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vertebral column > vertebral column of the neck > Flashcards

vertebral column of the neck Flashcards

1
Q

what are the functions of the vertebral column?

A
  • muscle attachment
  • mobility
  • protection
  • weight transfer
  • haematopoiesis
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2
Q

what classification of joint exists between the vertebral bodies?

A

secondary cartilagenous

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3
Q

what region of the vertebral column would you find the atlas and axis?

A

cervical region

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4
Q

is the curvature in the cervical region primary or secondary?

A

secondary

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5
Q

what shape is the atlas C1?

A

ring shaped

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6
Q

where does the atlas lie?

A

above axis

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7
Q

what is the anatomy of the atlas C1?

A 
transverse process
intervertebral process
anterior and posterior arches
2 thick lateral masses
groove for vertebral artery at base of posterior arch
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8
Q

where are the 2 lateral masses on the atlas?

A

lie anteriorly and medially forming a bony bridge

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9
Q

are the superior articular facets concave or convex?

A

concave for occipital condyles

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10
Q

what is the shape of the inferior articular facets?

A

round and flat for axis

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11
Q

what runs within the groove of the atlas?

A

first spinal nerve runs parallel to the vertebral artery within the groove

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12
Q

what is the anatomy of the axis C2?

A 
Large spinous process
pedicle
dens
body 
large laminae
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13
Q

what is the dens of the axis C2?

A

transverse groove which the transverse ligament of the atlas passes

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14
Q

what does the axis C2 articulate with?

A

C3 vertebrae via an oblique apophyseal joint

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15
Q

the angle upwards of the axis C2 is forming what?

A

pars interarticularis

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16
Q

what is the anatomy of the occipital bone?

A

superior nuchal line
inferior nuchal line
external occiput protuberance
occipital condyles

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17
Q

what is the midline protuberance along the superior nuchal line known as?

A

external occipital protuberance

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18
Q

what is more noticeable the inferior nuchal line or the superior nuchal line?

A

superior nuchal line

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19
Q

where is the inferior nuchal line?

A

between foramen magnum and superior line

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20
Q

what are the occipital condyles?

A

a pair of convex oval swellings flanking the foramen magnum

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21
Q

what do the occipital condyles articulate with?

A

the superior facets of the atlas

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22
Q

what are the ligaments of the cranio- cervical junction?

A 
anterior longitudinal ligament
interspinous ligament
tectorial membrane
small apical ligament
alar ligaments
nuchal ligament
transverse ligament
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23
Q

where does the anterior longitudinal ligament extend?

A

along the ventral surface of the vertebral bodies

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24
Q

what does the interspinous ligament connect to?

A

the posterior margin of the foramen magnum to the posterior arch of the atlas

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25
Q

what is the tectorial membrane?

A

an extension of the posterior longitudinal ligament

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26
Q

where does the small apical ligament extend to?

A

from the tip of the odontoid to the foramen magnum

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27
Q

where do the alar ligaments extend?

A

from the opposite sides of the odontoid process to occipital condyles

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28
Q

where does the nuchal ligament come from?

A

spinous process of C7 to the external occipital protuberance and crest

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29
Q

what do the transverse ligament connect?

A

connects both lateral masses of the atlas and passes dorsal to the odontoid

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30
Q

what arteries provide blood supply to the cranio-cervical region?

A

the vertebral and occipital arteries

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31
Q

what arises from the vertebral arteries?

A

anterior and posterior ascending vessels

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32
Q

where do the anterior and posterior ascending arteries pass?

A

pass ventral and dorsal to the body of the axis and the odontoid process, and in apical arcade in the alar ligament

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33
Q

what is the most mobile area of the spine and of the axial skeleton?

A

the cranio-cervical junction

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34
Q

the complex bony features, ligaments and joint orientations of the cranio-cervical junction allows what?

A

rotation, flexion, extension and lateral bending of the neck

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35
Q

extensive range of motion means the cranio-cervical joint is what?

A

the joint must compromise on stability

36
Q

the cervical spine is capable of axial rotation up to what degrees?

A

90’ in either direction

37
Q

the largest degree of rotation of the neck occurs at which joint?

A

the atlanto- axial joint, approx 15’

38
Q

is the atlanto- occipital joint involved in axial rotation?

39
Q

rotation of the neck is brought about by which muscles?

A

suboccipital muscles, trapezius and sternomastoid

40
Q

The transverse ligament allows what?

A

the atlas to pivot around the stationary dens

41
Q

The lateral masses of the atlas do what?

A

glide over the articular facets of the axis, 1 anteriorly, 1 posteriorly

42
Q

the alar ligaments limit what?

A

limit axial rotation

43
Q

other movements of the atlanto-axial joint are limited by what?

A

the odontoid process abutting against the margins of the atlas and transverse ligament

44
Q

25’ of flexion/ extension movements of the neck occur where?

A

cranio- cervical joint

45
Q

what facilitates most of the movement of flexion and extension of the neck?

A

the atlanto-occipital articulations

46
Q

what other articulations contribute to flexion and extension of the neck?

A

atlanto- axial articulations

47
Q

what degree of movement is the atlanto- occipital joint capable of doing in flexion and extension of the neck?

A

20’, by sliding of occipital condyles on lateral masses of the atlas

48
Q

flexion of the head is due to what?

A

at the atlanto- occipital articulation

49
Q

what slides posteriorly in flexion of the head?

A

occipital condyles

50
Q

where does the occiput move in flexion of the head?

A

moves superiorly away from posterior arch of atlas

51
Q

what is flexion of the head limited by?

A

the nuchal ligament and posterior suboccipital muscles

52
Q

what is the active force driving flexion in an upright position?

A

the weight of the head

53
Q

what controls the movement by acting against gravity in flexion of the head?

A

the postvertebral muscles

54
Q

what prevents head from flexing in a relaxed state?

A

neck muscle tone

55
Q

from a supine position flexion of the head is brought about by what?

A

the anterior neck muscles

56
Q

extension of the head is caused by what?

A

extension of atlanto-occipital articulation

57
Q

what occurs to the occipital condyles in extension of the head?

A

they slide anteriorly

58
Q

what happens to the occiput in extension of the head?

A

moves closer to posterior arch of the atlas

59
Q

what is extension of the head limited by?

A

collision of occiput and posterior arch of atlas

60
Q

extension of the head from upright position is controlled by what?

A

anterior neck muscles acting against weight of head like flexion

61
Q

from a prone position extension of the head is initiated by what?

A

the postvertebral muscles

62
Q

which junction is capable of a very small degree of lateral flexion of the neck, around 5’?

A

cranio- cervical junction

63
Q

what happens to the occipital condyles as the neck laterally flexes?

A

the slide laterally over the articular facets of the atlas, ipsilateral moves towards the midline, contralateral moves away from the midline

64
Q

lateral flexion of the neck is limited by what?

A

the contralateral alar ligament

65
Q

how does a dislocation of the atlanto- occipital joint occur?

A

when the ligaments and bony structures become damaged

66
Q

what is atlanto- occipital joint dislocation associated with?

A

high levels of morbidity and mortality but can be survivable due to improvements in the management

67
Q

what can occur with a atlanto- occipital joint dislocation?

A

often have some sort of neurological impairment

may cause trauma

68
Q

where is a atlanto-occipital dislocation most likely to occur? and why?

A
  • in children and adolescents
  • more horizontal plane of the articular surfaces
  • ligaments being more lax
  • relatively large head
  • higher effective fulcrum in the cervical spine
69
Q

what is the diagnosis of a atlanto-occipital dislocation?

70
Q

what is the treatment for a atlanto- occipital dislocation?

A

conservative using collars, fusion

71
Q

the atlanto- axial joint relies on what in order to limit dislocation?

A

the transverse ligament rather than the bony features

72
Q

what are the causes of a atlanto- axial dislocation?

A

trauma
congenital abnormalities e.g. downsydrome
inflammation e.g. rheumatoid arthritis

73
Q

what does a atlanto- axial dislocation cause?

A

type II odontoid fractures which are the most common and only type linked with this dislocation

74
Q

where does a type II odontoid fracture occur?

A

between transverse ligament and body of C2 body

75
Q

where is a atlanto- axial dislocation seen most?

A

adolescents

76
Q

what symptoms are associated with atlanto- axial dislocations?

A

numbness and weakness

77
Q

movement restrictions of numbness in the neck?

A

respiratory distress

78
Q

movement restrictions of weakness in the neck?

A

lower cranial nerve dysfunction

79
Q

diagnosis of atlanto- axial dislocations?

A

CT, MRI, radiographic measurements

80
Q

treatment for atlanto- axial dislocations?

A

surgical; fusion of atlantoaxial joint

conservative; cervical halter traction

81
Q

outcomes of atlanto- axial dislocations?

A

sudden death, neurological impairements

82
Q

what is Rheumatoid arthritis?

A

an inflammatory process affecting the joints and ligaments in the cervical spine

83
Q

in relation to Rheumatoid arthritis destructive changes are more pronounced where?

A

at the occipitoatlantoaxial junction

84
Q

when does Rheumatoid arthritis occur?

A

usually occur in those who have had arthritis for 10 or more years, can be asymptomatic for many years

85
Q

diagnosis of Rheumatoid arthritis?

A

CT, MRI, plain radiographs

86
Q

treatment of Rheumatoid arthritis?

A

regular radiographic follow up, surgical intervention- fusion

vertebral column (10 decks)

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