Cervical Spine Anatomy

Question 0

What puts the cervical spine at such a high risk for injury

Answer 0

Mobility is greater than stability

Question 1

Unless you know the EXACT SITE OF LESION what must be assessed when treating the cervical spine

What did Cyriax call this assessment?

Answer 1

Cervical spine occiput/c1- c7
Upper lim or portion there of

Scanning examination

Question 2

There are ___vertebrae and ___ nerve roots in the cervical spine

Answer 2

7

8

Question 3

Of which joint in the cervical spine does most of the rotation come from ? Which is more responsible for flexion and extension?

Answer 3

C1-C2 (axis) atlanto-axial joint

CO-C1 atlanto-occipital joint

Question 4

Rotation past ____ degrees may lead to kinking of the _____ on the contra lateral side; while the ipsilateral side may become kinked at ____degrees.

Answer 4

50
Vertebral artery
45

Question 5

What are some symptoms of vertebral artery compression

Answer 5

Vertigo 
Nausea
Tinnitus
Fainting
Visual disturbances

Question 6

What do the facet joints C4/C5; C5/C6; C6/C7 have in common (2 major things)

Answer 6

Greatest amount of flexion/extension of all facets joints as well as greatest amount of degeneration

Question 7

Whee does the greatest amount of degeneration occur in the C-spine

Answer 7

C4-C7 (joints between)

Question 8

Vertebral discs make up___% of cervical spine height however they are absent in which joints?

Answer 8

25%

C0/C1 and C1/C2

Question 9

MOI in the C-spine: 
(Sounds like....feels like...is like....) 
Trauma =..? 
Burning/stinging might be....?
Common overuse could lead to..?
Onset was insidious.....?

Answer 9

Whip lash
Brachial plexus compression
Thoracic outlet syndrome
Spondylosis

Question 10

Myotomal; dermatomal; and decreased reflexes are indicative of what in the cervical spine?

Answer 10

Cervical radiculopathy or nerve root injury

Question 11

Spinal cord injury presentation in the cervical spine:

Answer 11

Spastic weakness
Paresthesia
Lack of coordination in one or both limbs
Loss of propripception or sphincter dysfunction

Question 12

List signs that headaches have a cervical origin

Answer 12

Occipital or sub occipital headache
Mvmt of neck alters headache
Limitation of neck movement is painful 
Neck/head posture is abnormal 
Sub occipital/nuchal tenderness 
C0/C1 abnormal mobility 
Occipital and sub occipital abnormalities

Question 13

_____ can occur when pressure is applied to a nerve root

Answer 13

Paresthesia (pins&needles)

Question 14

Injuries in the cervicoencephalic region lead to symptoms of_____(5-6) and show the relationship between ____.

Answer 14

Headache
Fatigue 
Vertigo
Irritability 
Poor concentration 
Hypertonia of SNS 

C0/C1

Question 15

Injuries at the cervicocranial region have potential to involve what structures

Answer 15

Brain
Spinal cord
Brain stem (medulla pons midbrain)

Question 16

Cervicomyelopathy more likely to present as:

What’s another term for this

Answer 16

Spastic weakness(LMN lesion)
Paresthesia
Lack of coordination in one or both limbs
Possible sphincter dysfunction and proprioception loss

Spinal cord injury

Question 17

Cervico radiculopathy usually appears as:

Is also termed what?

Answer 17

Myotome weakness 
Dermatomal changes
Deceased reflexes 
Unilateral***** 
Nerve root injury

Question 18

What are some clinical signs that a headache is cervical in orgin

Answer 18

Occipital or sub occipital location to headache
Neck mvmt alters headache
Painful and limited neck movement
Abnormal head and neck posture
Occipital and nuchal tenderness
Abnormal mobility in C0/C1
Sensory changes in occipital and suboccipital area

Question 19

Name for a short neck

Answer 19

Klippel-Feil syndrome

Question 20

Rom of cervical spine

Answer 20

Flexion 80-90
Extension 70
Lateral flex 20-45
Rotation 70-90

Question 21

Absolute CIs when treating C-spine

Answer 21

Metastic spinal tumor
Acute anterior disc herniation with cord signs
Actuate brachial neuritis
Positive vertebral artery/carotid occlusion signs
Severe jugular vein distension
Tracheal displacement

Question 22

Local CIs for C-spine

Answer 22

Bilateral C1/2 instability
Acute fracture or dislocation
Deep suboccipital or cranial traction in alar/transverse ligament instability
Deep suboccipital techniques with vertebral artery insufficiency

Question 23

Precautions of C-spine

Answer 23

Deep bilateral medial pressure hyoid horns

No bilateral anterior neck work

Question 24

Reflex test for C6 C5/6? CNV C7/8?

Answer 24

Brachioradialis Biceps Trigeminal jerk Triceps

Question 25

Myotome dance for C-spine

Answer 25

``` C1/2= neck flexion C3= lateral flexion C4= shoulder shrug C5= abduction C6= elbow flex/wrist extension C7= elbow extension/ wrist flexion C8= thumb ext/ ulnar deviation T1= hand intrinsically abd and add ```

Question 26

List the 4 places greatest stress is placed on the vertebral artery

Answer 26

Where it enters tvp at C6 Within bony canals of vertebral tvps Between C1/2 Between C1 and entry into skull

Question 27

During coupled movements of rotation and side flexion explain where in the c spine they occur in the same direction and where they occur in opposite directions

Answer 27

C0-C2 and C7/T1 they occur in opposite directions | C2-C7 they occur in the same direction

Question 28

Regarding facet joint referral: What facets are said to refer to the scapula and lower shoulder?

Answer 28

C6/C7

Question 29

Your client comes in complaining of pain around the ear and extending down just below the occiput on the right side which facets would you consider testing to see if they were causing this

Answer 29

C2/3

Question 30

What facets joints are very similar in refera, both posterior and inferior to the ear and into the upper shoulder region above the scapula?

Answer 30

C3/4 C4/5

Question 31

Where does C5/6 facet joints radiate pain often

Answer 31

Spine of scapula post shoulder up to the lateral aspect of the SPs of about C2-C7

Question 32

What is upper crossed syndrome

Answer 32

Deep neck flexors are weak Rhomboids serratus anterior and lower traps weak Pec major and minor, Levator scap and upper traps tight

Question 33

Origin and insertion of rhomboid major

Answer 33

SPs T2-5 Vertebral border of scapula below the spine Dorsal scapular nerve C5

Question 34

Rhomboid minor origin and insertion

Answer 34

SPs C7-T1 Vertebral border of scapula spine and above including root Dorsal scapular nerve C5

Question 35

Serratus anterior origin and insertion

Answer 35

Ribs 1-9 Anterior vertebral border of scapula and inferior angle Long thoracic nerve C5-C8