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Spinal Kinetics & Kinematics > VI. Upper cervical biomechanics (C0-C1-C2) > Flashcards

VI. Upper cervical biomechanics (C0-C1-C2) Flashcards

1
Q

What is the most complex, specialized and unique area of the spine?

A

upper cervical

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2
Q

What is the dichotomous function of the upper cervical spine?

A

mobility and stability

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3
Q

What type of headache is often associated with dysfunction in the upper cervical spine?

A

cervicogenic headache

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4
Q

The upper cervical area is the emphasis of many chiropractic techniques including……

A

-Grostic -Nucca -Hole in one -Palmer Specific -Atlas Orthogonal -Blair -Kale

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5
Q

Are the condyles of the occiput concave or convex?

A

convex (steeper anteriorly)

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6
Q

What direction do the articular surfaces of the occipital condyles face?

A

laterally and inferiorly

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7
Q

The articular surfaces of the occipital condyles are widest _____ and narrowest _____.

A

posteriorly : anteriorly

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8
Q

Are the superior articular facets of the atlas concave or convex?

A

concave (compliment condyles of occiput)

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9
Q

What direction do the articular surfaces of the superior articular facets of Atlas face?

A

medially and superiorly

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10
Q

The superior articular surfaces of atlas are slightly wider ______

A

posteriorly

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11
Q

Both the condyles of the occiput and the superior facets of atlas converge ______

A

anteriorly

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12
Q

What is the combined (flexion/extension) segmental range of motion for the C0-C1 joint?

A

25º

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13
Q

Which flexion/extension segmental range of motion is greatest in the cervical spine?

A

C0-C1 with 25 degrees

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14
Q

Where is the IAR for flexion and extension of the C0-C1 joint?

A

just above the odontoid

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15
Q

What is the kinematic pattern of motion for flexion and extension in the C0-C1 joint?

A

predominantly in the sagittal plane with insignificant coupling

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16
Q

During cervical flexion, a large percentage of the population will extend at C0-C1 at the end renge of cervical flexion. This is called_____.

A

paradoxical movement of the occiput

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17
Q

It is hypothesized that paradoxical movement of the occiput results from what?

A

the tension in the posterior cervical muscles and possibly the nuchal ligaments

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18
Q

During flexion, the posterior joint surface of C0 glides ____ (up/down) the articular surface of C1 as the anterior surface glides ____ (up/down) and the gap ____ (widens/narrows) between the occiput and the posterior arch of the atlas.

A

up : down : widens

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19
Q

During extension, the posterior joint surface of C0 glides ____ (up/down) the articular surface of C1 as the anterior surface glides ____ (up/down) and the gap ____ (widens/narrows) between the occiput and the posterior arch of the atlas.

A

down : up : narrows

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20
Q

During flexion, the occiput rolls ____ (anteriorly/posteriorly) and slides ____ (anteriorly/posteriorly)

A

anteriorly : posteriorly

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21
Q

During extension, the occiput rolls ____ (anteriorly/posteriorly) and slides ____ (anteriorly/posteriorly)

A

posteriorly : anteriorly

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22
Q

What is the segmental range of motion for lateral flexion of the C0-C1 joint?

A

5º to each side

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23
Q

What limits range of lateral flexion of the C0-C1 joint?

A

alar ligaments

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24
Q

What is the IAR for lateral flexion of the C0-C1 joint?

A

midway between ondontoid tip and EOP

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25
Q

What is the kinematic pattern of motion for lateral flexion of the C0-C1 joint?

A

predominantly a movement in the coronal plane with contralateral coupled rotation

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26
Q

On the side of lateral flexion, the articular surface of C0 is gliding ____ (up/down) the articular surface of C1 as the side opposite the lateral flexion is gliding ____ (up/down).

A

down : up

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27
Q

What is the segemental range of motion for rotation at the C0-C1 joint?

A

5º the each side

28
Q

What limits the segmental range of motion for rotation of the C0-C1 joint?

A

articular anatomy and connections of the alar ligament

29
Q

Which segment of the cervical spine has the most range of motion for rotation?

A

C1-C2

30
Q

What is the IAR for rotation of the C0-C1 joint?

A

it has not been experimentally determined

31
Q

What is the kinematic pattern of motion for rotation of the C0-C1 joint?

A

descriptions of movement are limited

32
Q

On the side of rotation, the C0 articular surface slides ____ (anterior/posterior) and ____ (superior/inferior) on the articular surface of C1 while on the side opposite the rotation it slides ____ and ____.

A

posterior : superior

anterior : superior

33
Q

Describe the inferior facets of C1

A

circular in shape, convex, directly below superior facets

face inferiorly and medially

34
Q

Describe the superior facets of C2

A

oval shape, slightly convex

face superiorly and laterally

35
Q

The gutter at the posterior ondontoid, where the transverse ligament lies, is lined with what?

A

fibrocartilage

36
Q

The odontoid/atlas joint is imbedded in _____ tissue and lacks a _____

A

adipose : capsule

37
Q

What is the segmental range of motion for combined flexion and extension of the C1-C2 joint?

A

20 degrees

38
Q

What is the IAR for flexion/extension of the C1-C2 joint?

A

in the middle third of the dens

39
Q

What is the kinematic pattern of motion of the C1-C2 joint in flexion/extension?

A

angular sagittal plane motion coupled with slight sagittal plane translation

Flexion = +θ x with slight +z

Extension = -θ x with slight -z

40
Q

In flexion of the C1-C2 joint, the posterior joint surfaes and posterior arches _____ (separate/approximate) as the atlas articular surfaces slide (posteriorly/anteriorly)

A

separate : posteriorly

41
Q

In extension of the C1-C2 joint, the posterior joint surfaes and posterior arches _____ (separate/approximate) as the atlas articular surfaces slide (posteriorly/anteriorly)

A

approximate : anteriorly

42
Q

What is the segemental range of motion for lateral flexion of the C1-C2 joint?

A

averages 5 degrees to each side

43
Q

What is the IAR for lateral flexion of the C1-C2 joint?

A

undetermined

44
Q

What is the kinematic pattern of motion for lateral flexion of the C1-C2 joint?

A

coronal plane angular movement with translation in the coronal plane toward the side of lateral flexion

45
Q

C1 articular surfaces translate on the C2 articular surfaces ____ (toward/away from) the side of lateral flexion with slight tilting between the joint surfaces.

A

toward

46
Q

What is the segmental range of motion for rotation of the C1-C2 joint?

A

average of 40 degrees to each side

47
Q

The first how degrees of cervical rotation occur exclusively at C1-C2?

A

25 degrees

48
Q

Approximately how much of cervical rotation occurs at the C1-C2 joint?

A

half

49
Q

What is the IAR for rotation of the C1-C2 joint?

A

vertical axis in center of the dens

50
Q

What is the kinematic pattern of motion for rotation of the C1-C2 joint?

A

Atlas rotates around the dens in the horizontal plane with coupled vertical translation

51
Q

During rotation of the C1-C2 joint, the C1 articular surface slides ____ (anterior/posterior) on the side of rotation and ____ (anterior/posterior) on the side opposite rotation.

A

posterior : anterior

52
Q

What anterior muscles are invovled in kinetics of the upper cervicals?

A

rectus capitis anterior

longus capitis

53
Q

What posterior muscles are invovled in kinetics of the upper cervicals?

A

rectus capitis posterior major

rectus capitis posterior minor

obliquus capitis superior

obliquus capitis inferior

54
Q

What lateral muscles are involved in kinetics of the upper cervicals?

A

rectus capitis lateralis

55
Q

What muscles initiate flexion of the upper cervical spine?

A

bilateral anterior concentric activity of rectus capitis anterior and longus capitis

56
Q

What muscle guide flexion of the upper cervical spine?

A

bilateral posterior eccentric conctraction of subocciptals

57
Q

Flexion of the upper cervical spine is limited by?

A

eccentric activity of suboccipital muscles

joint capsule

PLL

nuchal ligaments

cruciate ligaments

chin hitting sternum

58
Q

What muscle initiate extension of the upper cervical spine?

A

bilateral concentric activity of suboccipitals

59
Q

What muscles guide extension of the upper cervical spine?

A

bilateral eccentric activity of rectus capitis anterior and longus capitis

60
Q

Extension of the upper cervical spine is limited by?

A

eccentric activity of anterior musculature

ALL

anterior atlanto-occipital membrane

capsular ligaments

cruciate ligaments

impact of occiput on posterior C1

impact of posterior arch of C1 on SP of C2

61
Q

What muscles initiate lateral flexion of the upper cervical spine?

A

concentric contraction of ipsilateral rectus capitis lateralis

62
Q

What muscles guide lateral flexion of the upper cervical spine?

A

eccentric contraction of contralateral rectus capitis lateralis

63
Q

Lateral flexion of the upper cervical spine is limited by?

A

eccentric activity or lengthening of contralateral rectus capitis lateralis

capsular ligaments

lateral atlanto-occipital and occipital ligaments

alar ligaments

64
Q

What initiates and guides rotation of the upper cervical spine?

A

movement is a combination of concentric activity on the side of rotation balanced by eccentric activity on the side opposite of rotation

65
Q

Rotation of the upper cervical spine is limited by?

A

contralateral eccentric muscle activity

apical and alar ligaments at C0-C1

cruciate ligaments at C1-C2

articular design of C0-C1

66
Q

What are the possible views to obtain by X-ray of the upper cervical spine?

A

AP open mouth

lateral cervical

Spinal Kinetics & Kinematics (10 decks)

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