Cervical and Thoracic Spine

Question 1

what is the purpose of the C spine
what other systems is the C spine connected to
the motor system of the C region complements what other vital functions

Answer 1

holds our head on shoulders, orients the head in space enabling us to navigate the environment, allows us to react quickly
auditory and visual
respiration, phonation, swallowing

Question 2

how many vertebrae are in the C spine
the C spine is divided into __ and ___
what is C0

Answer 2

7
upper (C0-C2) and lower (C3-C7)
your occiput

Question 3

what is your C0-C1 joint called
what does this joint articulate with
what bony landmarks does the atlas not have

Answer 3

occiput-atlas
the condyles of the occiput and superior facets of atlas
vertebral body and spinous process

Question 4

what movement does the atlas perform
what is the C1-C2 joint called
how are the facets aligned in the C1-C2 joint

Answer 4

nodding the head yes, minimal rotation
atlantoaxial
horizontally

Question 5

what movements is the atlantoaxial joint responsible for
the lower C spine runs from C __ to C ___

Answer 5

shaking head no (50% of cervical rotation), little to no side bending
3 to 7

Question 6

the facet joints of the lower C spine are angulated at __ degrees in the ___ plane
what does the orientation of the facet joints allow for
the lower C spine is responsible for what movements

Answer 6

45, sagittal
increased mobility compared to the T and L spine
64 deg of flexion, 24 deg extension, 40 deg side bending, 40 deg rotation

Question 7

which part of the spine is most susceptible to wear and tear from increased motion
the lower C spine has two ___ and two ___ joints

Answer 7

lower C spine (C3-C7)
facet, uncinate joints

Question 8

what movements do facet joints facilitate
what movements do uncinate/uncovertebral joints prevent

Answer 8

couples rotation and side bending
posterior translation and some side bending (lateral stability), are a gliding mechanism for flexion and extension

Question 9

what 3 things are intervertebral discs composed of
what injury do uncovertebral joints in the C spine protect against
in what way is the C spine unique in it’s structure

Answer 9

annulus fibrosis, nucleus pulposis, end plate (allows nutrients to pass into disc)
disc herniation
transverse foramen in C1-C6 which carry vertebral artery

Question 10

where does the vertebral artery arise from
after the vertebral artery passes through the foramen ___ it becomes the ___ artery

Answer 10

subclavian artery
magnum, basilar

Question 11

where do the alar ligaments insert and attach
the transverse craniovertebral ligament covers the ___ and has attachments ___ at C__

Answer 11

insert: on odontoid process (passes superiorly and laterally to inner aspect of the foramen magnum)
attaches: to dens and occipital condyles of cranium
dens, horizontally, C1

Question 12

where does the transverse ligament insert and attach
the transverse ligament is apart of what other ligament
why are the alar and cruciform ligaments important for the dens

Answer 12

inserts: transverse ligaments
attach: superiorly to occiput and inferiorly to C2
cruciform ligament
keeps the dens in close approximation to C1 and away from spinal canal

Question 13

what is the purpose of the ligamentum nuchae
what movement does the ligamentum nuchae limit
where does the ligamentum nuchae insert and attach

Answer 13

broad extensive ligament that increases depth of cervical spinous processes allowing muscular attachment
cervical flexion
insert: external occipital protuberance
attach: spinous process of C7

Question 14

what are the muscles of the posterior upper C spine
how many vertebral levels do these muscles cross

Answer 14

suboccipitals: rectus capitis posterior major, rectus capitis posterior minor, obliquus capitis inferior, obliquus captitis superior
1-2

Question 15

what are the muscles of the anterior upper C spine

Answer 15

rectus capitis anterior, rectus capitis lateralis, longus colli cervicis

Question 16

what are the muscles of the anterior lower C spine

Answer 16

sternocleidomastoideus, anterior scalene, middle scalene, posterior scalene, splenius capitis, cervicis, longus colli, longus capitis

Question 17

what is the function of the longus capitis
what is the function of the longus colli

Answer 17

capitis: ventral flexor of C spine and stabilizer
colli: stabilizer of mid C spine and provides dynamic tension of all the anterior longitudinal ligaments

Question 18

what are the muscles of the posterior lower C spine

Answer 18

splenius capitis, splenius cervicis
semispinalis capitus, semispinalis cervices
longissimus capitus, longissimus cervicis
spinalis cervicis, levator scapulae, upper traps

Question 19

how many muscles are there in the neck
where are the different regions of the head/neck these muscles can act on the neck

Answer 19

44
over the craniocervical region, in the cervical region, may span the craniocervical and cervical regions with attachments to upper thoracic

Question 20

do the superficial or deep muscles in the C spine have larger lever arms and cross sectional areas
the superficial muscles have greater capacity to exert what
how are the deep muscles arranged

Answer 20

superficial
torque
segmentally (segment to segment attachments)

Question 21

what does segmental arrangement of deep C spine muscles allow for
how are the spindle densities and muscle fibre composition of deep muscles different from superficial C spine muscles

Answer 21

guide and support of cervical motion
larger spindle densities and muscle fibre composition

Question 22

why is coordination between superficial and deep C spine muscles needed
which muscles in the neck region have the largest density of muscle spindles of all the muscles in the body

Answer 22

the deep cannot support the load of the head and superficial segments don’t support cervical segments
suboccipital and deep cervical muscles

Question 23

what type of joint is the occiput atlas joint
in the occiput atlas joint, the occiput is __ and the atlas is ___
what are the 3 separate articulations of the atlantoaxial joint
in the atlantoaxial joint the atlas is __ and the axis is __

Answer 23

simple, synovial, ellipsoid
convex, concave
2 lateral and 1 median joints
convex, concave

Question 24

what is fryettes first law of spinal motion (neutral mechanics)
what is the principle of the first law deemed

Answer 24

when the spine is in neutral, side bending to one side will be accompanied by horizontal rotation to the opposite side
coupled relationship between side bending and rotation

Question 25

what is fryettes second law of spinal motion (non-neutral mechanics)

Answer 25

when the spine is flexed or extended, side bending and rotation will occur on the same side

Question 26

what is fryettes third law of spinal motion how does this sum up the first two laws

Answer 26

when motion is introduced in one plane it will reduce or modify motion in other planes of movement by stating dysfunction in one plane will negatively effect all other planes of movement

Question 27

T or F: arthokinematics of the C spine is well understood the most common model of arthokinematics states which movements occur in the upper C spine when: A. it's in a neutral position B. it's flexed or extended

Answer 27

F A. it will side bend and rotate in opposite directions B. it will side bend and rotate on the same side

Question 28

the most common model of arthokinematics says which movements will occur in the lower C spine the alternate model of arthokinematics states which movements occur when the lower C spine is flexed

Answer 28

spine will always side bend and rotate in the same direction side bending and rotation in the same direction, extension in the opposite direction

Question 29

to understand couple movement what other factors do we need to understand how do the vertebral bodies of the thoracic spine change as you get more inferior on the spine the superior segments of the T spine share commonalities with the ___ spine the inferior segments of the T spine share commonalities with the __ spine

Answer 29

posture, local muscle contraction, gravity, vertebral level, direction of movement they become larger and more dense to support increased body mass cervical lumbar

Question 30

what type of joints are the facet joints of the thoracic spine the facet joints are oriented in which plane in the T spine how do the thoracic discs differ in the T spine compared to the C and L spine

Answer 30

facet, planar frontal they're thinner

Question 31

what contributes to the lower mobility of the T spine T or F: transverse processes correlate to the same level as the spinous process

Answer 31

thin thoracic discs and attachment to rib cage F

Question 32

what is the rule of 3's regarding transverse process location for the T spine

Answer 32

transverse processes are at the same level of the spinous processes at T1-T3 and T10-T12 transverse processes are 1/2 a level above the spinous processes at T4-T6 transverse processes are 1 level above spinous processes at T7-T9

Question 33

T or F: there are no specific ligaments that arise from the thoracic spine which ligaments attach the thoracic vertebrae to the ribs

Answer 33

T, ligaments run through the area superior, medial and lateral costovertebral ligaments

Question 34

muscles of the thoracic spine are mostly related to the __ area what is the biggest function of the muscles of the thoracic spine

Answer 34

cervical support segments from being exaggerated further in their kyphotic predisposition

Question 35

what muscles attach the T spine to the C spine what muscles attach the T spine to the scapula

Answer 35

upper trap, splenius capitis, splenius cervicis rhomboid +/-, middle and lower traps

Question 36

mid thoracic spine function is ___ and has influence on what structure T or F: although the ribcage increases stability of the T spine, the T segments are capable of moving independently of the ribcage

Answer 36

independent, rib case T

Question 37

end range shoulder flexion is coupled with end range thoracic ___ limited thoracic extension contributes to what mobility impairments

Answer 37

extension shoulder elevation

Question 38

explain the pump handle motion of the ribs during inspiration explain the bucket handle motion of the ribs during inspiration

Answer 38

anterior and superior migration of ribs at the costvertebral and costotransverse joints lateral and superior migration of ribs