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Anatomy LE > Cervical spine arthrology upper and lower > Flashcards

Cervical spine arthrology upper and lower Flashcards

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1
Q

Cervical Intervertebral Disc size

A

Relatively small
Transversely broad

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2
Q

where are there no IV-disc in the c-spine

A

No disc between A/O and A/A joints

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3
Q

the joint that the Intervertebral Disc creates

A

Forms symphysis between 2 vertebral bodies

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4
Q

Nucleus Pulposus in the c-spine

A

Constitutes less than 25% of disc volume at birth (lumbar about 50%)

Gel-like until adolescence – becomes fibrous at about 20 yrs of age

Penetrated by uncovertebral clefts

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5
Q

Annulus Fibrosis anterior portion c-spine

A

Fibers interweave & have angled orientation
No separate laminae

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6
Q

Annulus Fibrosis posterior portion c-spine

A

Smaller posterior portion

Fibers oriented vertically

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7
Q

Annulus Fibrosis posterior-lateral portion c-spine

A

Lacking posterolaterally where uncovertebral jts are located

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8
Q

Annulus Fibrosis anterior properties

A

Anterior annulus fibrosis is major stabilizer in cervical spine
Can be torn with whiplash injuries

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9
Q

Annulus fibrous innervation

A

Outer 1/3 of annulus fibrosis has sensory innervation
Can be a ​source of pain

(all AF have sensory innervation)

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10
Q

Uncovertebral Joints other name

A

Joints of VonLuschka

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11
Q

Uncovertebral Joints are what kind of joint

A

Synovial jts

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12
Q

location of Uncovertebral Joints

A

between uncinate processes of vertebra below and body of vertebra above

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13
Q

Uncovertebral Joints bordered by

A

Bounded anteromedially by IV disc, & posterolaterally by IVF

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14
Q

Uncovertebral Joints and arthritic changes

A

can impact the intervertebral​ foreman - Can impact the spinal nerve traveling through the intervertebral foramen

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15
Q

Uncovertebral clefts

A

Cleft can be thought at continuation of the uncovertebral space into the disc

  • These clefts can complete transect the posterior portion of the disc and if they do – this allows for more movement into the rotation at the interverbal disc
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16
Q

Intervertebral Joint are like what kind of joint

A

Resemble saddle joints

included Symphysis & U/V jts

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17
Q

Intervertebral Joint Movement types

A

Flexion/Extension in sagittal plane
Lateral flexion coupled with (isp) rotation in plane of facet jts

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18
Q

Intervertebral Joint Movement - Flexion/Extension in sagittal plane

A

Narrow Anterior/posterior dimension of disc allows greater sagittal plane motion
Uncovertebral joints guide sagittal plane motion

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19
Q

Intervertebral Joint Movement - Lateral flexion coupled with rotation in plane of facet jts

A

Broad transverse dimension of disc allows for limited lateral flexion

Uncinate processes provide lateral stability by limiting lat flexion

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20
Q

Typical Cervical Facet Joints

A

C2/3-C6/7

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21
Q

Typical Cervical Facet Joints types of joints

A

Synovial joints

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22
Q

Typical Cervical Facet Joints orientation

A

Orientation in oblique plane (roof shingles)

Inferior articular facets
Slightly concave
Face inf’ly & ant’ly

Superior articular facets
Slightly convex
Face sup’ly & post’ly

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23
Q

Facet orientation in the c-spine allow for what kind of motion

A

facilitates sagittal plane motion and requires that axial rotation and lateral flexion are always coupled

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24
Q

Facet Orientation also provides for

A

some weight-bearing capability

impediment to forward translation

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25
Typical Cervical Facet Joints - joint capsule
Enveloped in baggy capsules which are lax in neutral position and taut in extremes of motion
26
intra-articular inclusions in the c-spine
Fat pads, fibroadipose menisci
27
Anterior longitudinal ligament runs to
the occiput​
28
ALL function
Reinforce interver-tebral joints
29
ALL and pain fibers
Heavily innervated with pain fibers
30
ALL and cervical discs
May or may not have attachments into cervical discs
31
Longitudinal Ligaments extends to
Extends only to posterior body of C2
32
Posterior longitudinal ligament changes into the
Tectorial membrane is cranial extension of PLL
33
Ligamentum Flavum found between
connect the laminae of adjacent vertebrae
34
Ligamentum Flavum extend to
Extends to C1/2
35
Ligamentum Flavum made out of
elastic fibers
36
vertebral canal and the Ligamentum Flavum
Provides smooth post wall for vertebral canal
37
Ligamentum Flavum and movement
Too distensible to limit movement Accommodates large changes in intralaminar distance with flexion/extension
38
what is the Ligamentum Nuchae
In the cervical region, homologous to interspinous and supraspinous ligaments
39
Ligamentum Nuchae two parts
midline raphe and midline fascial septum
40
midline raphe
for origins of upper trapezius, splenius capitis, & rhomboid minor
41
midline fascial septum
separates semispinalis capitis
42
Movement in Lower Cervical Segments is determined by
by orientation of facets
43
facet joints what kind of joint surface
planar -synoivial joints
44
Sagittal Plane Motion - felxion, movement seen
Both upper facets move sup’ly & ant’ly on lower facets
45
Sagittal Plane Motion - felxion, movement limited by
Limited by tension in PLL, artic capsule & ligamentum nuchae
46
In full flexion what does facet contact look like
minimal facetal contact - opening-up
47
Sagittal Plane Motion - extension, movement seen
Both upper facets move inf’ly & post’ly
48
In full extension what does facet contact look like
Facetal approximation - closing down
49
Sagittal Plane Motion - extension, movement limited by
Limited by tension in ALL and impact of SPs, and sup articular processes of vertebra below with TPs of vertebra above
50
what side do Combined Lateral Flexion with Rotation occur on
Both occur to same side
51
example Combined Lateral Flexion with Rotation to the right
Right upper facet glides inferiorly and posteriorly (closing down) Left upper facet glides superiorly and anteriorly (opening up)
52
two Upper Cervical Joints
Atlanto-Occipital Joints Atlanto-Axial Joints Lateral atlanto-axial joints Median atlanto-axial joint
53
Atlanto-Occipital (A/O) Jointswhat kind of jt
Synovial ellipsoid jts
54
Atlantal facets properties
Concave, tilted medially Constricted in middle Long axes run obliquely ant & med
55
Occipital condyles
convex
56
Ligaments of A/O Joints
Fibrous capsule Anterior Atlanto-Occipital Membrane Posterior Atlanto-Occipital Membrane
57
Fibrous capsule of A/O joint
Thickened posterolaterally Thin & sometimes lacking medially where joint may communicate with bursa between dens & transverse ligament
58
Anterior Atlanto-Occipital Membrane
Broad, dense membrane between foramen magnum and anterior arch of atlas Strengthened by ALL
59
Posterior Atlanto-Occipital Membrane
Broad, thin membrane between foramen magnum & posterior arch of atlas Arches over groove for vertebral artery forming opening for artery
60
Movement at A/O Joints
The two joints act as one Movement may occur around transverse axis (nodding), and A/P axis (slight lateral flexion)
61
Flexion – nodding at the A/O joint
Occipital condyles roll ant’ly & glide post’ly About 10-degree range
62
Extension at the A/O joint
Occipital condyles roll post’ly & glide ant’ly About 25-degree range
63
Lateral flexion
Ipsilateral occipital condyle glides ant’ly, med’ly & inf’ly Contralateral occipital condyle glides post’ly, lat’ly & sup’ly So some conjunct rotation occurs to opposite side About 5 deg range
64
Lateral Atlanto-Axial Joints formed by
Articulations between: inferior articular surface of the lateral mass of atlas (C1) - the superior articular surface of the lateral mass of axis (C2)
65
Lateral Atlanto-Axial Joints what kind of joint
Synovial joints
66
Lateral Atlanto-Axial Joints capsule type
Capsules are thin & loose
67
Lateral Atlanto-Axial Joints facet shapes
Facet surface shapes are debatable The kinematic remain the same
68
Median Atlanto-Axial Joint
between dens & ring formed by ant arch of atlas & transverse ligament
69
Median Atlanto-Axial Joint type of joint
Synovial pivot joint
70
Median Atlanto-Axial Joint anterior
Ant’ly, capsule encloses space bet ant arch & dens
71
Median Atlanto-Axial Joint posteriorly
Post’ly, larger synovial cavity lies between transverse ligament & dens
72
what is the Transverse Ligament
Thick strong band dividing ring of atlas into 2 unequal parts
73
Transverse Ligament attaches to
Attached on each side to tubercle on lateral mass
74
median portion of the transverse ligament
Median portion lined with cartilage for articulation with dens
75
Transverse Ligament function
Function: Retains dens in contact with anterior arch of atlas during movement
76
cruciform ligament
cross made out of the: transverse ligament small band - extends up to the O ( large band - extends down to the body of the axis (sometimes absent)
77
where does the small band of the cruciform liagment lie
lies between tectorial membrane & apical ligament
78
Movement at A/A Joints in general
Occurs simultaneously at all 3 joints Lateral joints support weight of head via atlas, while medial joint guides rotation Consists primarily of rotation with minimal degree of flexion/extension
79
Rotation at A/A Joints dens momvement
During rotation dens should not move, but act as pivot around which movement occurs
80
facet movement with Rotation at A/A Joints
Inferior facet of atlas glides forward with contralateral rotation and backward with ipsilateral rotation (reform)
81
rotation at the A/A joint is limited by what
Limited by alar ligs
82
range of Rotation at A/A Joints
Total range: ~45 degrees - 20ish on each side
83
Flexion/Extension at A/A Jts - during flexion
inferior facets of atlas roll ant’ly & glide post’ly Anterior arch of atlas glides inf’ly
84
Flexion/Extension at A/A Jts -During extension
inferior facets of atlas roll post’ly & glide ant’ly ant arch glides sup’ly
85
Flexion/Extension at A/A Jts - dens movement
Regardless of the facet surface shapes, the dens will retain contact with the anterior arch of the atlas and the atlanto-odontoid interval will not open out Transverse Ligament is keeping dens in place
86
range of motion during Flexion/Extension at A/A Jts
10 degrees of movement
87
Ligaments Connecting Axis and Occipital Bone
Tectorial Membrane Alar Ligaments Apical Ligament
88
Tectorial Membrane
Lies within vertebral canal Extension of PLL Broad, strong Runs from body of axis to occipital bone in front of foramen magnum
89
Alar Ligaments
2 strong cords run from dens obliquely up and lat’ly to condyles of occiput
90
Alar Ligaments resitriction of movement
Primary restraints- for contralateral rotation & lateral flexion 2ndary restraint for flexion
91
alar ligament are most taut with
Flexion Extension combined with rotation
92
Apical Ligament of Dens
Runs from tip of dens to anterior margin of foramen magnum Very thin More reinforcement
93
Apical Ligament of Dens lie where
Lies between upper band of cruciform ligament & anterior atlanto-occipital membrane

Anatomy LE (13 decks)

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