vertebral column 2- cervical spine

Question 1

Cervical spine

Answer 1

mobilty, moving head and special senses, small weight bearing of head

Question 2

C1 ATLAS:

Answer 2

• “washer” shaped like a ring: no vertebral body, 2 lateral masses + anterior & posterior arches (link btwn c0/c1)
• 2 large kidney shaped concave superior articular facets = cradle the occiput
• 2 lateral masses= transmit forces from the head to the cervical spine •largetransverseprocesses = muscleattachment&leverage(momentarm) • large vertebral foramen= protection of the spinal cord
• transverse foramen = protection of the vertebral artery

Question 3

C2 AXIS:

Answer 3

• zygapophyseal joints & vertebral body: transmit the combined load of the head & C1 to the lower cervical spine
• odontoid process = provides an axis for axial rotation of the head & C1 on C2

Question 4

UPPER CERVICAL JOINTS: C0/1 atlanto-occipital joints

Answer 4

flexion – extension “nodding” “yes” = occipital condyle rolls fwd on c1 and glides posteriorly
• convex – concave rule applies
•Convex occipital condyles & deep concave superior articular facets of C1
- roll and glide in opp. directions
* MINIMAL C0/1 ROTATION OR LATERAL FLEXION DUE TO DEEP SOCKETS

Question 5

UPPER CERVICAL JOINTS: C1/2 atlantoaxial joints

Answer 5

Axial rotation “no”
• Contributes at least 50% of cervical spine rotation (1st 450 each direction)
• Head & C1 move together as a unit
• 3 SYNOVIAL JOINTS:
1 x median atlanto-axial joint:
odontoid process & osseo-ligamentous ring:
= anterior arch of C1 + transverse ligament
2 x lateral atlanto-axial joints:
convex inferior articular facets of C1 & convex superior articular facets of C2

Question 6

UPPER CERVICAL SPINE LIGAMENTS : transverse

Answer 6

• Inner surface of each lateral mass •Predominately collagen fibres
• Resists forward translation of C1 on C2

Question 7

UPPER CERVICAL SPINE LIGAMENTS : alar

Answer 7

•Posterior odontoid process to margins of foramen magnum •NO elastic fibres
•Resist:
anterior translation of C1 & skull on C2, flexion,
lateral flexion & axial rotation
of the head & C1 on C2
* Main limit for axial rotation
of the head & C1 on C2

Question 8

LOWER CERVICAL SPINE: C3 - 7

Answer 8

The intersegmental motions of the lower cervical spine are governed by the morphology of the:

1. interbody joint
2. zygapophyseal joints

Question 9

LOWER CERVICAL SPINE: C3 - 7 FUNCTIONS:

Answer 9

• transmit load 
•mobility and stability
•Flexion – extension (F – E)
  •Rotation
•Lateral flexion (LF)
“Coupled”

Question 10

coupled mvmt

Answer 10

A coupled movement consists of a primary movement in 1 plane
accompanied by an automatic movement in another plane.
-can’t dp pure mvmt eg. right rotation = + r lat. flx

Question 11

Uncinate processes / uncovertebral joints

Answer 11

Bony prominences / projecting edges on the lateral or posterolateral margins of the superior endplates of C3-C7
dvlp in first 20 yrs of life
* limits lateral flx. and amount of axial rotation and transverse glide of superior vertebrae

Question 12

Uncinate processes / uncovertebral joints - adults

Answer 12

In the adult, the uncinate processes on the vertebrae below articulate with the corresponding bevelled surfaces on the inferior aspect of the vertebrae above. The uncovertebral articulation contributes to the spinal motion segments mobility and stability as well as functions to protect the intervertebral foramen contents from herniated disc material.

Question 13

Cervical intervertebral disc structure

Answer 13

Annulus fibrosus (AF) = thick arrangement of oblique fibres anteriorly Nucleus is a fibrocartilaginous disc like soap texture

• Posteriorly, AF = thin, narrow band of vertical fibres
• Uncovertebral regions devoid of AF

Question 14

CERVICAL intervertebral disc structure

Answer 14

•Uncovertebral clefts = transverse clefts / fissures in the cervical disc •Develop from approximately 9 years of age
•Thick anterior annulus fibrosus = pivot for rotation
•Posterolateral uncovertebral clefts facilitate axial rotation
- uncovertebral joints are potential pain generators in the cervical spine

Question 15

Zygapophyseal joints of the lower cervical spine (C3-7):

Answer 15

Synovial plane joints between:
•inferior articular facet of cranial vertebra •superior articular facet of the caudal vertebra
Axis of lower cervical rotation:
= perpendicular to the plane of the joint
= 450 to the transverse plane
Ipsilateral “coupled”
rotation / lateral flexion

Question 16

movmt plane/axis

Answer 16

Axial rotation:
• transverse plane •Vertical axis
Lateral flexion: 
•frontal plane 
•sagittal axis

Question 17

cpled mtion in lw c spine

Answer 17

z joints and uncovertebral joints are the major contributors to coupled motion in the lower cervical spine and that the uncinate processes effectively reduce motion coupling and primary cervical motion (motion in the same direction as load application), especially in response to axial rotation and lateral bending loads.

Question 18

primary cervical motion

Answer 18

uncovertebral joints appear to increase primary cervical motion, showing an effect on
cervical motion opposite to that of the uncinate processes

Question 19

Cervical spine ligaments

Answer 19

Anterior longitudinal ligament: 
Posterior longitudinal ligament: 
Ligamentum flavum Ligamentum nuchae:
Replaces supraspinous ligament
•Dorsal raphe – occipital protuberance to C6 & C7 spinous processes
•Interlacing tendons of:
•Trapezius (cervical portion) 
•Splenius capitis •Rhomboid minor

•Midline septum = fascia from the ventral aspect of the dorsal raphe to the cervical spinous processes & occiput