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South College MSK 3 > Week 1- Cervical Spine Anatomy & Pathology > Flashcards

Week 1- Cervical Spine Anatomy & Pathology Flashcards

1
Q

Compare the relevance of anatomy in acute vs chronic neck pain

A 
Acute
- Could be significant source
of nociception and very
relevant to treat
- Requires exceptional
knowledge
Chronic
- Becomes less relevant to
pain
- Knowledge is
needed to test and help
reassure BEFORE pain
science
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2
Q

Characteristics of the cervical spine that make it challenging to treat

A
  • Extreme mobility
  • Complex series of joints
  • Different functions of the IVD and ZPJ
  • Vertebral and Carotid arteries
  • Seven vertebrae and 8 nerve roots
  • Close approximation to the shoulder
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3
Q

Upper cervical spine

A

C0-C2

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4
Q

Lower cervical spine

A

C3-C7

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5
Q

Unique characteristics of C1

A
  • No vertebral body
  • Anterior and posterior
    arches
  • Lateral masses contain
    superior and inferior
    articulating facets,
    both are concave
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6
Q

Unique characteristics of C2

A
  • Small vertebral body
  • Large bifid spinous
    process
    (easy to palpate)
  • Dens is superior
    projection off
    the body
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7
Q

Characteristics of the lower cervical vertebrae

A
  • Small vertebral body

- Uncinate processes located on superior surface of vertebral body

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8
Q

What is formed by the uncinate processes?

A

Joints of Luschka

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9
Q

Where are the uncinate processes located?

A

C3-C7

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10
Q

Functions of uncinate processes

A
  • Limit sidebending protecting cervical nerve roots
  • Support intervertebral discs from protruding
  • Form medial wall of the
    intervertebral foramen/ canal
  • Become weight-bearing with age and disc dehydration
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11
Q

What do the uncovertebral joints combine with the ZPJs to do?

A

Stability, protecting the IVD from severe torsion strain

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12
Q

Do the ZPJs in the C spine or L spine protect the IVDs more?

A

ZPJs in the L spine

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13
Q

What categories of cervical pathology do we examine?

A

Pathology due to:

  • Aging
  • Trauma
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14
Q

What pathologies due to aging do we examine?

A
  • Uncovertebral joints
  • Disc changes
  • Facet joint degeneration
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15
Q

Uncovertebral Joint Symptoms

A 
- Very little pain – vague
discomfort
- Stiffness > pain
- NO referred or
neurological symptoms
- Morning stiffness
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16
Q

Are uncovertebral joints potential pain generators in the cervical spine?

A

Yes

17
Q

Uncovertebral Joint Signs

A
  • Loss of extension
  • Neck in forward flexed position
  • Limited side bend in flexion,
    neutral and extension
  • Decreased rotation
  • Crepitus/”grinding”
18
Q

Describe the progression of the uncus at 8 years old

A

Uncus grows upwards from the lateral edge of the vertebral body

19
Q

When do the uncovertebral cleft appear?

A

By 12 years

20
Q

When do fine fissures extend across the discs?

A

Late 20s/early 30s

21
Q

Describe the progression of the disc fissuring at 35-40 years old

A
  • Nucleus and posterior annulus usually completely fissured

- Anterior annulus and longitudinal ligaments remain intact

22
Q

Describe the progression of the disc fissuring in the 50s and 60s

A

Disc thinning and resorption frequently seen at C5-6 or C6-7

23
Q

Describe the progression of the disc fissuring in the 70s and 80s

A

Spontaneous fusion is common in the lower cervical levels

24
Q

What happens as a result of decreasing disc height as we age?

A

Formation of uncovertebral osteophytes and hard posterior disc protrusions

25
Q

What do these formations do to the spaces in the spine

A

Encroach on the intervertebral and

spinal canals

26
Q

What are the implications of no nucleus in the IVD?

A 
- No inflammatory and immune
mediated chemicals to irritate the
nerve roots
- Lower incidence of upper cervical disc
injury and radiculopathy
27
Q

What are the implications of a present nucleus in the IVD?

A 
- Contains inflammatory and immune
mediated chemicals to irritate the
nerve roots
- Higher incidence of lower cervical disc
injury and radiculopathy
28
Q

Due to the disc changes from aging, what structures experience compressive effects?

A
  • Nerve roots
  • Vertebral arteries
  • Spinal cord
29
Q

Between the lumbar and cervical spine, where are disc lesions more common?

A

Cervical

30
Q

Discogenic clinical presentation

A
  • Cervical spine relatively pain- free/stiff/sore
  • Deep burning, toothache pain around
    the scapular border, supraspinous
    fossa and scapula
  • Referral to the shoulder
31
Q

What innervates facet joints?

A
  • Medial branch

- Dorsal ramus

32
Q

Facet Joint Symptoms

A
  • Sharp, localized pain
  • Unilateral
  • Spasms
  • Referral into the
    UE
33
Q

Facet Joint Signs

A
  • Extension
  • Rotation to the same side
  • Lateral flexion to the same
    side
34
Q

What can cause “stuck neck” or Acute Wry Neck?

A

Prolonged lateral flexion to one side, characterized by sharp catching pain on one side

South College MSK 3 (22 decks)

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