Intro to the C-Spine Flashcards
role of facets
let the v-bodies rotate and respect to one another
- lower segments are convex on concave and nearly 45 deg in inclincation
The joint of luschka
C3-C7
prevents posterior translation and limits lateral flexion
Increase the joint surface of vertebral body of the segment above
Joint of Luschka ROM
Control sagittal and coronal ROM
Joint of Luschka degeneration
Degen of uncinate process is a chief reason behind cervical spondylogenic changes and cervical radiculopathy
Superior and inferior intervertebral disc
between the hyaline cartilage on the centrum of the vertebral bodies
Uncovertebral joint
superior surface of the vertebra below curves upward to form a hyaline covered lip
lip articulates with the inferior surface of the vertebra above
this occurs bilaterally and the IV foramen in c-spine is bordered anteriorly
facet joint articulation
Lay at the junction of the pedicle and lamina
c-spine IV disc
Each contain annulus fibrosis and nucleus pulposus
- annulus is lacking posterior
- annulus does not surround the entire perimeter of the disc
- annulus is arranged vertically posteriorly
c-spine IV disc properties
separate disc of nucleus and annulus are reserved for younger population
- as one ages, nucleus is replaced by fibrocartilage and other fiber components
- happens as early as 2nd decade of life
IV and transverse foramen
Nerve roots in c-spine are identified in the caudal segment of the IV foramen
- in non-damaged segment, nerve root occupies between 25-33% of the foramina space
Special concerns of the tranverse foramen
house the vertebral artery, accessory vertebral vein, vertebral nerve
- goes through posterior aspect of skull
4 parts of vertebral artery
intracranial part
atlantal (suboccipital)
vertebral part
prevertebral
Vertebral artery muscle location
lateral to longus colli
medial to anterior scalene
Vertebral artery compression
compression and stretching at C1-C2 rotation
- 20deg of extension and rotation = reduce lumen of VA almost to full
Facet joint and transverse foramen red flags - cervical myelopathy
- sensory disturbances of hands
- muscle wasting of hadn intrinsic muscles
- unsteady gait
- Hoffman’s reflex
- Hyperreflexia
- bowel and bladder dysfunction
- multisegmental weakness and/or sensory changes
Facet joint and trasnverse foramen red flags - neoplastic conditions
- previous history of cancer
- unexplained weight loss
- constant pain with no relief with bed rest
- night pain
- age over 50 years
Facet joint and trasnverse foramen red flags - upper cervical ligamentous instability
- occipital headache and numbness
- severe limitation during neck AROM in all direction
- sign of cervical myelopathy
Facet joint and trasnverse foramen red flags - certical artery insufficiency
- drop-attacks
- dizziness
- lightheadedness related to neck movement
- dysphagia
- dysarthria
- diplopia
- postitive cranial nerve signs
cervical arterial dysfunction
arterial problem of the CS and embraces the entire arterial system (VBA, internal carotids and circle of willis)
Facet joint and trasnverse foramen red flags - inflammatory disease
- temp over 100F
- BP > 160/95
- resting pulse over 100bpm
- RR >25
- fatigue
Gross ROM
ages 20-59
F - 45 to 57
E - 60-75
L rot - 63-70
R rot - 70-78
L lat flex - 32-45
R lat flex - 35 - 47
Flexion biomechanics
superior and anterior glide of superior surface on inferior articular
Extension biomechanics
inferior and posterior glide
Rotation biomechanics
superior and anterior glide of the superior facet on one side and slight inferior
- posterior glide on opposite side
Ex: left rotation –> sup/ant glide of right facet and inf/post facet
