Week 2:The Cervical Spine Flashcards
The upper cervical (craniovertebral) region consists of what 3 structures?
occiput
atlas (C1)
Axis (C2)
The lower cervical region goes from:
C3 - C7
What are your atypical vertebrae in your cervical spine?
Atlas (C1)
Axis (C2)
C7
What are your typical vertebrae in your cervical region?
C3 - C6
What are the 2 functions of the atlas??
cradle occiput and transmit force from occiput to lower C - spine
What 2 structures does the atlas not have that most vertebrae do have?
no vertebral body
no spinous process
what structure is shaped like a ring and has 2 lateral masses separated by anterior and posterior arch?
the atlas
what are 2 functions of the axis?
it transmits combined load of the head/ atlas to C - spine
it also provides axial rotation of the head/atlas
What is the vertical projection from the superior surface of the body on the axis called?
Dens
What is special about the spinous process of the axis?
It is large, elongated, and BIFID
What are 3 characteristics of C7?
- largest cervical vertebrae
- has many characteristics of thoracic vertebrae
- largest spinous process
What are the characteristics of the cervical vertebrae regarding the body, transverse processes, spinous processes and intervertebral disc?
- the body is small and uncinate processes arise from posterolateral margins which give the upper surface a concave shape
- transverse foramen are on the transverse processes
- bifid spinous processes
- intervertebral disc are crescent shape (thick anteriorly and taper laterally) AND
- posterior longitudinal ligament contains nucleus posteriorly.
What is our “yes” joint?
our atlanto - occipital joint.
Our ___________ (concave/convex) occipital condyles articulate with ____________ (concave/convex) superior facets of atlas.
This is a synovial ____________ joint.
convex; concave; condyloid
What is our “no” joints?
Our atlanto - axial joints
how many atlanto - axial joints do we have? What are their names?
2! Median atlanto - axial joint and Lateral atlanto - axial joint
There are ____ lateral atlanto - axial joints.
2
The median AA joint is an articulation between:
It is a synovial ______ joint
The dens and the anterior arch of atlas/ transverse ligament
plane
The lateral AA joints are articulations between:
It is a synovial _________ joint and is ___________ with meniscoids
inferior facets of atlas with superior facets of axis
plane; biconvex
What is the function of the transverse ligament (cruciform ligament)?
It prevents anterior displacement of C1 on C2
What is the unlabeled ligament called?
transverse ligament
Which ligaments TAUT in neck flexion and with axial rotation and also limits LATERAL flexion and prevent distractions of C1 on C2?
The alar ligaments
Label B and A.
A - transverse ligament
B - alar ligament
What are 2 conditions that can compromise the integrity of the transverse ligament, which can result in instability of C1 and C2?
rheumatoid arthritis
down syndrome
What are the 3 characteristics of the facet joints?
they are synovial joints containing fibroadipose meniscoids
the joint capsules are lax
lower cervical facet joints are approximately 45 degrees off the frontal plane and transverse processes
When someone protracts their neck,
the upper cervices ___________
the lower cervices ____________
extends
flexes
When someone extends their neck,
the upper cervices ___________
the lower cervices ____________
flexes
extends
Prolonged protraction results in forward head posture which causes:
lengthening of the deep neck flexors and scapular retractors and tightening of pecs and upper trap and levator scapula
what is the primary motion that occurs at the atlanto - occipital joint in the sagittal plane?
convex occipital condyles on concave superior articular facets of atlas
convex occipital condyles on concave superior articular facets of the atlas have an opposite _________ and _________ in the sagittal plane?
Roll and glide
Describe the movement of your atlanto-occipital joints in a frontal plane?
convex occipital condyles on concave superior articular facet of atlas.
Convex occipital condyles on concave superior articular facet of atlas in the frontal plane of the AO joint creates an opposite ________ and _________.
roll and glide
Flexion at the AO joint: your occipital condyles roll __________ and slide ______________.
anterior;posterior
Extension at the AO joint: Your occipital condyles roll _________ and slide ____________.
posterior; anterior
Movement at the AO joint in the transverse plane is limited by:
deep joint congruency
The atlanto-axial joint can move in the transverse plane thanks to the articulations of:
- anterior arch and transverse ligament and dens
2. inferior facet of the atlas/superior facet of the axis
The anterior arch and transverse ligament in transverse plane allows:
rotation
the inferior facet of the atlas/superior facet of the axis in the transverse plane produces:
ipsilateral posterior glide
contralateral anterior glide
The AA joint can move in the sagittal plane thanks to:
- the anterior arch and transverse ligament/dens
2. inferior facet of atlas/superior facet of axis
The anterior arch and transverse ligament is responsible for what in the sagittal plane?
tilt of the atlas on axis
What movement limits rotation at the AA joint?
alar ligament
what ligament limits tilting of the axis at the AA joint with flexion?
transverse ligament
Lateral flexion and rotation occur _____________.
simultaneously
lateral flexion and rotation are coupled in:
the same direction (this means lateral flexion to the R occurs with rotation to R)
If the lower cervical spine were to rotate or flex in lateral flexion as an isolated movement, what would happen?
The facet joints would come into contact with one another blocking motion.
What happens when the C3 - C7 facet joints flex (in sagittal plane)?
inferior facet glides anterior and superior
What happens when the C3 - C7 facet joints extends (in the sagittal plane) ?
inferior facet glides posterior and inferior
What happens when the C3 - C7 facet joints flex in transverse plane?
same side rotation: inferior facet glides posterior and slightly inferior
opposite side as rotation: inferior facets glid anterior and slightly superior
What happens when the C3 - C7 facet joints laterally flex in the frontal plane?
same side as lateral flexion: inferior facets glides inferiorly and slightly posterior
opposite side of lateral flexion:
describe the arthrokinematics of R rotation @ C4 - C5.
__________ (ipsilateral) C4 facets slides _______________ and slightly _______________ on C5 facets
__________ (contralateral) C4 facets slides _________ an slightly _________ on C5 facet.
R; posterior; inferior
L; anterior; superior
What is the function of the C spine?
Stability and protection
C-spine demonstrates most flexibility
Atlas designed to allow for more free space to prevent impingement
Mobility
What are the muscles of the anterior-lateral craniocervical region
SCM
scalenes
longus colli
longus capitis
what are the muscles of the posterior craniocervical region?
splenius cervicis splenius capitis suboccipital muscles: - Rectus capitis posterior major -Rectus capitis posterior minor - Obliquus capitis superior - Obliquus capitis inferior
Excessive tension placed on the __________________ and the ________________ with prolonged protraction cause which muscle to become fatigued?
levator scapulae and semispinalis capitis
rectus capitis posterior major
what are the 3 reasons for muscular imbalances in the neck?
- excessive or violent hyperextension movement strain SCM, longus colli, and anterior scalenes causing chronic spasm or guarding
- inhibition, pain, weakness, fatigability of deep flexors (longus colli/capitis) resulting in SCM and anterior scalene becoming more dominant.
- ergonomics: protracting to improve visual contact with computer screen.
