The Cervical And Thoracic Spine

Question 1

How many cervical vertebrae are there? Which ones are atypical and which ones are typical

Answer 1

7
Atypical are C1, C2 and C7
Typical are C3-C6

Question 2

What are the key characteristics of typical cervical vertebrae

Answer 2

Body that is small and broad from side to side
Large triangular vertebral foramen
Bifid spinous process
Transverse foramen in the transverse process ( for vertebral artery,vein and sympathetic plexus)
Articular facets orientated in coronal plane

Question 3

what is C1 called and what does it consist of

Answer 3

atlas
anterior and posterior arch connected by two lateral masses
superior articular facets articulate with occipital condyles of the skull
inferior articular facets articulate with superior facets of c2 vertebra

Question 4

which joint permits nodding of the head

Answer 4

Atlanta-occipital joint (between occipital of skull and the atlas vertebra)
also contributes to 50% of total range flexion and extension of the head and neck

Question 5

what is the Atlanta-axial joint responsible for

Answer 5

50% total rotation of head and neck

Question 6

what is c2 known as

Answer 6

axis

Question 7

where is the odontoid process and what are its other names

Answer 7

also known as dens or odontoid peg
on c2
projects vertically upwards from the body of the axis

Question 8

how is the dens held in place and why

Answer 8

by transverse ligament of atlas and acts as a pivot joint

prevents horizontal displacement of the atlas on the axial

Question 9

what is atlantoaxial instability

Answer 9

excessive movement between c1 and c2

Question 10

what is c7 called and name some features

Answer 10

vertebra prominens
longest spinous process which is not bifid
foramen transversarium is small and only transmits the accessory vertebral veins

Question 11

how do the thoracic and lumbar spinal nerve roots exit the spinal cord

Answer 11

through spinal canal

exit below their respectively named vertebra

Question 12

how do spinal nerve exit in the cervical region

Answer 12

above its respectively named vertebral body until c7/T1 junction as the C8 nerve root is the one exiting between them.

Question 13

what is the ligamentum nuchae (nuchal ligament) and what are its roles

Answer 13

thickening of the supraspinous ligament
maintain secondary curvature of cervical spine
assist cervical spine to support weight of the head

Question 14

function and position of anterior longitudinal ligament

Answer 14

from tubercle of atlas to sacrum

prevents hyperextension of vertebral column

Question 15

position of posterior longitudinal ligament

Answer 15

runs posterior to vertebral bodies from axis to sacral canal

Question 16

what movement does cervical spine allow

Answer 16

nodding of head-50% of flexion and extension of Atlanto-occipital joint and rest by facet joints between cervical vertebrae
rotation (shaking head side to side )- 50% Atlanta-axial joint and the rest is facet joints
45 degree lateral flexion

Question 17

how many thoracic vertebrae are there

Answer 17

12

Question 18

key characteristics of thoracic vertebrae

Answer 18

medium sized heart shaped vertebral bodies
small and circular vertebral foramen
transverse processes that have transverse costal facets to articulate with ribs
long spinous process

Question 19

why does the thoracic spine have limited flexibility compared to cervical and lumbar spine

Answer 19

because the rib cage is connected to each segment of the thoracic spine

Question 20

which vertebrae in the thoracic spine are atypical and what is atypical about them

Answer 20

T1- superior costal facet is not a demi facet but a whole facet
T9 & T10- whole costal facets articulate with then ribs
T11 &T12- whole costal facet located on pedicles

Question 21

movements of thoracic spine

Answer 21

lateral flexion and rotation

no flexion or extension

Question 22

what is cervical spondylosis

Answer 22

chronic degenerative OA affecting intervertebral joints in cervical spine
narrowing of intervertebral foramina can put pressure on spinal nerves leading to radiculopathy. symptoms : paraesthesia,pain, motor weakness
narrowing of spinal canal may put pressure on spinal cord leading to myelopathy (muscle weakness, gait, loss of balance , loss of bowel and bladder control)

Question 23

what is Jefferson’s fracture

Answer 23

fracture of ant and post arches of atlas.
mechanism of injury is axial loading (diving into shallow water , falling from playground equipment)
c1 vertebra burns open like polo
causes likelihood of impingement on spinal cord
typically causes pain but no neurological signs
however vdamge to arteries at the base of the skull can lead to neurological problems like ataxia, stroke , Horner’s syndrome