L4 Cervical Spine

Question 1

prevalance of cervical pain

Answer 1

25-70% experience pain at some point
30% chronic neck pain
increased mobility of cervical spine

Question 2

characteristics of cervical vertebrae

Answer 2

small
large vertebral canal
short, bifid spinous process
each transverse process has a foramen for the vertebral artery, only C7 doesn’t

Question 3

considerations of the vertebral artery

Answer 3

runs in the cervical vertabrae C6 and above
there is slack so head can move
supplies 15% blood to head
can be occluded and cause dizziness or fainting, especially in combined motion ext/rot/lat flexion
enters skull through foramen magnum

Question 4

upper vs lower cervical

Answer 4

upper - C1-2, 50% rotation and head nod
lower - C3-C7, function as a unit

Question 5

characteristics of C1

Answer 5

atlas
ring shape with no body or spinous process
2 large lateral masses for occipital condyles
anterior and posterior arches
large transverse process for muscle attachments

Question 6

characteristics of C2

Answer 6

axis
vertical projection/dens from anterior portion of the body
dens articulates with the anterior arch of atlas and transverse ligament posteriorly

Question 7

function of the alar and transverse ligaments

Answer 7

limit rotation of the head

Question 8

function of the axis

Answer 8

axial motion
transmit combined load of head and atlas

Question 9

What cervical joint does the most rotation?

Answer 9

AA, 50% rotation cervical
head and atlas move on the axis for rotation

Question 10

What craniovertebral ligaments limit flexion?

Answer 10

posterior atlanto occpital membrane
posterior atlantoaxial ligament
nuchal ligament

Question 11

function of cruciate ligament

Answer 11

hold dens in place

Question 12

function of nuchal ligament

Answer 12

stabilize head and neck

Question 13

function of posterior atlanto occipital ligament

Answer 13

support OA joint

Question 14

posterior atlanto axial ligament

Answer 14

reinforce AA joint
limit flexion

Question 15

dens fracture

Answer 15

40% of axis fractures are at the dens because the transverse ligament is stronger than the dens
if dens completely fractures the transverse ligament can go below it and cut it off from the body causing necrosis

Question 16

rupture of transverse ligament

Answer 16

spinal cord compression - quadriplegia
if dens is fractured, there will be less compression because the spinal cord will push the dens forward to make more room

Question 17

What joint are those with down syndrome at risk for instability at?

Answer 17

AA
10-20%
more in cervical flexion which puts more tension on the ligament
often asymptomatic
can fuse C1-2
precaution to avoid neck injury

Question 18

characteristics of a typical cervical vertebrae

Answer 18

C3-6
uncinate processes preventing lateral flexion
small rectangular body
not as flat
short pedicle
thin lamina
ant/post tubercles on transverse processes
larger triangle shaped vertebral canal

Question 19

how do cervical osteophytes form?

Answer 19

if disc deteriorates, more stress put on the uncovertebral joint and osteophytes can form

Question 20

carotid tubercle

Answer 20

on C6
landmark for brachial plexus block

Question 21

characteristics of C7

+possible bony abnormality

Answer 21

most prominent cervical vertebrae
large transverse processes, single pointed spinous process like thoracic
could accomodate cervical ribs impinging brachial plexus

Question 22

function of the sub occipitals

Answer 22

extend, rotate head at AA
(capital extension)

Question 23

sub occipital muscles

innervation and blood supply

Answer 23

innervation: post. ramus 1st cervical nerve
vascular: vertebral and occipital arteries

Question 24

What can be found in the sub occipital triangle

Answer 24

vertebral artery
suboccipital nerve

Question 25

rectus capitis posterior major

Answer 25

origin: C2 spinous process
insertion: occiput below inferior nuchal line
action: extend head, rotate

Question 26

rectus capitis posterior minor

Answer 26

origin: C1 post tubercle
insertion: medial occiput below inferior nuchal line + dura mater (allow CSF flow)
action: extend head

Question 27

obliquus capitis superior

Answer 27

origin: transverse process C1
insertion: occipital between superior/inferior line
action: extend/bend head

Question 28

obliquus capitis inferior

Answer 28

origin: spinous process C2
insertion: transverse process C1
action: rotation