Cervica Spine l Flashcards

(143 cards)

1
Q

What is the primary function of the cervical spine?

A

Mobility, support, and protection of the spinal canal and neural structures

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2
Q

How many vertebra are in the cervical spine?

A

7

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3
Q

How many of the vertebra in the cervical spine are typical, in comparison to the amount that are atypical?

A

4 are typical
3 are atypical

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4
Q

How many intervertebral discs are in the cervical spine

A

6

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5
Q

How many pairs of exiting nerve roots are there in the cervical spine?

A

8

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6
Q

Where does most of the cervical lordosis occur?

A

At the C1-C2 segment

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7
Q

What degree does cervical lordosis average at C7?

A

40 degrees

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8
Q

What is C0?

A

Cervical lordosis occiput

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9
Q

Where does nerve C1 appear?

A

Emerges between the skill and the C1 vertebra

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10
Q

Where do nerves C2-C7 emerge?

A

Superior to the pedicles

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11
Q

Where does the nerve C8 emerge?

A

Inferior t the pedicles of the C7 vertebra

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12
Q

Where does approximately 50% of flexion and extension occur in the cervical spine?

A

At the cervical occiput (C0-C1)

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13
Q

Where does approximately 50% of rotation occur?

A

A C1-C2

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14
Q

Where in the cervical spine is mobility prioritised?

A

C0-C2

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15
Q

Where in the cervical spine is stability prioritised?

A

C3-C7

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16
Q

Which vertebra in the cervical spine are typical?

A

C3-6

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17
Q

What are the features of a typical cervical vertebra?

A

Vertebral body
Transverse process
Transverse foramen
Anterior/posterior tubercles
Pedicle
Articular pillar
Lamina
Bifid spinous process
Vertebral foramen

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18
Q

What do the anterior and posterior tubercles allow for?

A

Muscular attachments

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19
Q

What do uncinate processes form?

A

Uncoverterbal joints

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20
Q

Where does the vertebral artery run through?

A

The foramen transversarium

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21
Q

What are uncovertebral joints also known as?

A

Joints of Hubert von Luschka

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22
Q

What type of joint are uncovertebral joints?

A

Synovial plane joints

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23
Q

Where else can uncovertebral joints be found?

A

Nowhere, they are only present in the cervical spine

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24
Q

Which vertebra in the cervical spine are atypical?

A

C1 - Atlas
C2 - Axis
C7- Vertebra Prominens

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25
What are the distinct features of C1?
Ring shaped Lateral masses Biconcave superior articular surface for occiput Anterior arch for odontoid Posterior arch with posterior tubercle Inferior articular surface Transverse foramen x2 Transverse processes
26
What are the distinct features of C2?
Odontoid peg (aka dens) 2 lateral articular facets Transverse processes and transverse foramen x2 Lamina (2 narrow) Bifid spinous process
27
Which cervical vertebra is most prominent when palpating, and why?
C7 because the spinous process is the longest
28
What type of joint is the Atlanta-Occipital joint?
Synovial ellipsoid
29
What are the articular surfaces of the Atlanto-Occipital joints?
C0- occipital condyles (convex) C1 - superior articular facet on the atlas (concave)
30
What type of joint is the Median Atlanto-Axial joint?
Synovial pivot
31
What are the articulating surfaces of the Median Atlanto-Axial joint?
Convex rectangular facet n the front of the dens Concave facet inner aspect of anterior arch of atlas Posterior surface of the dens articulates with the transverse ligament
32
What type of joint is the Lateral Atlanto-Axial joint?
Synovial plane
33
What are the articular surfaces of the Lateral Atlanto-Axial joint?
Two concave inferior facets of the atlas articulate with the 2 convex superior facets of the axis
34
What is the articular pillar?
C2-7 Facet joints between the vertebrae causing a slope from anterior to posterior
35
What are the 8 ligaments in the upper cervical spine?
Transverse Ligament Cruciform Ligament Alar Ligament Apical Ligament Tectorial Membrane Ligamentum Nuchae Posterior Atlantoaxial membrane Anterior Atlantoaxial membrane
36
What is the function of the transverse ligament?
Prevent anterior displacement of the Atlas on the Axis (increases the stability of the Atlanto-axial joint)
37
What is the transverse ligament also referred to as?
Transverse atlantal ligament
38
What are the attachments of the transverse ligament
Runs transversely between the lateral masses of the atlas, attaching to tubercles on their medial aspects
39
What is the dens covered in, and why?
Articular cartilage to provide cushioning between the dens and the ligament
40
What is the cruciform ligament further divided into?
The superior longitudinal band and the inferior longitudinal band
41
What is the function of the cruciform ligament?
Stability of the region by limiting flexion
42
What are the attachments of the superior longitudinal band of the cruciform ligament?
Prox: basilar part of the occipital bone Dist: superior margin of the transverse ligament
43
What are the attachments of the inferior longitudinal band of the cruciform ligament?
Prox: inferior margin of the transverse ligament Dist: posterior aspect of the body of the axis
44
What are the attachments of the alar ligament?
Prox: medial aspect of the occiput Dist: apex of the dens (either side)
45
What is the function of the alar ligaments?
Limits flexion, rotation and side flexion Prevents distraction of C1 on C2
46
What are the attachments of the apical ligament?
Prox: anterior edge of the foramen magnum Dist: apex of the dens (centrally)
47
What is the function of the apical ligament?
UNKNOWN
48
What are the attachments of the tectorial membrane
Prox: basilar pat of the occipital bone Dist: posterior surface of the body of C2
49
What is the function of the tectorial membrane?
Limits flexion
50
What is the tectorial membrane a continuation of
The posterior longitudinal ligament
51
What are the attachments of the ligamentum nuchae?
Prox: external occipital protuberance to the foramen magnum Dist: spinous processes of vertebra C7
52
What is the function of the ligamentum nuchae?
Supports the head Resists flexion Provides attachment for adjacent muscles
53
What is the ligamentum nuchae a continuation of?
The Supraspinous ligament
54
Where are the additional attachments of the ligamentum nuchae?
Posterior tubercle of C1 and the spinous processes of the other cervica vertebrae
55
What is the Posterior Atlanto-Axial membrane a continuation of?
The ligamentum flavum
56
Where does the Postior Atlanta-Axial membrane connect?
Lamina of C1-2
57
What is the Anterior Atlanto-Occipital membrane a continuation of?
The anterior longitudinal ligament
58
Where does the anterior atlanto-occipital membrane attach?
Anterior aspect of the Dens to the anterior aspect of the Atlas
59
What are the 6 lower cervical spine ligaments?
Anterior Longitudinal ligament Posterior longitudinal ligament Ligamentum flavum Intertransverse ligaments Interspinous ligaments Ligamentum nuchae (supraspinous)
60
Where does dissection of the vertebral artery typically occur?
C1
61
Where does the vertebral artery travel?
In transverse processes through transverse foramens
62
What movements are available at the cervical spine?
Protraction, retraction Flexion, extension Lateral flexion Rotation
63
What happens during protraction?
Upper cervical spine extends Lower cervical spine flexes
64
What happens to the cervical spine during retraction?
The upper cervical spine flexes The lower cervical spine extends
65
What are the superficial muscles?
Upper trapezius Levator scapulae Sternocleidomastoid
66
What are the deep muscles?
Erector spinae
67
What are the deep neck flexors?
Rectus capitis lateralis Rectus capitis anterior Longus colli Longus capitis
68
What are the sub-occipital muscles?
Rectus capitis posterior major and minor Obliquus capitis superior and inferior
69
What are the segmental muscles?
Multifidus Semispinalis Rotatores Interspinales Intertransversus
70
Which muscles flex the cervical spine?
Sternocleidomastoid Anterior scalenes Longus colli Longus capitis Rectus capitis anterior and lateralis
71
What muscles cause extension in the cervical spine?
Levator scapulae Upper trapezius Erector spinae Splenius cervicis and capitis Rectus capitis posterior major/minor Obliquus capitis superior/inferior
72
What muscles cause lateral flexion in the cervical spine?
Scalenes Sternocleidomastoid Upper traps Levator scapulae Erector spinae Splenius cervicis and capitis
73
What muscles cause rotation at the cervical spine?
Sternocleidomastoid Anterior scalenes Splenius capitis and cervicis Semispinalis cervicis
74
What is the Sternocleidomastoid?
A superficial, long strap like muscle that runs on the anterior and lateral aspects of the neck
75
What does the Sternocleidomastoid form the border of?
The triangle in the neck (body space)
76
How many heads does the Sternocleidomastoid have?
2
77
What are the sternal head of the Sternocleidomastoid’s attachments?
Prox: upper anterior surface of the manubrium Dist: lateral 1/2 of the superior nuchal line and the lateral surface of the mastoid process
78
What are the attachments for the clavicle head of the Sternocleidomastoid?
Prox: superior surface, medial 1/3 of the clavicle Dist: lateral 1/2 of the superior nuchal line and the lateral surface of the mastoid process
79
What are the 2 heads of the Sternocleidomastoid called?
Sternal head and the clavicular head
80
What are the actions of the Sternocleidomastoid?
Bilateral cervical flexion Unilateral Ipsilateral side flexion Unilateral contralateral rotation Accessory muscle of respiration
81
What is the nerve supply of the Sternocleidomastoid?
Accessory Nerve (cranial nerve 11) Anterior rami (C2-3)
82
What are the attachments of the longus capitis?
Prox: transverse processes C3-C6 Dist: inferior surface occipital bone
83
What is the action of the Longus capitis?
Flexes the head and the neck
84
What nerve supplies the longus capitis?
Anterior rami (C1-3)
85
What are the proximal attachments of the longus colli?
Anterior tubercles of the transverse processes C3-5 Anterior surface vertebral bodies C5-T3
86
What are the distal attachments of the longus colli?
Tubercle of anterior arch of atlas Anterior tubercle of transverse processes C5-6 Anterior surface vertebral bodies C2-4
87
What nerve supplies the longus colli?
Anterior rami C1-3
88
What is the action of the longus colli?
Cervical flexion Slight Ipsilateral side flexion, contralateral rotation
89
What nerve are the rectus capitis anterior and lateralis supplied by?
Anterior rami C1-2
90
What are the attachments of the rectus capitis anterior and lateralis?
Both run from the atlas to the occiput
91
What are the rectus capitis anterior and lateralis?
Deep flexors at C0-C1 (Atlanto-axial joint) Stabilisers at C0-C1
92
What are the attachments of POSTERIOR scalenes?
Posterior tubercle on transverse processes C4-7 Upper surface of rib 2
93
Which nerve supplies the posterior scalenes?
Anterior rami C5-7
94
What are the attachments of the MIDDLE scalenes?
Transverse processes C2-7 Upper surface of rib 1 (posterior to the subclavian groove)
95
What is the nerve supply of the middle scalenes?
Anterior rami C3-7
96
What are the attachments of the ANTERIOR scalenes?
Anterior tubercles on transverse processes C3-6 Scalene tubercle and upper surface of rib 1
97
Which nerve supplies the anterior scalenes ?
Anterior rami C4-7
98
What are the actions of the scalenes?
Elevation of ribs 1 and 2 Cervical side flexion Cervical flexion
99
What are the attachments of the Levator scapulae?
Prox: upper portion, medial border of the scapula Dist: transverse processes of C1-4
100
What are the actions of Levator scapulae?
Elevates scapula Bilateral cervical extension Unilateral cervical side flexion
101
What is the nerve supply of the Levator scapulae?
Dorsal scapula nerve (C4-5) Anterior rami (C3-4)
102
What are the proximal attachments of the upper trapezius?
Superior nuchal line External occipital protuberance Iigamentum nuchae
103
What is the distal attachment of the upper trapezius?
Lateral 1/3 of the clavicle
104
What are the actions of the upper trapezius?
Scapula elevation Unilateral cervical side flexion Bilateral cervical extension
105
Which nerve supplies the upper trapezius?
Accessory Nerve (cranial nerve 11)
106
What are the actions of the erector spinae?
Bilateral spinal extension Unilateral spinal side flexion Unilateral cervical rotation
107
What are the 3 divisions of the erector spinae?
Iliocostalis Longissimus Spinalis
108
What are the attachments of iliocostalis?
Rib angles Transverse processes of the lower cervical vertebrae Common origin
109
What are the attachments of the Longissimus?
Associated with the transverse processes throughout the spine Common origin
110
What are the attachments of the Spinalis?
Interconnects spinous processes of adjacent vertebrae
111
Which part of the erector spinae is the most medial column?
Spinalis
112
Where is the Spinalis often absent?
In the cervical region
113
What are the attachments of the Splenius cervicis?
Prox:spinous processes T3-6 Dist: transverse processes C1-3
114
What are the actions of the Splenius cervicis ?
Bilateral cervical extension Unilateral Ipsilateral cervical rotation
115
What nerve supplies the Splenius cervicis?
Posterior rami (lower cranial nerves)
116
What are the proximal attachments of the Splenius capitis?
Lower 1/2 of ligamentum nuchae Spinous processes C7-T4
117
What are the distal attachments of the Splenius capitis?
Mastoid process Skull inferior to later 1/3 superior nuchal line
118
What are the actions of the Splenius capitis?
Bilateral cervical extension Unilateral Ipsilateral cervical rotation
119
Which nerve supplies the Splenius capitis?
Posterior rami (middle cranial nerves)
120
What are the subocipital muscles?
A small group of deep muscles in the upper cervical region. They connect C1, C2 and the occiput
121
Which muscles are included in the suboccipital muscle group?
Rectus capitis posterior major (C2-0) Rectus capitis posterior minor (C1-0) Obliquus capitis superior (C1-0) Obliquus capitis inferior (C2-C1)
122
Which nerve supplies the sub-occipital muscles?
Posterior rami (C1)
123
What are the actions of the rectus capitis posterior major?
Bilateral extension of the head Unilateral Ipsilateral rotation of the head
124
What is the action of the rectus capitis posterior minor?
Extension of the head
125
What are the actions of the Obliquus capitis superior?
Bilateral Extension of the head Unilateral Ipsilateral side flexion
126
What is the action of the Obliquus capitis inferior?
Unilateral Ipsilateral rotation
127
What are the 5 segmental muscles?
Semispinalis Rotatores Multifidus Interspinales Intertransversarii
128
What are the attachments of the Spinalis?
Transverse processes to spinous processes
129
What are the attachments of the rotatores?
Articular processes to the spinous processes
130
What are the attachments of the multifidus?
Articular processes to spinous processes
131
What are the attachments of the interspinales?
Spinous processes of adjacent vertebrae
132
What are the attachments of intertransverseraii?
Transverse processes of adjacent vertebrae
133
What are the borders of the ANTERIOR triangle of the neck?
- Sternocleidomastoid - anterior midline of the neck - lower border of the mandible
134
What are the contents of the ANTERIOR neck triangle?
- vessels (carotids) - cranial and cervical nerves - supra and infrahyoid muscles
135
What are the borders of the POSTERIOR neck triangle?
- anterior margin of the trapezius - posterior margin of the sternocleidomastoid - middle third of the clavicle
136
What are the contents of the POSTERIOR neck triangle?
- subclavian artery and jugular vein - spinal accessory nerve, cervical and brachial plexus - scalenes, Levator scapulae, Splenius capitis muscles
137
What are the 3 areas of the thoracic outlet?
Interscalene triangle Costoclavicular triangle Subcoracoid space
138
Where abouts is the interscalene triangle?
Anterior and middle scalenes 1st rib
139
What are the borders of the costoclaviclar triangle?
Clavicle, 1st rib and the upper scapula
140
What are the borders of the subcoracoid space>
Coracoid process, pectoralis minor tendon and ribs 2-4
141
What is the contents of the thoracic outlet?
- brachial plexus - subclavian artery - subclavian vein
142
What can compression of the structures within the thoracic outlet cause?
Thoracic outlet syndrome (TOS)
143