Cervical Spine Flashcards by Hannah Bledsoe

Which cervical vertebrae are atypical

Atlas
Axis
C7

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How is the atlas different from a typical cervical vertebra

No vertebral body or spinous process

Shaped like a ring- 2 lateral masses separated by anterior and posterior arch

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How does the axis differ from a typical vertebra

Anterior portion extends inferiorly
Dens (vertebral projection from superior surface)
Spinous process is large/elongated and bifid

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How does c7 differ from a typical vertebrae?

Largest cervical vertebrae

Large spinous process

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Describe typical cervical vertebral body

Unicinate processes arise from posterolateral margins which give the upper surface a concave shape

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Transverse processes of a typical cervical vertebra contain __________

Transverse foramen

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Describe the Atlanta-occipital joint

“Yes” jt
Convex occipital condoles articulate with concave superior faces of atlas
Synovial condyloid jt

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The Atlanto-axial jt has 3 articulations. What are they?

Median AA jt (dens and anterior arcs of axis/transverse ligament)

2 lateral AA jts ( inferior facet of axis with superior facet of axis)

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What type of jt is the median AA jt

Synovial pivot jt

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Lateral AA jts are what type of jt? Do they follow the convex-concave rule?

Synovial plane jt

No! They are biconvex with meniscoids

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That is the role of the transverse ligament in relation to C1 and C2?

Prevent anterior displacement of C1 on C2

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The alar ligaments are taunt in ______ with _________

Neck flexion

Axial rotation

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Function of the alar ligaments:

Limit lateral flexion and prevent distraction of C1 on C2

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What conditions can compromise the integrity of the transverse ligament resulting in instability of c1/c2

Rheumatoid arthritis & Down syndrome

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What is the orientation of cervical facet jts

Approximately 45 degrees off the frontal plane and transverse planes

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Osteokinematics of cervical vertebrae are

Flexion
Extension
Lateral Flexion
rotation

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What are the Osteokinematics of protraction?

Upper cervical extension and lower cervical flexion

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What are the Osteokinematics of retraction in the cervical spine?

Upper cervical flexion

Lower cervical extension

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How does prolonged protraction result in a forward head posture?

It causes lengthening of the deep neck flexors and scapular retractors and tightening of the pecs and upper trap/levator scap

What is the primary motion that occurs at the atlanto-occipital jt?

Flexion/ext
Also does some lateral flexion
“Yes” jt

Arthrokinematics of AO movement in the sagittal plane

Convex occipital condole on concave articular facet of atlas (opposite roll and glide)

(Flex/ext)

Arthrokinematics of AO movement in the frontal plane

Convex occipital condoles on concave superior articular facet of atlas (opposite roll and glide)

(Lat flex)

Arthrokinematics of AO movement in the transverse plane

Negligible-limited by deep jt congruency

Rotation

During cervical flexion, in the AO jt the occipital condyles roll ____________ and slide ____________. During extension this process is _______________.

Anterior
Posterior

Reversed

What is the primary motion that occurs are the AA jt?

“No” jt, rotation

Arthrokinematics of AA jt movement in the transverse plane

Medial AA jt- rotation of anterior arc and transverse ligament around the dens Lateral AA jt- -ipsilateral: inferior facet of the atlas glides posteriorly on the superior facet of the axis - contralateral: inferior facet of the atlas glides anteriorly on the superior facet of the axis

Arthrokinematics of the AA jt movement in the sagittal plane

Middle AA jt- anterior arch and transverse ligament allow for a “tilt” of the atlas on the axis (dens) Lateral AA jt- ligaments and spinal cord block gliding of the inferior facet of the atlas on the superior facet of the axis

Arthrokinematics of the AA jt in the frontal plane

Negligible

What ligament limits rotation at the AA jt?

Alar ligament

What ligament limits tilting of axis at the AA jt with flexion?

Transverse ligament

In the lower cervical spine _______________ and __________ occur simultaneously in the __________ direction.

Lateral flexion and rotation Same

With spinal coupling, performing movements in isolation would ……

Cause the facet jts to come in contact with one another blocking motion.

Arthrokinematics of c3-c7 facet jts in the sagittal plane

Flexion: inferior facet glides anterior and superior Extension: inferior facet glides posterior and inferior Same thing occurs bilateral

Arthrokinematics of the c3-c7 (facet jt) movement in the transverse plane

Ipsilsterally: inferior facet glides posterior and slightly inferior Contralateral: inferior facet glides anterior and slightly superior

Arthrokinematics of c3-c7 (facet jts) in the frontal plane

Ipsilateral: inferior facet glides inferior and slightly posterior Contralateral: inferior facet glides superior and slightly anterior

Describe the Arthrokinematics of R rotation at C4-C5

Right (ipsilateral) c4 facet SLIDE POSTERIOR and SLIGHTLY INFERIOR on C5 facet Left (contralateral) C4 facet SLIDES ANTERIOR and SLIGHTLY SUPERIOR on C5 facet

Function of cervical spine

Stability and protection | Mobility

The cervical spine provides protection for the _____________ by way of the __________________ and protects the _______________ by way of the __________________.

Spinal cord by way of the ledge vertebral canal (especially at c1) Vertebral artery by way of the transverse foramen

Stability in the cervical spine is especially important in what jts?

AO & AA

The atlas is designed to allow for ________ to prevent __________

Free space | Impingement

When cervical movement is added to eye movement the visual field can reach:

330 degrees

Musculature of the anterior-lateral craniocervical region

SCM Scalenes Longus Collin Longus capitis

Muscles of the posterior craniocervical region

Splenius cervicis Splenius capitis Suboccipital muscles

Muscles of the thorax that have action on the neck

``` Erector Spinae Semispinalis capitis and cervicis Rotatores Multifidi Interspinalis Inertransversarius ```

Causes of Muscular imbalance in the cervical spine

1. Excessive hyper extension straining the SCM, Longus colli and anterior or scalenes causing chronic spasm/guarding 2. Inhibition, pain, weakness, or fatigability of deep flexors resulting in dominant SCM and anterior scalene 3. Ergonomics

Optimal posture allows for ___________________ of flexor and extensor muscles. This contributes to __________________ of the cervical spine.

Co-contraction Vertical stability