Week 2 - Mid to Lower Cervical Spine Flashcards
What fraction of the population experiences neck pain?
2/3rds
What percent of individuals with neck pain will have chronic pain?
10%
Does the frequency of neck pain increase or decrease with age?
increases
Which gender and age has the highest incidence rate of neck pain?
Female and middle age
As physical therapists working in outpatient centers approximately what percentage of patient are will be related to neck pain?
25%
Which region of the spine is the most mobile?
Cervical
What is the primary function of the cervical spine?
To accommodate for a wide range of motion required by the head.
How many cervical vertebrae are there?
7 bony vertebrae
Is the normal curvature of the spine kyphotic or lordotic?
lordotic
What is the typical angulation of the cervical region?
angulation of lordosis typically ranging from 30-35 degrees
Which cervical vertebrae are considered typical?
C3-C6
Are typical cervical vertebrae bodies square or rectangular in shape?
rectuangular
Are typical cervical vertebrae bodies wider in the medial to lateral aspects or anterior to posterior
wider in the medial to lateral aspects than anterior to posterior.
Are the typical cervical vertebrae bodies flat or curved?
bodies are curved almost saddle shapped
Are the typical cervical vertebral canal triangular or rectangular in shape? small or large? why?
more triangular in shape and is large to accomodate the increased thickness of the spinal cord that is associated with the cervical and brachial plexus.
What is the saddle shape of the bodies of the cervical vertebrae due to?
Uncinate processes
What are Uncinate processes?
A raised lateral hook on the superior lateral aspect of the bodies of cervical vertebrae C3-C7.
What is a uncovertebral joint (u joint)?
a “psuedo joint” of articulation between the uncinate process and adjacent part of the vertebrae above
What is the purpose of the u joint?
has a contribution in range of motion as the control lateral flexion and permit sagittal movement of flexion and extension.
What is the clinical significance of the u joint?
degeneration may occur, intervertebral disc blends with so increase in compressive forces may develop bone spurs impinging nerve roots rendering neurological symptoms (muscle weakness, impaired sensation, and numbness and tingling in hands)
What is another name for articular processes?
facets
How many facets does each vertebrae have?
With the exception of C1, each vertebrae has a pair of superior and inferior facets.
What is another name for facet joints?
apophyseal joints
What type of joint is a facet joint?
flat plane synovial joint
What lines facet joints?
articular cartilaged
What encloses facet joints?
synovial lines capsule
Is the facet joint capsule innervated?
yes
What forms the facet joint?
the superior and inferior articular processes of the adjacent vertebrae
How would you describe the orientation of the facet joint?
oblique
What are the facet joints responsible for?
guiding intervertebral motion.
C2 Facet Orientation:
- Superior facet articulates with ___.
- Degree orientation of facet?
- Favor what type of movment
- Superior facet articulates with INFERIOR FACET OF C1.
- 20 degree inclination to the horizontal plane.
- Favor axial rotation.
C3-C7 Facet Orientation: Degree orientation of facet?
45 degree inclination to the horizontal and frontal planes.
What primarily influences the range of motion throughout the spine?
facet orientation
The mid-lower cervical spine permits movement in what planes? What does this support?
All 3: sagittal, horizontal, and frontal. Supports primary role of cervical spine supporting the required movement of the head.
Collectively the mid-lower cervical spine renders between what degree of flexion?
35-40 degrees
Collectively the mid-lower cervical spine renders between what degree of extension?
55-60 degrees
Collectively the mid-lower cervical spine renders between what degree of rotation and lateral flexion?
30-35 degrees
Across the entire craniocervical spine, what is the the total degree of flexion?
45-50 degrees
Across the entire craniocervical spine, what is the the total degree of extension?
75-80 degrees
Across the entire craniocervical spine, what is the the total degree of unilateral rotation?
65-75 degrees
Across the entire craniocervical spine, what is the the total degree of unilateral flexion?
35-40 degrees
Flexion and Extension occurs about which plane in the C2-C7 spine?
Sagittal Plane
What angle plane does the flexion and extension motion follow in the C2-C7 spine?
oblique plane (recall the 45 degree inclination that exits between facet joints)
Describe the motion of the facets of the C2-C7 spine during flexion.
the INFERIOR articular facets of the superior vertebrae slide superiorly and anteriorly, relative to the superior articular facets of the inferior vertebrae.
During flexion, the sliding action between relatively flat articular surfaces of facets C2-C7 creates what? what purpose does this serve?
creates a “gapping” or opening between the two surfaces of joint separation. This allows for flexion.
What structures limit flexion of C2-C7 and are they located anterior or posterior? (4)
Posterior Structures:
- Posterior Longitudinal Ligament
- Ligamentum Nuchae
- Interspinous Ligaments
- Muscles
Describe the motion of the facets of the C2-C7 spine during extension.
the INFERIOR articular facet of the superior vertebrae slide inferiorly and posteriorly relative to the superior articular facets of the inferior vertebrae .
During extension, the sliding action between relatively flat articular surfaces of facets C2-C7 creates what?
Facets approximate or “close” down as the move closer to one another moving in the posterior direction.
What structures limit extension of C2-C7 and are they located anterior or posterior? (3)
Anterior Structures: 1. Anterior Longitudinal Ligament 2. Approximation of Apophyseal Joints (close of facet joints) 3. Muscles
Describe the motion of the facets of the C2-C7 spine during lateral flexion.
Ipsilateral Side (sidebend): inferior articular facets of the superior vertebrae slide inferiorly and a little posteriorly
Contralateral Side:
inferior articular facets slide superiorly and slightly anteriorly
During lateral flexion, the sliding action between the relatively flat articular surfaces of C2-C7 creates what?
Ipsilateral Side (sidebend): facets downslide aka close down
Contralateral Side:
facets upslide aka slightly gaps/opens
Describe the motion of the facets of C2-C7 spine during axial rotation.
Ipsilateral Side of Rotation:
inferior facet of the superior vertebrae slides posteriorly and slightly inferior
Contralateral Side of Rotation:
inferior facet of the superior vertebrae slides anteriorly and slightly superior
When describing the movment of the facets during motion of the spine, what is used as the reference point?
the inferior facet of the superior vertebrae and its sliding movement on the superior facet of the superior vertebrae (bilaterally or unilaterally - ipsilateral/contralateral)
Is spinal coupling the same for the upper and mid-lower cervical spine?
No, opposite.
Describe the coupling pattern between lateral flexion and axial rotation in the upper cervical spine AA joint.
In the upper cervical spine AA joints lateral flexion and axial rotation coupling occurs to the opposite side or contralaterally
Describe the coupling pattern between lateral flexion and axial rotation in the mid-lower cervical spine C2-C7.
In the mid-lower cervical spine axial rotation and lateral flexion coupling pattern occurs to the same side or ipislaterally.