Cervical Spine I

Question 1

fucntions/ goal of cervical spine

Answer 1

goal: keep the eyes level - compensates for SD in other areas of the body

• Transfers weight from a 2-column (occipital condyles) to a 3-column system (body of cervical vertebrae + two facet joints)
• protection
• support an dmobility

Question 2

curve of cervical spine

Answer 2

lordotic

Question 3

cervical - level where are problems most common

Answer 3

C5-C6

Question 4

superior facets of cervical face:

Answer 4

backwards, upwards, and medial (BUM)

Question 5

bifid cervical vertebrae?

Answer 5

C3-C6

Question 6

C3-C6 info:

Answer 6

• Saddle shaped bodies
• Short, bifid spinous processes
• Short, modified bifid transverse processes with transverse foramen for the vertebral arteries
• Superior facets face BUM

Question 7

large non-bifid spinous process?

Answer 7

C7

Question 8

C7 info

Answer 8

• Thick, long non-bifid spinous process
• Vertebral Prominens
• Large, non bifid transverse processes
• Vertebral artery does not pass through the transverse foramen (the vertebrae vein however)

Question 9

Atlas C1 info

Answer 9

• No vertebral body…
• No spinous process
• Concave superior facets
• Palpable transverse processes=not bifid
• No disc between the occiput & the atlas (Occipital-Atlantal [OA] joint)

Question 10

Axis C2 info

Answer 10

• Modified Vertebral body
• Odontoid process (dens)serves as the body of C1
• No disc between atlas & axis (Atlanto-Axial [AA] joint)
• Superior facet articulations are convex and articulate with convex cartilage covering the inferior facets of C1
• Convex on convex apposition (AA joint)

Question 11

Zygapophyseal Joints

Answer 11

• Facet joints
• Located between
  a) Inferior articular facet of the superior vertebra &
  b) Superior articular facet of the inferior vertebra
• Superior facet at an angle: BUM

Question 12

In contrast to the thoracic and lumbar spine, we are palpating

Answer 12

the facets rather than transverse processes for diagnosis

Question 13

Joints of Luschka (Uncovertebral Joints) - functions

Answer 13

• Located at the lateral/posterior surface of the cervical vertebral bodies
• Guides cervical motion
• Supports lateral side of cervical discs
• Protects cervical nerves from pressure

Question 14

Classic area for degeneration & spur formation

Answer 14

Joints of Luschka (Uncovertebral Joints) -

Question 15

Anterior Longitudinal Ligament prevents

Answer 15

hyperextension

Question 16

Posterior Longitudinal Ligament prevents

Answer 16

hyperflexion

Question 17

Ligamentum Flavum - prevents

Answer 17

separation of the vertebral lamina, stopping abrupt flexion of the vertebral column (whiplash

Question 18

Nuchal Ligament provides muscular attachment for which muscles?

Answer 18

splenius cervicis
splenius capitis
upper trap

Question 19

Alar Ligament

Answer 19

• goes from C2 to the occiput:
• Two strong bands that extend from the side of the dens to the lateral margins of the foramen magnum of the occiput
• Limits rotation

Question 20

Transverse ligament

Answer 20

• goes from C1 across the dens to C1
• Holds the dens of C2 against the anterior arch of C1
• Anterior surface of the spinal cord lies immediately posterior to the dens

Question 21

down syndrome or rheumatoid arthritis patients have issues with which ligaments?

Answer 21

• increased laxity of the Alar ligaments and the Transverse ligaments
• can pinch the spinal cord

Question 22

find C1 landmark

Answer 22

– Between the angle of the mandible & mastoid process

Question 23

find C2 landmark

Answer 23

angle of mandible

Question 24

find C3 landmark

Answer 24

hyoid bone

Question 25

find C4 landmark

Answer 25

superior thyroid cartilage

Question 26

find C5 landmark

Answer 26

inf thyroid cartilage

Question 27

find C6 landmark

Answer 27

cricoid cartilage

Question 28

find C7 landmark

Answer 28

vertebral prominens

Question 29

muscles that span a few vertebrae

Answer 29

-Suboccipital Triangle: Rectus Capitis post major; Obliquus capitis superior; Obliquus capitis inferior -Rectus Capitis Posterior Minor -Short Restrictors: Rotatores Intertransversarii; Interspinales

Question 30

muscles that span entire cervical spine anteriorly

Answer 30

-SCM -scaene (ant, middle, posterior) omohyoid -platysma

Question 31

Occipital-Atlanto Joint

Answer 31

- “Yes” joint - Flexion & extension greatest at the OA joint - Two articulations are formed by the occipital condyles & the superior articular facets of the atlas (C1) - Occipital condyles are convex - Superior articular facets of the atlas (C1) are concave - No disc between joint

Question 32

Occipital-Atlanto Joint - primary movements

Answer 32

- Flexion & Extension (Type II mechanics) | - Due to the condyles of the occiput

Question 33

during flexion of the head

Answer 33

occipital condyle slides posterior

Question 34

during extension of the head

Answer 34

occipital condyle slides anterior

Question 35

Occipital-Atlanto Joint - secondary movements

Answer 35

Coupled sidebending & rotation to opposite sides (Type I mechanics) Multiple reasons for motion coupling Sidebending One occipital condyle slides upward on one side of the atlas and downward on the other (~5° in each direction) Rotation Coupled with sidebending

Question 36

Atlanto-Axial Joint - 4 articulations

Answer 36

- ---Right & Left zygapophyseal joints (facet joints) - Convex inferior cartilage of the atlas articulates with the convex superior facets of the axis - ---Dens articulation - Anterior surface of the dens articulates with the atlas - Posterior surface of the dens articulates with the transverse ligament

Question 37

Atlanto-Axial Joint - primary motion

Answer 37

**Primary Motion = Rotation** **“No” joint ** 50% of cervical rotation occurs at the AA joint Secondary motion = small amounts of flexion & extension