W4: Cervical Spine Anatomy

Question 1

What is the shape of a cervical vertebrae body?

Answer 1

Small & Oval

Question 2

Which vertebrae lacks a body?

Answer 2

C1

Question 3

What feature is on the body of C2?

Answer 3

The dens

Question 4

Shape of the cervical vertebral foramen?

Answer 4

Triangular

Question 5

How are the vertebrae of the spinous process of cervical vertebrae shaped?

Answer 5

Short and Bifid

Question 6

Why are the spinous process bifid on cervical vertebrae?

Answer 6

It is bifid becauseit develops from two separate secondary centres of ossification.

This increases surface area for muscle attachment (also allows ligament nuchae to run through)

Question 7

Cervical articular facets are what shape?

Which direction do the superior and inferior facets face?

Answer 7

Flat & oval

Superior = backward, upward and slightly medial (BUM)

Inferior = Forward, downward and slightly laterally (FDL)

Question 8

Role of the nuchal ligaments

Answer 8

Limits forward flexion of the head and cervical spine

Question 9

What vertebrae allows rotation?

Answer 9

C1 (Atlas) & C2 (Axis)

C1 and C2 form a unique set of articulations that provide a great degree of mobility for the skull. C1 is where the skull rests upon and articulates in a pivot joint with the dens or odontoid process of C2

Question 10

What percentage of flexion/extension happens between the occiput and C1?

Answer 10

50%

Question 11

What percentage of rotation happens between C1 & C2?

Answer 11

50%

Question 12

The cervical vertebrae is much more ….. than the thoracic or lumbar regions in the spine

Answer 12

Mobile

Question 13

What feature does the cervical vertebrae have that are not present in the lumbar or thoracic?

Answer 13

Transverse foramina in each vertebrae for the vertebral arteries that supply blood to the brain

Question 14

The nuchal ligament attaches to the spinous process of….

Answer 14

C2 to C7 (and to the posterior tubercle of the atlas)

Question 15

How can you find the palpation spot for C6/C7?

Answer 15

Passively flex and extend neck  C6 moves in and out, C7 remains stationary

Question 16

Facet joints can be found ….. - ….. laterally from the spinous process (felt as a hard-bony mass under fingers

Answer 16

1.3-2.5cm

Question 17

Signs and symptoms of Vertebrobasilar insufficiency?

Answer 17

5Ds and 3Ns…,

• Dizziness
• Diplopia
• Dysarthria
• Dysphagia
• Drop attacks
• Nystagmus
• Nausea
• Numbness

Question 18

Cardiovascular risk factors of VBI?

Answer 18

The patient may have cardiovascular risk factors such as hypertension, elevated cholesterol and smoking.

Question 19

What is the positional test for VBI?

Answer 19

Sustained rotation in sitting

Question 20

Most common age group for VBI?

Answer 20

Characteristically seen in older patients over 65.

It can occur in younger people or as a feature of vertebral artery dissection.

Question 21

What are the superficial neck muscles? *3

Answer 21

• Trapezius
• Splenius capitis & cervicis
• Semispinalis capitis & cervicis

Question 22

What are the deep neck muscles? *5

Answer 22

Rectus capitus posterior major
Rectus capitus posterior minor
Superior oblique
Inferior oblique
Levator scapulae

Question 23

Where does the sternocleidomastoid sit and what is its role?

Answer 23

A prominent muscle on the side of the neck, extending from the sternum and clavicle to the mastoid process of the temporal bone, important for rotating and flexing the head.

Question 24

Position & role of the rectus capitis posterior minor?

Answer 24

A small muscle connecting the atlas (C1) to the occipital bone, helping to extend the head.

Question 25

Position & role of the rectus capitis posterior major

Answer 25

A larger muscle from the axis (C2) to the occipital bone, also involved in head extension and rotation

Question 26

Position & role of the obliquus capitus superior

Answer 26

A muscle running from the superior surface of transverse process of atlas (first cervical vertebra) to the superior and inferior nuchal lines on the external surface of occipital bone, involved in extension of neck.

Question 26

Position & role of the obliquus capitis inferior?

Answer 26

A muscle running from the axis (C2) to the atlas (C1), involved in rotating the head.

Question 27

Anterior superficial neck muscles?

Answer 27

- Sternocleidomastoid - Scalene: anterior, middle & posterior

Question 28

Deep anterior neck muscles

Answer 28

Rectus capitus anterior Rectus capitus lateralis Longus capitus Longismus colli

Question 29

Origin and insertion of the scaleni?

Answer 29

Transverse processes c2-c7- to first and second rib

Question 30

Prevalence of cervical ribs? Where do they attach?

Answer 30

Cervical ribs tend to occur in approximately 0.5 to 1% of the population. They are commonly attached to the seventh cervical vertebra. It's not usually a problem, but if it presses on nearby nerves and blood vessels, it can cause neck pain, numbness in the arm and other symptoms. This is known as thoracic outlet syndrome.

Question 31

The movement at the following joint permits a person to look towards the right or left : A. Atlanto-occipital joint B. Atlanto-axial joint C. C2-C3 joint D. C3-C4 joint

Answer 31

Atlanto axial joint?

Question 32

The hyoid bone is at what level? a) C2 vertebra b) C3 vertebra c) C4 vertebra d) C5 vertebra e) C6 vertebra

Answer 32

B) C3 vertebrae

Question 33

Regarding the cervical spine, which is TRUE? a) all seven cervical vertebrae have spinous processes b) rotatory movements of the head occur mostly at the atlanto-occipital joints c) the odontoid process (peg) is encased by a bony canal in the axis d) all seven cervical vertebrae have foramina transversaria for the vertebral artery to pass through it e) spinous processes, where present, are all bifid except for C7

Answer 33

C) the odontoid process (peg) is encased by a bony canal in the axis

Question 34

For sternocleidomastoid, which is TRUE? a) contraction of one muscle rotates the head to the ipsilateral shoulder b) it is crossed superficially by the external jugular vein c) it is supplied by the transverse cervical nerve d) its clavicular fibres mainly insert into the superior nucal line e) it is superficial to the deep cervical fascia

Answer 34

B) it is crossed by the external jugular vein

Question 35

The seventh cervical vertebra a. Is typical b. Has a bifid spinous process c. Transmits the vertebral artery through the foramen in the transverse process d. Has the supra-pleural membrane attached to the anterior tubercle e. Has a short spinous process

Answer 35

E) Has a short spinous process *this is false - C7 has a short spinous process which is longer than those the other cervical vertebrae

Question 36

9. The atlas a. Has no foramen in the transverse process b. Is the narrowest cervical vertebra c. Has a body d. Has a posterior arch grooved by the vertebral artery e. Has a short spinous process

Answer 36

D) has a posterior arch grooved by the vertebral artery