name for C1

A

atlas

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4
Q

other name for C2

A

axis

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5
Q

anatomy of atlas (C1)

A

-lacks a body; consists of an anterior & posterior arch connected by a lateral mass

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6
Q

AA joint anatomy

A

-superior articular facets (convex) articulate with inferior articular facets of C1 (convex) - stabilized by ligaments

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7
Q

How are the inferior articular facets shaped?

A

-as rest of the C-spine (45 degrees to the horizontal)

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8
Q

primary motions at OA joint

A

-flexion/extension motion (“yes joint”)

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9
Q

primary motions at AA joint

A

-rotation

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10
Q

Innervation of anterior & posterior suboccipital muscles, dura of posterior cranial fossa, the AO joint, the AA joint, the C2-3 facet joints, all ligaments, SCM, upper trap, & the vertebral arteries?

A
  • dorsal & ventral rami of C1-C3

- pain can arise from any of these structures

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11
Q

transverse foramen

A
  • foramen for the vertebral artery which lies anterior to the gutter
  • present from C1-C6
  • subject to degenerative changes
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12
Q

What anatomical structure(s) provide the primary stabilization for the UCS region?

A

-ligaments (atlas to occiput, transverse ligament, alar ligaments)

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13
Q

transverse ligament

A
  • atlas to axis

- passes behind dens, stabilizing dens in contact with the atlas, controlling ant-post movement at the AA joint

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14
Q

If the transverse ligament were cut what would happen?

A

-the atlas displaces forward 7 mm

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15
Q

alar ligaments

A
  • run from lateral margins of the foramen magnum to the tip of the odontoid
  • very thick, strong ligaments
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16
Q

What happens to the dens if the alar ligaments were to rupture?

A

-the dens would fracture

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17
Q

tectorial membrane

A

-continuation of the PLL

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18
Q

apical ligament

A

-runs from odontoid to the anterior margin of the foramen magnum

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19
Q

rectus capitis posterior major attachment

A

-C2 spinous process to lateral aspect of nuchal line

20
Q

rectus capitis posterior major function

A

-bilaterally extends the head; unilaterally produces ipsilateral side flexion & rotation

21
Q

rectus capitis posterior minor attachment

A

-C1 to medial aspect of nuchal line

22
Q

rectus capitis posterior minor function

A

-extension of head & minor contribution to ipsilateral side-flexion

23
Q

superior oblique attachment

A

-C1 transverse process to lateral aspect of nuchal line

24
Q

superior oblique function

A

-bilaterally extends head, unilaterally produces ipsilateral side-flexion & contralateral rotation

25
Q

inferior oblique attachment

A

-C2 spinous process to C1 transverse process

26
Q

inferior oblique function

A

-produces ipsilateral rotation

27
Q

rectus capitis anterior attachment

A

-muscle runs deep to the longus capitis from the lateral mass of the C1 to the base of the occiput

28
Q

rectus capitis anterior function

A

-produces flexion of the head & minimum assistance with rotation

29
Q

rectus capitis laterals attachment

A

-from superior surface of the C1 transverse process to the inferior surface of the jugular process of the occiput

30
Q

rectus capitis lateralis function

A

-ipsilateral side flexion of the head

31
Q

deep cervical flexors (longus colli) attachment

A

-from TP (1-5) & articular processes of C4-C7 to mastoid process

32
Q

deep cervical flexors (longus colli) function

A

-neck flexion

33
Q

UCS forward bend/retraction biomechanics?

A
  • convex occipital condyles roll anterior & glide posteriorly on concave atlas
  • atlas tilts around its axis (atlas glides forward & tilts anteriorly), ultimately causing C2 to glide forward on C3
34
Q

OA biomechanics in forward bend/retraction?

A

-occiput flexes on atlas about 15 degrees

35
Q

AA biomechanics in forward bend/retraction?

A

-minimal flexion - atlas tilts anteriorly, separating atlas from dens about 3 mm

36
Q

UCS biomechanics of backward bend/protraction?

A
  • convex occipital condyles roll posterior & glide anteriorly on concave atlas
  • atlas tilts around its axis (atlas glides backward & then tilts posteriorly), ultimately causes C2 to glide backwards on C3
37
Q

OA biomechanics in backward bend/protraction?

A

-occiput extends on atlas about 25 degrees

38
Q

AA biomechanics in backward bend/protraction?

A

-minimal extension - atlas tilts posteriorly & slides up dens very slightly

39
Q

Osteokinematics of UCS during rotation (R rotation)?

A
  • occiput rotates right creating tension on both alar ligaments which rotates C2 to the R. Occiput sidebends (L) due to convex-concave rule.
  • atlas rotates (R) with occiput but sideglides (L) in response to the (L) sidebending of occiput & the wedge shape of the lateral bodies of the atlas
40
Q

Rotation arthrokinematics of OA joint (using R rotation as example)?

A

-(R) & (L) occipital condyles (L) roll & (R) glide

41
Q

Rotation arthrokinematics of AA joint (using R rotation as example)?

A

-(R) atlas posterior glide on axis (L) atlas anterior glide on axis

42
Q

UCS osteokinematics of side bending?

A
  • occiput sidebends (R) creating tension in the (L) alar ligament which rotates C2 to the right
  • (R) sidebending at occiput induces (L) rotation of the atlas due to the convex-concave rule however due to the wedge shape of the atlas, it side glides slightly to the (R)
43
Q

OA arthrokinematics in side bending?

A

-(R) occipital condyle posterior rotation & anterior glide (L) occipital condyle anterior rotation & posterior glide

44
Q

AA arthrokinematics in side bending?

A

-(R) atlas anterior glide on axis (L) atlas posterior glide on axis

45
Q

Coupled movement with rotation?

A
  • cervical R rotation results in R rotation & L side bending at occiput & C1
  • all vertebrae from C2 down are rotated R & sidebent R; opposite occurs to the L
46
Q

Coupled movements in sidebending?

A

-occiput & C1 move together; cervical R side bending results in R side bending & R rotation from C2 down; occiput & C1 will rotate to the L

MSK 2 (16 decks)

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