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Cervical Spine
Functional Anatomy and Examination
179
Anatomy
Graduate
09/18/2014

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Cards

Term
What is the normal position of the head?
Definition
mid-poisition between flexion and extension
Term
There is an equal loss of rotation in these two capsular patterns for the Cervical spine
Definition
sidebending, extension
Term
This capsular pattern of the cervical neck maintains full rotation
Definition
flexion
Term
The upper cervical spine is also called this
Definition
craniovertebral
Term
What is included within the upper cervical/craniovertebral spine?
Definition
occiput-c2
Term
The upper cervical spine does what
Definition
allows increased mobility, protects medulla oblongata
Term
What comprises the lower cervical spine
Definition
c2-c7
Term
The lower cervical spine compromises on what to allow increased mobility
Definition
stability
Term
The lower cervical spine comprises on stability to allow increased what?
Definition
mobility
Term
What makes up the cervicothoracic junction
Definition
c7-t1
Term
THe cervicothoracic junction is made up of what functionally?
Definition
c7-t2, 1st and 2nd ribs, manubrium
Term
The cervicothoracic junction is what type of zone?
Definition
transitional
Term
The upper cervical joints lack this feature
Definition
intervertebral discs
Term
Between C1 and C2 there is little what
Definition
bony congruity
Term
Stability is provided to the upper cervical joints with what?
Definition
ligamentous and muscular structures
Term
What are the shape of the occipital condyles?
Definition
biconvex
Term
What shape doe the superior facets of the atlas have?
Definition
biconcave
Term
The long axis of the the superior facets of the atlas converge how
Definition
anterior
Term
Would you nod your agreement to atlanto-occipital articulaton being this type of joint?
Definition
yes
Term
THe atlanto-occipital articulation is this type of joint
Definition
synovial
Term
The atlanto-occipital articulation has two degrees of freedom
Definition
flex/ext, sidebending
Term
The atlanto-occipital articulation has how many degrees of flexion
Definition
10
Term
The atlanto-occpital joint articulation has how many degrees of extension
Definition
15-20
Term
Atlanto-Occipital Arthrokinematics: Flexion
Definition
both convex occipital condyles glide in the opposite direction of movement of the occiput, (posterior)
Term
Atlanto-Occipital Arthrokinematics: Extension
Definition
both occipital condyles glide in the opposite direction of the movement of the occiput, anterior
Term
Atlanto-Occipital Arthrokinematics: Sidebending (on side of sidebending)
Definition
occipital condyles glide medial, inferior, and anterior
Term
Atlanto-Occipital Arthrokinematics: coupled motion of upper cervical
Definition
rotation and sidebending to opposite sides
Term
What is the shape of the inferior surfaces of the lateral mass of C1
Definition
convex
Term
THe superior articular surfaces of C2 are what shape?
Definition
convex
Term
THe bony configuration of the AA joint may be what shape?
Definition
concave
Term
The articular cartilage of the AA joint provides this surface
Definition
convex
Term
AA Articulation has what shape?
Definition
bi-convex
Term
The AA joint has bi-convex articulation meaning
Definition
vertical height of the joint decreases with movement away from apex of convexity
Term
What articulates with the posterior surface of the anterior arch of the atlas?
Definition
dens/odontoid
Term
How many synovial joints are there in the AA joint?
Definition
3
Term
You would shake your head, knowing that the AA is this type of joint
Definition
No
Term
The AA joint has these degrees of freedom
Definition
rotation, flexion/extension
Term
AA Articulation: Range of Motion: Rotation (single direction)
Definition
40-45 degrees
Term
AA articulation: Range of motion: Combined flexion/extension
Definition
10 degrees
Term
Atlantoaxial Arthrokinematics: Rotation (to the right)
Definition
right facet of C1 glides in a posterior direction and the left facet glides anterior
Term
Atlantoaxial Arthrokinematics: Rotation, can be imagined as what
Definition
Hands on a steering wheel
Term
Atlantoaxial Arthrokinematics: Flexion
Definition
Both facets roll anterior and glide posterior. Anterior arch of C1 glides caudal on the anterior surface of the Dens
Term
Atlantoaxial Arthrokinematics: Extension
Definition
both facets roll posterior, glide anterior, anterior arch of C1 glides cephalic on the anterior surface of the dens
Term
The mid/lower cervical spine primarily serves as what?
Definition
load-bearing structure for compressive forces
Term
THe uncinate processes project in which directio from the posterolateral rims of the vertebral body
Definition
updwards
Term
THe uncinate processes project upwards from the _________ rims of the vertebral body
Definition
posterolateral
Term
What is the role of the uncinate processes?
Definition
prevent lateral shear
Term
THe uncinate processes convert the planar plateau into what?
Definition
modified concave surface
Term
THe articulations of the uncinate processes form this joint
Definition
uncovertebral joints
Term
Uncovertebral joints are also known as what
Definition
joints of Lushka
Term
The uncovertebral joints span through these vertebra
Definition
c3-t1
Term
There are usually how many saddle-shapped diarthrodial articulations?
Definition
10
Term
THe uncovertebral joints are formed between the uncinate processes found on the lateral aspect of the superior surface of the inferior vertebra, and what?
Definition
beveled inferior-lateral aspect of the superior vertebra
Term
Zygaphophysial joints are this typical joint
Definition
synovial
Term
THe facets of zygapophysial joints are lined with what?
Definition
articular cartilage
Term
THe joint capsules of zygapophysial joints are lax allowing for what?
Definition
increased mobility
Term
This intra-articular inclusion is always present in zygapophysial joints
Definition
fibroapidose meniscoids
Term
The plane of the zygapophysical joint facets of the upper cervical spine are what orientation?
Definition
horizontal
Term
The plane of the zygapophysical joint facets of the upper cervical vertebra is closer to what?
Definition
35 degrees from horizontal
Term
The plane of the zygapophysical joint facets of the lower cervical vertebra take what orientation?
Definition
65 degrees below the horizontal
Term
Orientation of the zygapophysial joints dictates what?
Definition
movement patterns and coupled movements
Term
Zygapophysical joint referral patterns: Pain is associated with what
Definition
movement of joint
Term
Mid/Lower Cervical Spine Articular Surfaces: Inferior articular surfaces face how?
Definition
inferior and anterior
Term
Mid/Lower Cervical Spine Articular Surfaces: superior articular surfaces of the vertebrae face how?
Definition
superior and posterior
Term
Unciform processes extend what of the vertebral body
Definition
superior plateau of either side
Term
Unciform processes extend the superior plateau of the vertebral plateau of the vertebral body on either side and articulate with a facet on what plateau of the vertebra above?
Definition
inferior
Term
How many discs are there in the cervical spine
Definition
5
Term
Where is the first cervical disc located?
Definition
c2-c3
Term
How are the cervical discs named?
Definition
after vertebra above
Term
What is the name of the disc between c4 and c5
Definition
c4
Term
The IVD height to vertebral body height is greatest where?
Definition
cervical spine
Term
The IVD height to cervical vertebral body ration is what?
Definition
2:5
Term
The IVD make up approximately how much of the superior to inferior height of the cervical spine
Definition
25%
Term
Anterior the cervical annulus fibrosis consists of these type of interwoven fibers
Definition
alar
Term
Posterior the anulus fibrosis lacks these types of fibers
Definition
oblique
Term
Posteriorly, annulus fibrosis consists exclusively of these fibers
Definition
vertically oriented
Term
In no region of the cervical annulus, do successive lamellae exhibit alternating orientations as seen in what portion of the spine?
Definition
lumbar
Term
The cervical discs are protected from herniation by what structures?
Definition
uncovertebral, posterior longitudinal ligament, disc morpohology
Term
You are less likely to have a herniated disk the older you get as a result of what?
Definition
nucleus becomes more fibrocartilagenous
Term
Considering the structure of the cervical annulus fibrosis, the possibilities that emerge for mechanisms of discogenic pain are
Definition
strain or tears of anterior AF
Term
Mechanisms of discogenic pain are usually a result of what?
Definition
hyperextension trauma, strain of the lateral portions of the Posterior longitudinal ligament when stretched by a bulging disc
Term
What cervical disc tend to involve nerve roots?
Definition
c7, c6, c4/c5
Term
What are the 3 degrees of freedom of the Mid/lower cervical spine?
Definition
flex/ext, lateral flexion, axial rotation
Term
flex/ext of c2-c3
Definition
8 degrees
Term
flex/ext of c3/c4
Definition
13 degrees
Term
flex/ext of c4-c5
Definition
12 degrees
Term
flex/ext of c5-c6
Definition
17 degrees
Term
flex/ext of c6-c7
Definition
16 degrees
Term
flex/ext of c7-t1
Definition
6 degrees
Term
Arthrokinemeatics of the Mid/lower Cervical Spine: Flexion
Definition
both facets of the upper vertebrae glide up and forward (open)
Term
Arthrokinemeatics of the Mid/lower Cervical Spine: extension
Definition
both facets of the upper vertebrae glide down and back (close)
Term
Arthrokinemeatics of the Mid/lower Cervical Spine: rotation to the right
Definition
right facet glides down and back while the left facet glides up and forward
Term
Arthrokinemeatics of the Mid/lower Cervical Spine: sidebending to the right
Definition
the right facet glides down and back while the left facet glides up and forward
Term
Coupled movements of the mid/lower cervical spine
Definition
rotation and sidebending occur to the same side
Term
If the head is in protraction, the upper cervical spine is in
Definition
extension
Term
If the head is in protraction the lower cervical spine is in
Definition
flexion
Term
If the head is in retraction, the upper cervical spine is in
Definition
flexion
Term
If the head is in retractoin, the lower cervical spine is in
Definition
extension
Term
The transverse ligament attaches on either side of the
Definition
atlas
Term
The transverse ligament courses posterior to the
Definition
dens
Term
What is the primary stabilizer preventing anterior translation of C1 on C2
Definition
transverse ligament
Term
What results in a 4 mm increase in anterior movement of the dens on C1
Definition
transection of transverse ligament
Term
The alar ligament is made up of two portions, one that attaches to the ________ and the other to the _________
Definition
atlas, occiput
Term
The alar ligament runs from the lateral odontoid to the medial margins of what
Definition
foramen magnum
Term
The alar ligament runs from the medial margins of the foramen magnum to what
Definition
lateral ondontoid
Term
What is the primary restraint for cervical flexion, lateral flexion, and most importantly axial rotation
Definition
alar ligament
Term
The posterior longitudinal ligament is widest where
Definition
cervical spine
Term
THe PLL blends with what
Definition
posterior annulus and vertebral bodies
Term
The PLL checks the posterior migration of what?
Definition
nucleus pulposus
Term
The PLL resists what
Definition
tension
Term
The tectorial membrane is a continuation of what
Definition
posterior longitudinal ligament
Term
The tectorial membrane attaches to what
Definition
foramen magnum
Term
WHat bridges spaces between adjacent lamina
Definition
ligamentum flavum
Term
This ligament is highly elastic
Definition
ligamentum flavum
Term
The ligamentum flavum possibly prevents this motion of the neck
Definition
hyperflexion
Term
The ligamentum flavum provides a smooth posterior wall to what
Definition
vertebral canal
Term
The supraspinous ligament and ligamentum nucahe serve as what
Definition
intermuscular septa
Term
The supraspinous ligament and ligamentum nuchae is taught with what motion of the neck
Definition
extreme of neck flexion
Term
The supraspinous ligament and ligamentum nuchae are taught with the extreme of neck flexion resulting in what
Definition
flattening of the cervical lordosis
Term
the supraspinous ligament and ligamentum nuchae possibly prevents what motion of the neck
Definition
hyperflexion
Term
The vertebral arteries come together to form what
Definition
basilar artery
Term
Partial to complete occlusion of the vertebral artery may occur as a result of what
Definition
extension and rotation of the cervical spine
Term
5 D's
Definition
dizziness, drop attack, dysphagia, dysarthra, diplopia
Term
Vertebral Artery insufficiency: Positive examination findings
Definition
nystagmus, slurring of speech, blurring of vision, dizziness, loss of consciousness, nausea, perioral numbness
Term
nystagmus
Definition
involuntary eye movements
Term
stretching and occlusion of VA occurs with what
Definition
normal ADL's
Term
The VA contributes how much of total cerebral blood flow
Definition
11%
Term
89% of cerebral blood flow comes from where
Definition
carotids
Term
Rotation of teh C1/C2 articulation results in what
Definition
stretching of the VA
Term
Deep muscles of Head and neck: suboccipitals: combined action
Definition
extension, ipsilateral rotation, lateral flexion
Term
What is contained within suboccipital triangle
Definition
vertebral artery and dorsal ramus of c1
Term
There is a large concentration of what in the suboccipitals
Definition
muscle spindles
Term
Shortening of the suboccipitals affects what
Definition
posture
Term
The multifidus in cervical region is most likely more important for ______ rather than being a prime mover
Definition
proprioception
Term
The semispinalis muscles are prime movers for what
Definition
extension
Term
The semispinalis muscles are capable of some of what motion?
Definition
lateral flexoin
Term
The semispinalis muscles are active during what
Definition
upright posutres, stabilizes lower cervical
Term
The semispinalis capitis is pierced by what
Definition
greater occipital nerve
Term
This structure may be subject to entrapment by tension in the semispinalis capitis muscle
Definition
greater occipital nerve
Term
The splenius muscles have what actions
Definition
extension, lateral flexion, ipsilateral rotation
Term
These muscles are very active during extension
Definition
splenius
Term
The splenius muscles may ______ with forward head posture
Definition
shorten
Term
The levator scapulae is responsible for what
Definition
scapular elevation and downward rotation
Term
If the scapula remains fixed, what are the actions of the levator scapulae
Definition
extension, lateral flexion, ipsilateral rotation
Term
This muscle stabilizes the head and neck with anterior muscles, while being involved with the scapula
Definition
levator scapulae
Term
This muscle tends to lengthen with poor posture
Definition
levator scapulae
Term
WHat is the primary function of the trapezius
Definition
move the shoulder
Term
The trapezius moves the scapula how?
Definition
depresses, retracts, upwardly rotates
Term
If the scapula remains fixed, the trapezius performs these actiosn
Definition
bilaterally extension of cervical spine. Unilateral flex and contralaterally rotates cervical spine
Term
What forms the medial border of the anterior/supraclavicular triangle
Definition
sternocleidomastiod
Term
what is the bilateral action of the sternocleidomastiod
Definition
flexion
Term
what is the unilateral action of the sternoclediomastiod
Definition
ipsilateral flexion, contralateral rotation
Term
Torticollicis
Definition
spasmodic and congential
Term
torticollicis
Definition
head is tipped one way, with chin going in another
Term
the sternocleidomastoid can be affected by this MVA injury
Definition
whiplash
Term
unilateral action of the scalenes
Definition
laterally flex, contrallaterally rotate, elevate rib
Term
bilateral action of the scalenes
Definition
flexion of the neck
Term
the scalenes are an accessory muscle for this action
Definition
breathing
Term
tightness of the scalenes may result in compression of these structures
Definition
brachial plexus, subclavian artery
Term
Compression of the brachial plexus and subclavian artery by the scalenes is called what
Definition
thoracic outlet syndrome
Term
What are the deep cervical flexors
Definition
longus colli, rectus capitis
Term
What are the actions of the deep cervical flexors
Definition
flexion, ispilateral rotaiton
Term
What is the role of the deep cervical flexors
Definition
stabilize the head and neck and prevent hyperextension
Term
The deep cervical flexors are often damaged as a result of what
Definition
whiplash
Term
Dysfunction of the deep cervical flexors has a relationship with what
Definition
cervical instability, headaches
Term
Muscle contraction coupled with the weight of the head produces considerable _______ forces on the neck
Definition
compressive
Term
Cervical Root Assessment: C1: Dermatome
Definition
None
Term
Cervical Root Assessment: C1: Myotome
Definition
neck flexion
Term
Cervical Root Assessment: C1: DTR
Definition
none
Term
Cervical Root Assessment: C2: Dermatome
Definition
behind the ear
Term
Cervical Root Assessment: C2: myotome
Definition
neck extension
Term
Cervical Root Assessment: C2: DTR
Definition
none
Term
Cervical Root Assessment: C3: dermatome
Definition
lateral neck
Term
Cervical Root Assessment: C3: myotome
Definition
neck sidebending
Term
Cervical Root Assessment: C3: DTR
Definition
none
Term
Cervical Root Assessment: C4: dermatome
Definition
upper trapezius
Term
Cervical Root Assessment: C4: myotome
Definition
shoulder elevation
Term
Cervical Root Assessment: C4: dtr
Definition
none
Term
Cervical Root Assessment: C4: DTR
Definition
none
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