Exam 2: Cervical

Question 1

how many joints does the cervical spine consist of

Answer 1

37, which allow for more motion than any other region of the spne

Question 2

when you increase mobility

Answer 2

you decrease stability (more vulnerable to both direct and indirect trauma)

Question 3

a complete examination of the cervical spine requires

Answer 3

that the patient unless to the waist exposing the neck area as well as the entire upper extremeity

Question 4

what do surgical scars on the anterior portion of the neck most often indicate

Answer 4

previous thyroid surgery

Question 5

what do irregular, pitted scars in the anterior triangle could be

Answer 5

previous tuberculous adenitis

Question 6

what articulations is each pair of vertebrae in the cervicals connected by

Answer 6

a pair of zygzapophyseal joints
uncovertebral joints
IVD

Question 7

the structure of the cervcial vertebrae combined with orientation of the zygapophyseal facets provide

Answer 7

very little bony stability

Question 8

the lax soft tissue restraints permit

Answer 8

large excursions or motions

Question 9

what kind of curve is in the cervical spine

Answer 9

lordotic curve that develops secondary to the response of an upright posture, which initially occurs when the child begins to lift the head at 3-4 months

Question 10

what does the presence of the curve allow

Answer 10

allows the head and eyes to remain oriented forward, and provides a shock absorbing mechanism to counteract the axial compressive force produced by the weight of the head (how many pounds?)

Question 11

where is the weight of the head

Answer 11

directly above the center of gravity

Question 12

what happens in forward head translation

Answer 12

if the head is 3 inches in front of the COG an estimated 30 pounds of weight is produced in structures of the c-spine

Question 13

what is palpation performed

Answer 13

• check for any vasomotor changes such as an increase in skin temperature
• localize specific sites of swelling
• identify specific anatomical structures and their relationship to one another
• identify sites of point tenderness
• indentify soft tissue texture changes or myofascial restriction
• locate changes in muscle tone resulting from, trigger points, muscle spasm, hypertonicity, or hypotonicity

Question 14

where is the hyoid bone located

Answer 14

opposite of C3

Question 15

where is the thyroid cartilage located

Answer 15

“adams apple” level of the C4/C5 vertebral body

Question 16

where is the first cricoid ring located

Answer 16

opposite C6 vertebral body

Question 17

where is the carotid tubercle located

Answer 17

C6- used as an anatomical landmark for anterior surgery

Question 18

common bony growths on the front of the spine

Answer 18

anterior cervical osteophytes

• most patients have no symptoms from the osteophytes
• these small bony lumps push against the back of the throat and make swallowing difficult

Question 19

occiput is located

Answer 19

on the back of the skull

Question 20

the inion is located

Answer 20

on the center of the superior nuchal line

Question 21

the mastoid process is located

Answer 21

lateral to the superior nuchal line

Question 22

which spinous process is the first palpable

Answer 22

C2

Question 23

which vertebrae is considered typical and which one is considered atypical

Answer 23

sixth cervical= typical

seventh= atypical

Question 24

what happens if the vertebra shift

Answer 24

can result in unilateral facet dislocation or spinous fracutre

Question 25

how does the superior facet of the contralateral side move

Answer 25

anterior-superior and over the tip of the inferior particular facet of the involved side, resulting in placement in the intervertebral foramen anterior to they inferior facet

Question 26

what injuries are associated with a unilateral facet dislocation

Answer 26

- disruption of the non dislocated joint - concomitant fracture of either facet or the complete lateral mass - partial tearing of the PLL - additional bony fractures of the remaining cervical spine

Question 27

how many zygapophyseal joints are there

Answer 27

14- from C0-T1

Question 28

what kind of joints are the zygapophyseal joints

Answer 28

typical synovial joints and are covered with hyaline cartilage

Question 29

what is the average horizontal angle of the zygapophyseal joints

Answer 29

approximately 45 degrees

Question 30

where do the uncovertebral joints extend from

Answer 30

C3-T1

Question 31

how many uncovertebral joints are there

Answer 31

10 saddle-shaped, diarthrodial articulations

Question 32

how are the uncovertebral joints fromed

Answer 32

between the incinerate process found on the lateral aspect of the superior surface of the inferior vertebrae, and the beveled inferior-lateral aspect of the superior vertebra

Question 33

what did Penning and Wilmink highlight

Answer 33

a possible correlation between uncovertebral joint configuration and the coupled cervical segmental motion of side bending and axial rotation

Question 34

a more recent study of C5-6 segment level by Clausen et al. found that both the z joints and Luschka joints are

Answer 34

the major contributors to coupled motion in the lower c spine, and that the uncinate processes effectively reduce motion coupling and primary cervical motion

Question 35

what serves as the principal routes of entry and exit of the neurovascular systems to and from the vertebral canal

Answer 35

intervertebral foramina

Question 36

intervertebral region is vulnerable to

Answer 36

narrowing with certain motions or with osteophyte growth

Question 37

what happens to the intervertebral foramen with full extension and ipsilateral side bending of the cervical spine

Answer 37

decrease

Question 38

what may compress the nerve root and cervical cord posteriorly

Answer 38

osteophytes

Question 39

what is the most common area for pathology in C-spine

Answer 39

c5/c6

Question 40

what does the cervicothoracic junction comprise

Answer 40

the C7-T1 segment, although functionally it includes the C7 vertebra, T1 and T2 vertebrae, ribs 1+2, and the manubrium

Question 41

the CTJ also forms

Answer 41

the thoracic outlet | -through which the neruovascular structures of the upper extremities pass