Cervical and Lumbar Spine

Question 1

How many articulations does a cervical vertebrate have?

Answer 1

5

• Two Z joints
• Two uncinate joints
• 1 disc

Question 2

What is the closed and resting position of the zygapophyseal joints (articular facets)?

Answer 2

closed: full extension
resting: slight flexion

Question 3

What is the pattern of restriction of the cervical joints?

Answer 3

side flexion, extension

Question 4

What two components make up intervertebral discs?

Answer 4

Annulus fibrosis (outer ring)
Nucleus pulposis (inner ring)

Question 5

Which area intervertebral discs is avascular?

Answer 5

NP contains no blood or nerve supply

Question 6

Explain the arthrokinematics of the Alanto-occipital joint.

Answer 6

Occiput = convex
Atlas = concave
Flexion anterior roll and posterior slide
Extension posterior roll, slide anterior

Question 7

Explain the arthrokinematics of the Alanto-axial joint.

Answer 7

Atlas = concave
Axis = convex with concave properties due to cartilage

Rotation is the primary movement “No”

Question 8

What cervical ligament prevents damage to the spinal cord during movement?

Answer 8

Transverse

- prevents anterior displacement of the atlas on the axis

Question 9

What does the vertebral artery branch off into?

Answer 9

basilar artery

Question 10

What are the signs of spinal cord problems?

Answer 10

hyperreflexia, clonus, +VE Babinski, ataxic gait, +VE sharp-purser

Question 11

What is a cervical myelopathy?

Answer 11

narrowing of cervical spinal cord

Question 12

What is the structural difference between the lumbar and cervical vertebrae?

Answer 12

The lumbar spine does not contain a transverse foramen or unicate joints.

Both vertebrae don’t articulate with the ribs

Question 13

Nucleus Pulposis

Answer 13

the inner part of the intervertebral disc

- absorbs water to help shock absorption and provides nutrients

Question 14

Annulus fibrosis

Answer 14

the outer part of the intervertebral disc

• concentric laminar fibers support stability and shock absorption
• helps prevent disc bulging

Question 15

List the primary functions of the lumbar spine

Answer 15

transmit load to the pelvis

• stabilize during weight-bearing activities
• bending and reaching mobility

Question 16

Describe the arthrokinematics of the lumbar spine

Answer 16

Anterior Tilt
-Anterior slide + conjunct upward slide of the inferior facet

Posterior Tilt
-Posterior slide + conjunct downward slide of the inferior facet

Right Tilt > airplane wing drops right (inferior and superior)

Question 17

What are the four types of disc pathologies?

Answer 17

o Bulge, nucleus breaks but doesn’t not break outer later
o Prolapse, bulge with outer later intact > almost broken
o Extrusion, bulge extrudes outside of the annular fibers
o Sequestrian, annular fibers disrupted and nucleus bulges onto spinal cord

Question 18

What are the referred pain sources of the lumbar region?

Answer 18

o	Pancreatic tumor (Gallbaldder)
o	Ankylosing spondylitis (spinal inflammation)
o	Scheuermann’s disease
o	Mechanical pain (less with rest)
o	Disc pain (sustained postured)
o	Prostate/ovarian cancer

Question 19

What is the purpose of the uncinate joints?

Answer 19

They allow for flexion and extension and limit lateral flexion in the cervical spine.
- reinforce the IV disc posteriorly and prevent lateral translation of discs