week 6- cervical spine Flashcards
What is the primary function of the cervical spine?
mobility, support, and protection of spinal canal and neural structures
How many pairs of exiting nerve roots are in the cervical spine?
8
How many intervertebral discs in the cervical spine?
6
where does most of the lordosis occur in the cervical spine?
at C1-C2 segment
Where does approximately 50% of flexion-extension occur in the cervical spine?
occiput-C1
Where does approximately 50% of rotation occur in the cervical spine?
C1-C2
What are uncovertebral joints also known as?
joints of Hubert von Luschka
Where are uncovertebral joints found?
only in the cervical spine
What type of joint are uncovertebral joints?
synovial plane joints
Name the atypical vertebra in the cervical spine
Atlas (C1)
Axis (C2)
Vertebra prominens (C7)
Why is the atlas ring shaped?
provides a big surface for occipital to sit on
Name some features of the atlas
ring shaped
2 lateral masses
biconcave superior articular surface
anterior and posterior arch
inferior articular surface
transverse foramen x 2
transverse processes
What is another name for the dens?
odontoid peg
Name some features of the axis
odontoid peg
2 lateral articular facets
transverse processes and foramen x2
lamina
bifid spinous process
name the most prominent vertebra we can palpate in the cervical spine
Vertebra Prominens
What type of joint is the atlanto-occipital joint?
synovial ellipsoid
Name the articular surfaces of the atlanto-occipital joint
C0- occipital condyles
C1-superior articular facet on the atlas
How many joints in the atlanto-axial joint region?
two
What can atlanto-axial instability occur due to?
traumatic, congenital or inflammatory disorder
What is the median atlanto-axial joint between?
dens and articular facet on atlas
What type of joint is the median atlanto-axial joint?
synovial pivot joint
Name the articular surfaces of the median Atlanto-axial joint
convex rectangular facet on the front of the dens
concave facet inner aspect of anterior arch of the atlas
posterior surface of the dens articulates with the transverse ligament
What type of joint is the lateral Atlanto-axial joint?
synovial plane joint
What are the articular surfaces of the lateral Atlanto-axial joint?
two concave inferior facets of the atlas articulate with the two concave superior facets of the axis
Name the upper cervical spine ligaments
transverse ligament
cruciform ligament
alar ligament
apical ligament
tectorial membrane
ligamentum nuchae
posterior atlantoaxial membrane
anterior atlantoaxial membrane
Where are the attachments of the transverse ligament?
Runs transversely between the lateral masses of the atlas, attaching to the tubercle on their medial aspects
What is the function of the transverse ligament?
To prevent anterior displacement of the atlas on the axis
What is the proximal attachment of the superior longitudinal band of the cruciform ligament?
basilar part of the occipital bone
What is the distal attachment of the superior longitudinal band of the cruciform ligament?
superior margin of the transverse ligament
What is the proximal attachment of the inferior longitudinal band of the cruciform ligament?
inferior margin of the transverse ligament
What is the distal attachment of the inferior longitudinal band of the cruciform ligament?
posterior aspect of the body of axis
What is the function of the cruciform ligament?
stability of the region by limiting flexion
What is the proximal attachment of the alar ligament?
medial aspects of the occiput
What is the distal attachment of the alar ligaments?
apex of the dens
What is the function of the alar ligaments?
limits flexion, rotation and side flexion
Prevents distraction of C1 on C2
What is the proximal attachment of the apical ligament?
anterior edge of the foramen magnum
What is the distal attachment of the apical ligament?
apex of the dens (centrally)
What is the function of the apical ligament?
unknown
What is the proximal attachment of the tectorial membrane?
basilar part of the occipital bone
What is the distal attachment of the tectorial membrane?
posterior surface of the body of C2
What is the function of the tectorial membrane?
Limits flexion
Which ligament in the cervical spine is a continuation of the posterior longitudinal ligament?
tectorial membrane
What is the proximal attachment of ligamentum nuchae?
external occipital protuberance to the foramen magnum
What is the distal attachment of ligamentum nuchae?
spinous process of vertebra C7
What is the function of ligamentum nuchae?
supports the head
resists flexion
provides attachment for adjacent muscles
Name some other attachments of ligamentum nuchae (not the distal or proximal main ones)
posterior tubercle of C1 and the spinous processes of the other cervical vertebra
Which ligament in the cervical spine is a continuation of ligamentum flavum?
posterior Atlanto-axial membrane
What does the posterior Atlanto-axial membrane do?
Connects the lamina of C1-C2
Which ligament in the cervical spine is a continuation of the anterior longitudinal ligament?
Anterior Atlanto-occipital membrane
Where does the anterior Atlanto-occipital membrane attach?
anterior aspect of the dens to the anterior aspect of the atlas
Name the lower cervical spine ligaments
anterior longitudinal ligament
posterior longitudinal ligament
ligamentum flavum
intertransverse ligament
interspinous ligament
ligamentum nuchae (supraspinous ligament)
What supplies 10-20% of blood to brain?
vertebral artery
What ligaments limit flexion in the cervical region?
transverse ligament
tectorial membrane
posterior atlanto-axial/atlanto-occipital ligament
alar ligament
What ligaments limit extension in the cervical region?
tectorial membrane
anterior atlanto-axial/atlanto-occipital ligament
What limits rotation in the cervical region?
contralateral alar ligaments
joint capsules
tectorial membrane
both atlanto-axial ligaments
What is lateral flexion limited by in the cervical spine?
alar ligaments
Approximately how much cervical flexion should you have?
70 degrees
How do you visually estimate full range cervical flexion?
patient should be able to get chin to sternum or chin to within 2 fingers width of sternum for full range to be achieved
Approximately how much cervical extension should you have?
70 degrees
How can you visually estimate full range of cervical extension?
patient should be able to get forehead parallel to ceiling for full range to be acheived
Approximately how much cervical rotation should you have?
90 degrees
How do you visually estimate if a patient has full range of cervical rotation?
patient should be able to get nose level with acromion process
Approximately how much cervical lateral flexion should you have?
45 degrees
