VI. Regions of the Vertebral Column--Cervical Region Flashcards

1
Q

Which mammals do not have seven cervical vertebrae?

A

the two toed sloth, manatee, ant bear, and three toed sloth

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2
Q

Which mammals have more than seven cervical vertebrae?

A

ant bear, three toed sloth

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3
Q

Which mammals have less than seven cervical vertebras?

A

two toed sloth, manatee

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4
Q

What is the number of vertebrae in the typical cervical spine?

A

seven

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5
Q

Which vertebrae are typical cervicals?

A

C3-C6

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6
Q

Which vertebrae are atypical cervicals?

A

C1, C2, C7

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7
Q

What is the shape of the typical cervical vertebral body from the cranial view?

A

rectangular

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8
Q

What is the appearance of the typical cervical vertebral body from the lateral view?

A

posterior height is greater than anterior height by a few millimeters

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9
Q

What would be the direction of the cervical curve based on osseous features?

A

posterior or kyphotic

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10
Q

What accounts for the direction of the typical cervical curve?

A

the intervertebral disc height

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11
Q

What is the direction of the typical cervical curve?

A

anterior or lordotic

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12
Q

Which vertebral couples will demonstrate a decrease in intervertebral disc height?

A

C2/C3 down to C4/C5

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13
Q

At which vertebral couple will the cervical curve again increase intervertebral disc height?

A

C5/C6

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14
Q

What are the names of the lateral modification of the superior epiphyseal rim?

A

uncinate process, unciform process, uncovertebral process, uncus or lateral lip

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15
Q

What are the modifications of the inferior epiphyseal rim of a typical cervical?

A

anterior lip, posterior lip, right and left lateral grooves

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16
Q

What is the joint classification for the anterior lip-anterior longitudinal ligament-anterior groove articulation?

A

fibrous (amphiarthrosis) syndesmosis

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17
Q

What is the joint classification for the posterior lip-posterior longitudinal ligament-posterior groove articulation?

A

fibrous (amphiarthrosis) syndesmosis

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18
Q

What is the joint classification for the uncinate process-lateral groove articulation?

A

modified synovial saddle (diarthrosis sellar)

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19
Q

What is the joint classification for the spongy bone-intervertebral disc articulation?

A

cartilaginous (amphiarthrosis) symphysis

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20
Q

How many joints are present on the upper surface of a typical cervical vertebral body?

A

five

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21
Q

How many joints are present on the lower surface of a typical cervical vertebral body?

A

five

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22
Q

How many total joint surfaces are present on the vertebral body of a typical cervical?

A

ten

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23
Q

What is the name given to the uncinate process-lateral groove articulation?

A

joint of Luschka or uncovertebral joint

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24
Q

The joint of Luschka is formed from what surfaces?

A

the uncinate process and lateral groove

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25
Q

How many total synovial joint surfaces are present on the vertebral body of a typical cervical?

A

four

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26
Q

What is the functional significance of the joint of Luschka?

A

it appears to stabilize the intervertebral disc while accommodating flexion-extension and requiring couple motion (axial rotation with lateral bending) in the cervical spine

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27
Q

What muscle attaches to the typical cervical vertebral body?

A

the longus colli muscle

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28
Q

What is the orientation and angulation of the pedicle of a typical cervical?

A

posterolateral, 45 degrees

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29
Q

In the vertebral couple, which cervical vertebral body will contribute more toward the height of the intervertebral foramen?

A

neither, both contribute equally to the intervertebral foramen height

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30
Q

What is the direction of projection of the cervical lamina?

A

posteromedially

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31
Q

What ligament attaches to the lamina of a typical cervical?

A

ligamentum flavum

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32
Q

What joint classification will be associated with the ligamentum flavum and its attachment?

A

fibrous (amphiarthrosis) syndesmosis

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33
Q

Ossification of the ligamentum flavum at the attachment site on the lamina will result in what feature?

A

para-articular processes

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34
Q

Ossification of the ligamentum flavum at the attachment site on the lamina will be associated with which classification of bone?

A

accessory bone

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35
Q

Ossification within the length of the ligamentum flavum will be associated with which classification of bone?

A

heterotopic bone

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36
Q

What is the outline of the vertebral foramen of a typical cervical vertebra?

A

heart-shaped or triangular

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37
Q

Which is the greatest diameter of the vertebral foramen of typical cervicals?

A

transverse

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38
Q

The greatest transverse diameter of the typical cervical vertebra occurs at _____?

A

C6

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39
Q

What osseous parts form the typical cervical vertebra transverse processes?

A

costal element, anterior tubercle, costotransverse bar, posterior tubercle, true transverse process

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40
Q

What muscles will attach to the anterior tubercle of a typical cervical vertebra?

A

anterior scalene, longus capitis, longus colli, anterior intertransversarii

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41
Q

What muscles may attach to the posterior tubercle of a typical cervical vertebra?

A

splenius capitis, iliocostalis cervicis, longissimus cervicis, levator scapula, middle scalene, posterior scalene, rotators and posterior intertransversarii

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42
Q

What muscles will attach to the costotransverse bar?

A

middle scalene and posterior intertransversarii

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43
Q

What produces the primary tension on the transverse process that will cause remodeling in the anterolateral and inferior directions?

A

cervical spinal nerves as they are directed anterolaterally and inferiorly to form the cervical and brachial plexuses

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44
Q

What is the name given to the superior margin of the costotransverse bar?

A

sulcus for the ventral primary ramus of a cervical spinal nerve

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45
Q

What is the orientation and angulation of a typical cervical transverse process?

A

60 degrees anterolaterally (from midsagittal plane), 15 degrees inferiorly (from the horizontal plane)

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46
Q

What is the name give to the modification of the anterior tubercle of the C6 transverse process?

A

the carotid tubercle

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47
Q

What will occupy the typical cervical vertebra transverse foramen?

A

the vertebral artery, vertebral venous plexus and postganglionic sympathetic motor nerve fibers

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48
Q

What is the name of the surface feature observed between the ends of the articular pillar?

A

the groove/sulcus for the dorsal ramus of a cervical spinal nerve

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49
Q

What is the classic angulation of typical cervical articular facets?

A

40 to 45 degrees from the coronal plane

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50
Q

Recent work suggests what angulation for typical cervical articular facets?

A

55 to 60 degrees

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51
Q

What is the orientation of the typical cervical superior articular facet?

A

backward, upward, medial (BUM)

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52
Q

What is the orientation of the typical cervical inferior articular facet?

A

forward, lateral, downward (FoLD)

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53
Q

What muscles will attach to typical cervical articular processes?

A

the longissimus capitis, longissimus cervicis, semispinalis capitis, semispinalis cervicis, multifidis and rotators

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54
Q

What muscles blend with the capsular ligament of cervical zygapophyses?

A

the semispinalis capitis, multifidis and rotator longus

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55
Q

What is the joint classification for the typical cervical zygapophysis?

A

synovial plane (diarthrosis arthrodia) joint

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56
Q

What modifications of the synovial joint are observed in the cervical spine?

A

meniscoidal folds

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57
Q

What function will meniscoidal folds provide in cervical zygapophyses?

A

they are assumed to distribute pressure across the joint surface

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58
Q

The greatest range of flexion-extension among the typical cervical vertebrae occurs at which vertebral couple?

A

typically C5/C6

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59
Q

What motions are couple in the cervical spine?

A

lateral bending and axial rotation

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60
Q

Ranges in coupled motion among the typical cervical vertebrae will be similar for what cervical vertebral couples?

A

the C2/C3, C3/C4, C4/C5 vertebral couples

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61
Q

Ranges of coupled motion among the typical cervical vertebrae will begin to decrease at what cervical vertebral couple?

A

the C5/C6 vertebral couple

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62
Q

What is the usual condition for the Caucasian typical cervical spinous process?

A

they are bifid

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63
Q

What is the usual condition for the African-American typical cervical spinous process?

A

they are non-bifid

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64
Q

What muscles may attach to the typical cervical spinous process?

A

the spinalis cervicis, simispinalis cervicis, semispinalis thoracis, multifidis, rotators and interspinalis

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65
Q

What ligaments will attach to the typical cervical spinous process?

A

the interspinous ligament and ligamentum nuchae

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66
Q

What will form the anterior boundary of a typical cervical intervertebral foramen?

A

the lateral groove and vertebral body of the segment above, the uncinate process and vertebral body of the segment below, the intervertebral disc and the posterior longitudinal ligament

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67
Q

What will form the posterior boundary of a typical cervical intervertebral foramen?

A

the inferior articular process (post-zygapophysis), the superior articular process (pre-zygapophysis), the capsular ligament and the ligamentum flavum

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68
Q

What will form the superior boundary of a typical cervical intervertebral foramen?

A

the inferior vertebral notch/incisure

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69
Q

What will form the inferior boundary of a typical cervical intervertebral foramen?

A

the superior vertebral notch/incisure

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70
Q

What is the unique anterior boundary of the intervertebral foramen for the C4 spinal nerve?

A

the lateral groove of C3 and uncinate process of C4 forming the joint of Luschka

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71
Q

What is the name of the first cervical vertebra?

A

atlas

72
Q

What features are lacking at C1?

A

vertebral body, pedicles, a spinous process and the intervertebral disc

73
Q

What is thought to represent the pedicle at C1?

A

the anterior arch

74
Q

What osseous modification is observed to the front of the anterior arch of C1?

A

the anterior tubercle

75
Q

What muscle attaches to the anterior arch of C1?

A

longus colli

76
Q

What ligaments will attach to the anterior arch of C1?

A

the anterior longitudinal, anterior atlanto-occipital and anterior atlanto-axial ligaments

77
Q

What is observed on the back of the anterior arch of C1?

A

the fovea dentis

78
Q

What joint classifications are observed on the anterior arch of C1?

A

fibrous (amphiarthrosis) syndesmosis joint and synovial pivot (diarthrosis trochoid) joint

79
Q

What is the morphology of the superior articular facet of C1?

A

they are elliptical, closer together in front and often demonstrate an elevation subdividing the facet surface into two separate surfaces

80
Q

What is the orientation of the superior articular facet of C1?

A

backward, upward, medial (BUM)

81
Q

What is the joint classification of the atlanto-occipital zygapophysis?

A

synovial (diarthrosis) ellipsoidal joint

82
Q

What are the morphological characteristics of the inferior articular facet of C1?

A

asymmetrical, slightly concave or flattened

83
Q

What is the orientation of the inferior articular facet of C1?

A

backward, medial, downward (BMD)

84
Q

What is the joint classification of the atlanto-axial zygapophysis?

A

synovial plane (diarthrosis arthrodia) joint

85
Q

What is the name of the rounded elevation on the medial aspect of the lateral mass of C1?

A

tubercle for the transverse atlantal ligament

86
Q

What muscles attach to the lateral mass of C1?

A

levator scapula, splenius cervicis and rectus capitis anterior

87
Q

What part of C1 represents the spinous process?

A

posterior tubercle of posterior arch

88
Q

What is the distance from the posterior tubercle of posterior arch to the skin in each gender?

A

males: about fifty millimeters; females: about thirty-seven millimeters

89
Q

What attaches to the posterior tubercle of the posterior arch of C1?

A

rectus capitis posterior minor muscle and ligamentum nuchae

90
Q

What superior surface modifications of the posterior arch of C1 are present?

A

groove/sulcus for the vertebral artery and arcuate rim

91
Q

What attaches to the arcuate rim of C1?

A

the posterior atlanto-occipital ligament

92
Q

Ossification of the free margin of the posterior atlanto-occipital ligament results in which atypical bone classification?

A

accessory bone

93
Q

What is the earliest age of development where ossification of the anterior free margin of the posterior atlanto-occipital was observed?

A

about age 7 years old

94
Q

Based on the amount of ossification of the anterior free margin of the posterior atlanto-occipital ligament what structures will form?

A

an incomplete ponticulus posticus or a comple ponticulus posticus

95
Q

What names are given to the opening formed by the ponticulus posticus?

A

arcuate forament or retroarticular canal

96
Q

Ponticulus posticus has observed in what ethnic populations?

A

all ethnic populations studied thus far

97
Q

What is the general range of incidence of ponticulus posticus in the populations studied?

A

1% - 4%

98
Q

What is the gender bias now associated with ponticulus posticus?

A

female

99
Q

What is the incidence of a complete ponticulus posticus versus an incomplete ponticulus posticus?

A

the incidence of a complete ponticulus posticus is about fifteen percent; the incidence of an incomplet ponticulus posticus may be as high as forty-one percent

100
Q

What are the osseous parts of the transverse process of C1?

A

costal element, posterior tubercle, true transverse process

101
Q

Whats muscles attach to the transverse process of C1?

A

rectus capitis anterior, rectus capitis lateralis, middle scalen, levator scapula, splenius cervicis, obliquus capitis superior, obliquus capitis inferior and intertransversarii muscles

102
Q

What suboccipital muscles are know to have fascial projections attaching to the spinal dura?

A

rectus capitis posterior minor, rectus capitis posterior major, obliquus capitis inferior

103
Q

What are the connections between suboccipital muscles and the spinal dura called?

A

myodural bridges

104
Q

What are the lateral bridges of atlas connected to?

A

the lateral mass and the transverse process of atlas

105
Q

What forms of the lateral bridges are observed in the population?

A

incomplete lateral bridges and complete lateral bridges

106
Q

What opening is identified when a complete lateral bridge is formed?

A

the retrotransverse foramen

107
Q

What are the possible contents of the retrotransverse foramen?

A

the vertebral artery, a branch from the suboccipital nerve and veins communicating with the venous senuses of the neck

108
Q

Which of the ponticles (bridges) of atlas is most numerous?

A

ponticulus posticus

109
Q

Which of the ponticles (bridges) of atlas is only observed in humans?

A

lateral bridges

110
Q

What is observed in the transverse foramen of C1?

A

vertebral artery, vertebral venous plexus, postganglionic sympathetic motor nerve fibers

111
Q

What is the gender variation for measurements of the transverse diameter of C1?

A

males: 78 millimeters and females: 72 millimeters

112
Q

What is the distance from the posterior tubercle of the transverse process of C1 to the skin for each gender?

A

a little over 30 millimeters for both males and females

113
Q

How many synovial joint surfaces are observed at C1?

A

five

114
Q

What names are given to C2?

A

axis or epistropheus

115
Q

What unique vertebral body modification is characteristic of C2?

A

the dens or odontoid process

116
Q

How many joint surfaces are present on the odontoid process of C2?

A

five

117
Q

What joint surfaces are present on the odontoid process of C2?

A

facet for fovea dentis, groove for transverse atlantal ligament, attachment sites for the alar ligaments, attachment site for the apical-dental ligament

118
Q

What is the name/classification given to the odontoid process when the tip of the dens is directed posterior?

A

lordotic dens

119
Q

What is the name/classification given to the odontoid process when the tip of the dens is directed anterior?

A

kyphotic dens

120
Q

What joint surfaces are present at the inferior part of the vertebral body of C2?

A

anterior lip, posterior lip, right and left lateral grooves and cancellous bone

121
Q

How many joints are formed by the inferior part of the vertebral body of C2?

A

five

122
Q

How many joint surfaces are present at the vertebral body of C2?

A

ten

123
Q

What joint classifications are present at the vertebral body of C2?

A

fibrous (amphiarthrosis) syndesmosis, synovial plane (diarthrosis trochoid), modified synovial saddle (diarthrosis sellar) and cartilaginous (amphiarthrosis) symphysis

124
Q

What ligament will represent the cranial continuation of the posterior longitudinal ligament?

A

membrana tectoria

125
Q

What ligament forms the anterior boundary for the spinal canal above C2?

A

membrana tectoria

126
Q

What ligament forms the anterior boundary for the spinal canal below C2?

A

posterior longitudinal ligament

127
Q

What is the location of the superior vertebral notch of C2?

A

on the lamina-pedicle junction

128
Q

What attaches to the lamina of C2?

A

obliquus capitis inferior muscle, posterior atlanta-axial ligament, ligamentum flavum

129
Q

What is the appearance of the superior articular facets of C2?

A

they are asymmetrical and slightly convex

130
Q

What is the facet orientation of the superior articular facet of C2?

A

backward, upward, and lateral (BUL)

131
Q

What is the orientation of the inferior articular facets of C2?

A

forward, lateral, and down (FoLD)

132
Q

What muscle attaches to the articular processes of C2?

A

longissimus cervicis

133
Q

What will be observed in the transverse foramen at C2?

A

vertebral artery, vertebral venous plexus, postganglionic sympathetic motor nerve fibers

134
Q

What is the gender variation for the transverse diameter of C2?

A

males: fifty-seven millimeters and females: about fifty millimeters

135
Q

What muscles attach to the transverse process at C2?

A

levator scapulae, middle scalene, splenius cervicis, longissimus cervicis and intertransversarii

136
Q

What is the characteristic appearance of the C2 spinous process in humans?

A

bifid

137
Q

What muscles attach to the spinous process of C2?

A

rectus capitis posterior major, obliquus capitis inferior, spinalis cervicis, semispinalis cervicis, multifidis, rotators and interspinalis muscles

138
Q

What ligaments attach to the spinous process of C2?

A

ligamentum nuchae, interspinous ligaments

139
Q

What names may be give to C7?

A

vertebra prominens and vertebral prominence

140
Q

What is the name given to the topographical elevation observed at the base of the neck?

A

vertebral prominence

141
Q

What names is given only to C7?

A

vertebral prominens

142
Q

What is the segment and gender bias for vertebrae other than C7 becoming the vertebral prominence?

A

C6 is more common in females and T1 is more common in males

143
Q

How many joint surfaces are present at the vertebral body of C7?

A

eight

144
Q

What joint classifications are observed at the vertebral body of C7?

A

fibrous (amphiarthrosis) syndesmosis, cartilaginous (amphiarthrosis) symphysis and modified synovial saddle (diarthrosis sellar) joint

145
Q

What muscle(s) attaches to the vertebral body of C7?

A

longus colli muscle

146
Q

What features are typically present in the transverse foramen of C7?

A

vertebral venous plexus, postganglionic sympathetic motor fibers

147
Q

What muscles attach to the transverse process of C7?

A

middle scalene, iliocostalis thoracis, longissimus cervicis, semispinalis capitis, rotators, intertransversarii and levator costarum brevis

148
Q

What is the orientation of the superior articular facet of C7?

A

backward, upward, medial (BUM)

149
Q

What is the orientation of the inferior articular facet of C7?

A

forward, medial, downward (ForMeD)

150
Q

What muscles will attach to the articular process of C7?

A

longissimus cervicis, longissimus capitis, semispinalis cervicis and multifidis

151
Q

What muscles attach to the spinous process of C7?

A

trapezius, rhomboid minor, serratus posterior superior, splenius capitis, spinalis capitis, spinalis cervicis, semispinalis thoracis, multifidis, rotators and interspinalis

152
Q

What ligaments attach to the spinous process of C7?

A

ligamentum nuchae and interspinous ligaments

153
Q

The vertebral artery on which side is typically larger?

A

left vertebral artery

154
Q

What is the gender bias regarding size of the vertebral artery?

A

men have larger vertebral arteries than women

155
Q

Which side artery was tested during the course of the vertebrovasilar artery insufficiency exam?

A

the ipsilateral artery on the side of rotation

156
Q

Typically, at what vertebral level will the vertebral artery first become located in the transverse foramen?

A

C6

157
Q

At what location will the vertebral artery form its first compensatory loop?

A

the atlanto-axial ligament

158
Q

At what location will the vertebral artery form its second compensatory loop?

A

the atlanto-occipital ligament

159
Q

At what segments will the vertebral artery be firmly attached to the transverse foramen?

A

both C1 and C2

160
Q

What is the purpose of the vertebral artery loops between C2, C1, and occiput?

A

the increased length will accommodate the greater rotation at these locations

161
Q

What happens to the vertebral artery after it enters the subarachnoid space at C1?

A

the vertebral artery ascends along the medulla oblongata to the pontine-medullary junction where the right and left arteries unite to form the basilar artery

162
Q

Which suboccipital muscles attach to C1?

A

rectus capitis posterior minor, obliquus capitis superior, obliquus capitis inferior

163
Q

Which suboccipital muscles attach to C2?

A

rectus capitis posterior major, obliquus capitis inferior

164
Q

What joint classifications are present at C1?

A

synovial (diarthrosis) ellipsoidal, synovial pivot (diarthrosis trochoid), synovial plane (diarthrosis arthrodia) and fibrous (amphiarthrosis) syndesmosis

165
Q

What joint classifications are present at C2?

A

synovial pivot (diarthrosis trochoid), synovial plane (diarthrosis arthrodia), modified synovial saddle (diarthrosis sellar), fibrous (amphiarthrosis) syndesmosis and cartilaginous (amphiarthrosis) symphysis joint

166
Q

What joint classifications are present at each typical cervical?

A

synovial plane (diarthrosis arthrodia), modified synovial saddle (diarthrosis sellar), fibrous (amphiarthrosis) syndesmosis and cartilaginous (amphiarthrosis) symphysis

167
Q

What joint classifications are present at C7?

A

synovial plane (diarthrosis arthrodia), modified synovial saddle (diarthrosis sellar), fibrous (amphiarthrosis) syndesmosis and cartilaginous (amphiarthrosis) symphysis

168
Q

What forms the boundaries for the exit of the C1 nerve from the spinal canal?

A

occipital condyle, superior articular process of C1, capsular ligament, arcuate rim, groove for the vertebral artery, posterior atlanto-occipital ligament

169
Q

What forms the boundaries for the exit of the C2 nerve from the spinal canal?

A

inferior articular process of C1, superior articular process of C1, capsular ligament, inferior vertebral notch of C1, superior vertebral notch of C2, posterior arch of C1, lamina of C2, posterior atlanto-axial ligament

170
Q

What forms the anterior boundary for the C2 nerve exit from the spinal canal?

A

inferior articular process of C1, superior articular process of C2, capsular ligament

171
Q

What forms the posterior boundary for the C2 nerve exit from the spinal canal?

A

the posterior arch of C1, lamina of C2 and posterior atlanto-axial ligament

172
Q

What forms the anterior boundary for the C3-C7 nerve exit from the spinal canal?

A

the vertebral bodies, inervertebral disc, posterior longitudinal ligament, uncinate process, lateral groove

173
Q

What forms the anterior boundary for the C8 nerve exit from the spinal canal?

A

the vertebral bodies of C7 and T1, intervertebral disc, posterior longitudinal ligament, capsular ligament of the costocentral joint, superior costal facet of T1 and articular surface of the first rib

174
Q

What are the superior articular facet orientations for the cervical vertebrae?

A

C1 is backward, upward, medial (BUM), C2 is backward, upward, lateral (BUL), C3-C7 is backward, upward, medial (BUM)

175
Q

What are the inferior articular facet orientations for the cervical vertebrae?

A

C1 is backward, downward, medial (BUM), C2-C6 is forward, downward, lateral (FoLD), C7 is forward, downward, medial (ForMeD)

176
Q

How many synovial joints are identified for each cervical vertebra?

A

C1 = five, C2 = eight, C3-C6 = eight, C7 = six

177
Q

How many joints are identified at the vertebral body of each cervical vertebra?

A

C1 = none, C2 = ten, C3-C6 = ten, C7 = eight