Upper Cervical Spine

Question 1

What vertebrae are the smallest and most mobile?

Answer 1

cervical vertebrae

Question 2

What passes through the transverse foramina of the cervical spine?

Answer 2

vertebral artery

Question 3

What vertebrae holds the neck/head up?

Answer 3

C1 - Atlas

Question 4

What are the atypical vertebrae of the cervical spine?

Answer 4

C1 - atlas
C2 - axis
C7

Question 5

What are the typical vertebrae of the cervical spine?

Answer 5

C3-C6

- have near identical features

Question 6

Primary function of the atlas (C1)?

Answer 6

holds up the head

Question 7

What 4 features does the Atlas (C1) NOT have?

Answer 7

1) Body
2) Pedicle
3) Lamina
4) Spinous process

Question 8

Arthrokinematics of AO joint?

Answer 8

convex (occipital) moving on concave (C1)

Question 9

The superior articular facet of the atlas (C1) articulates with what?

Answer 9

superior articular facet of C1 (concave) articulates with the occipital condyles of the skull (convex)

Question 10

The inferior articular facets of the atlas articulate with what?

Answer 10

the superior facets of C2 (axis)

Question 11

What cervical vertebrae has the largest transverse process in the cervical region?

Answer 11

atlas (C1)

Question 12

What is the key attachment point for several small neck muscles to control fine movements?

Answer 12

transverse process of the atlas (C1)

Question 13

What muscles attach to the transverse process of the atlas (C1) and where do they go?

Answer 13

a) rectus capitis anterior - occipital bone
b) rectus capitis lateralis - occipital bone
c) obliquus capitis superior - occipital bone
d) obliquus capitis inferior - spinous process of axis (C2)
e) splenius cervicis - spinous processes of T02-T05
f) levator scapulae - superior part of medial border of the scapula
g) intertransversarius posterior cervicis - transverse process of the axis (posterior tubercule)
h) intertransversarius anterior cervicis - transverse process of the axis (anterior turbercle)

Question 14

The superior articular facets of the axis (C2) are convex or concave?

Answer 14

slightly convex

Question 15

The superior articular facets of the axis (C2) are oriented how much (in degrees) from the horizontal plate?

Answer 15

20 degrees

Question 16

The superior articular facets of the axis (C2) articulate with what?

Answer 16

inferior facets of the atlas (C1)

Question 17

What is the primary movement of the AO joint?

Answer 17

flexion/extension (nodding)

Question 18

How much ROM do you get at the AO joint for each:

a) flexion
b) extension
c) axial rotation
d) lateral flexion

Answer 18

a) +/- 5 degrees
b) +/- 10
c) 0-5
d) +/- 5

Question 19

Why does the AO joint have very little axial rotation?

Answer 19

because of the bony constructure of the lateral masses on the vertebrae

Question 20

Arthrokinematics of the AA joint?

Answer 20

concave (atlas) on convex (axis)

Question 21

Primary motion of the AA joint?

Answer 21

rotation

Question 22

What is the vertical axis of the rotation for the AA joint?

Answer 22

dens of C2 allows for rotation on the pivot point located on C1

Question 23

How much ROM do you get at the AA joint for each:

a) flexion
b) extension
c) axial rotation
d) lateral flexion

Answer 23

a) +/- 5 degrees
b) +/- 10
c) 35-40 degrees
d) 0-5

Question 24

50% of ROM we see in the cervical spine comes from what?

Answer 24

AA joint

Question 25

Arthrokinematics of cervical flexion at AO joint?

Answer 25

- convex on concave | - occipital condyles: anterior roll, posterior slide

Question 26

Arthrokinematics of cervical flexion at AA joint?

Answer 26

- flat to slightly concave | - Atlas tilts forward

Question 27

Arthrokinematics of cervical extension at AO joint?

Answer 27

- roll posterior | - slide anterior

Question 28

Arthrokinematics of cervical extension at AA joint?

Answer 28

- atlas tilts backward

Question 29

Why is the AA joint ideal for axial rotation?

Answer 29

because of the medial joint and the 20 degree angle of lateral facets

Question 30

Arthrokinematics of cervical lateral flexion at the AO joint?

Answer 30

- small amount of roll - convex on concave - slide in opposite direction of the roll

Question 31

Arthrokinematics of cervical lateral flexion at the AA joint?

Answer 31

- spinal coupling | - frontal and horizontal planes

Question 32

What is spinal coupling?

Answer 32

- One motion around one plane is associated with another motion around a different plane - rotating with cervical spine to the right occurs with side bending to the left (vice versa) - lateral flexion is coupled with contralateral rotation - rotation is coupled with contralateral lateral flexion

Question 33

Spinal coupling occurs between what two motions?

Answer 33

occurs between lateral flexion and axial rotation

Question 34

Nodding action is greatest at what joint?

Answer 34

AO joint

Question 35

50% of axial rotation occurring at the cervical spine happens at what joint?

Answer 35

AA joint

Question 36

What 2 muscles are known as the "dynamic" anterior longitudinal ligament and are necessary for vertical stability?

Answer 36

- longus capitis | - longus colli

Question 37

What group of muscles are responsible for fine control over the AO and AA joints?

Answer 37

suboccipital muscles

Question 38

Attachments of the alar ligament?

Answer 38

- lateral side of the apex of the dens | - medial side of the occipital condyles

Question 39

Function of the alar ligament?

Answer 39

Limits contralateral head rotation and contralateral lateral flexion

Question 40

Attachments of the transverse ligament?

Answer 40

atlas to axis

Question 41

Function of the transverse ligament?

Answer 41

holds DENS in place on posterior side of the dens

Question 42

What is known as the cranial continuation of the posterior longitudinal ligament?

Answer 42

tectorial membrane

Question 43

Attachments of tectorial membrane?

Answer 43

body of C2 to occipital bone

Question 44

Function of tectorial membrane?

Answer 44

limits flexion of upper cervical spine and provides multidirectional stability

Question 45

The tectorial membrane covers what two ligaments?

Answer 45

the cruciate and alar ligaments

Question 46

Injury to suboccipital muscles causes what?

Answer 46

WAD - fat develops within the muscles