Vertebral Column II

Question 1

what are the components of the upper cervical spine?

Answer 1

C0 (occiput); C1 (atlas)- no vertebral body but instead have 2 large lateral masses, it gets dragged with occipital condyles during rotation; C2 (axis)- dens/odontoid process

Question 2

what are the ligaments of the upper cervical spine? and what do they resist?

Answer 2

1) transverse ligament of atlas: resists forward translation of C1 on C2
2) alar ligaments: resists flexion, lateral flexion and axial rotation of head and C1 on C2, 2 degrees restraint to anterior translation of C1 and skull on C2

Question 3

what are the joints of the upper cervical spine?

Answer 3

C0/1 atlanto-occipital joint, C1/2 atlanto-axial joint

Question 4

in regards to the atlanato-occipital joint, what movements does it produce and what does it consist of?

Answer 4

movements: flexion-extension (nodding, yes)
components: convex occipital condyles and deep concave superior articular facets of C1
note: minimal C0/1 rotation or lateral due to deep socket

Question 5

in regards to the atlanto-axial joint, what movement does it produce and what does it consist of?

Answer 5

movements: axial rotation
components: 3 synovial joints (1 x median atlanto-axial joint, 2x lateral atlanto-axial joint)

Question 6

what does the median atlanto-axial joint consist of?

Answer 6

odontoid process and osseo-ligamentous ring = anterior arch of C1 + transverse ligament

Question 7

what does the lateral atlanto-axial joints consist of?

Answer 7

convex inferior articular facets of C1 and convex superior articular facets of C2

Question 8

describe the weight transmission in the lower cervical vertebral column (C3-7)

Answer 8

weight of head comes inferiorly through occipital condyles –> lateral masses of C1 –> C2 and down have 3 pathways which share the load:

• path A- down the middle: the weight is transmitted inferiorly through the inverterbral bodies and cervical intervertebral discs (occurs C2-C7) (36%)
• path B x 2- lateral two sides: weight through the articular facets of the zygapophysial joints (32%)

Question 9

what is the uncinate process of the interbody joint and what does it do?

Answer 9

• bony projections on the lateral or posterolateral margins of the C3-7 superior endplates
• contribute to the spinal motion segments mobility and stability (by restricting inner translation in rotation)
• protects the invertebral forament contents from herniated disc material

Question 10

what are the uncovertebral joints of the interbody joint?

Answer 10

uncinate process of the inferior vertebrae; articulate w/ the inferior aspect of the vertebrae above

Question 11

describe the mobility and stability of the zygapophysial joints

Answer 11

C3 and C7 stable, C5 mobile.
superior articular facets of C3 and C7 are more vertical than C5; fits function- C3 represents a transition between upper and lower cervical spine so need to have a more vertical facet to stability C2; C7 represents transition between cervical and thoracic; C5 most mobile bc of horizontal facet (C4-6 most injured bc less stability)

Question 12

what are the cervical spine ligaments?

Answer 12

anterior longitudinal ligament, posterior longitudinal ligament, ligamentum flavum, ligament nuchae replaces supraspinous ligament

Question 13

describe the path of the vertebral artery

Answer 13

comes off the subclavian artery and ascends through the cervical transverse foramen (not C7) and joins to become basilar artery

Question 14

what are the anterior muscles of the axial muscles?

Answer 14

rectus capitis anterior, rectus capitis lateralis, longus capitis, longus colli

Question 15

what are the lateral muscles of the axial muscles? and what are they innervated by?

Answer 15

anterior scalene, middle scalene, posterior scalene. innervation: ventral rami cranial nerves

Question 16

what are the 5 groups of the posterior muscles of the cervical spine?

Answer 16

sub-occipital, segmental, transversospinales, erector spinae, spinotransverse

Question 17

what are the muscles of the sub-occipital group, their innervation and combined action?

Answer 17

rectus capitis posterior minor, rectus capitis posterior major, obliquus capitis superior, obliquus capitis inferior
innervation- suboccipital nerve (dorsal ramus of C1)
combined action- bilateral = head/C1 extension of C2; unilateral = ipsilateral axial rotation/LF

Question 18

what are the muscles of the segmental group?

Answer 18

interspinales, intertransverales

Question 19

what are the muscles of the transversospinales group?

Answer 19

rotatores, multifidus and semispinalis

Question 20

what are the muscles of the erector spinae group?

Answer 20

spinalise, longissimus and iliocostalis

Question 21

what are the muscles of the spinotransverse group and actions?

Answer 21

splenius cervicis and splenius capitis; bilateral- head and neck extension, unilateral- ipsilateral axial rotation/LF

Question 22

what are the muscles of the axio-appendicular muscle group?

Answer 22

upper trapezius, levator scapulae, sternocleidomastoid

Question 23

what is the bilateral and unilateral action of upper trapezius?

Answer 23

B: cervical extension
U: ipsilateral LF, contralateral axial rotation

Question 24

what is the bilateral and unilateral action of levator scapulae?

Answer 24

B: cervical extension
U: ipsilateral LF, ipsilateral axial rotation

Question 25

what is the bilateral and unilateral action of sternocleidomastoid?

Answer 25

B: upper cervical extension, lower cervical flexion
U: ipsilateral LF, contralateral axial rotation