Upper Cervical Spine

Question 1

What feature is unique to the cervical vertebrae?

Answer 1

Transverse foramina

Question 2

What passes through the transverse foramina?

Answer 2

Vertebral arteries

Question 3

How many cervical vertebrae are there?

Answer 3

7

Question 4

Which cervical vertebrae are “typical”?

Answer 4

C3-C6

Question 5

What is another name for C1?

Answer 5

Atlas

Question 6

What is another name for C2?

Answer 6

Axis

Question 7

What is the primary function of the atlas?

Answer 7

Hold up the head

Question 8

What arthrokinematic rule holds true for the AO joint?

Answer 8

Convex on concave

Question 9

In the spine, when we discuss movements, we refer to the (1) superior/inferior vertebrae moving on the (2) superior/inferior vertebrae.

Answer 9

(1) Superior

(2) Inferior

Question 10

What joins the 2 lateral masses of the atlas?

Answer 10

Anterior and posterior arches

Question 11

What is the orientation of the inferior articular facet of the atlas?

Answer 11

Sloped downwards by 20º

Question 12

What does the inferior facet of the atlas articulate with?

Answer 12

The superior articular facet of C2

Question 13

What is the orientation of the superior articular facet of the axis?

Answer 13

20º below the horizontal plane

Question 14

What is the shape of the superior articular facet of the axis?

Answer 14

Slightly convex

Question 15

What is the arthrokinematic rule at the AO joint?

Answer 15

Convex on concave

Question 16

What is the primary movement at the AO joint?

Answer 16

Flexion/extension

Question 17

Do we have more flexion or extension at the AO joint?

Answer 17

Extension

Question 18

What is the arthrokinematic rule at the AA joint?

Answer 18

SLIGHTLY concave on convex

Question 19

What is the primary movement at the AA joint?

Answer 19

Rotation

Question 20

What articulates with the anterior arch of the atlas?

Answer 20

Dens of the axis

Question 21

How much of the rotation in the cervical spine comes from the AA joint?

Answer 21

50%

Question 22

What are the arthrokinematics of cervical right lateral flexion at the AO joint?

Answer 22

Right roll

Left slide

Question 23

What is spinal coupling?

Answer 23

One motion around one plane is associated with another motion around a different plane

Question 24

What is the spinal coupled motion hat occurs during right lateral flexion?

Answer 24

Left rotation

Question 25

What is the spinal coupled motion that occurs during right rotation?

Answer 25

Left lateral flexion

Question 26

Which direction does longus capitis rotate the head?

Answer 26

Same side rotation

Question 27

What are the functions of longus colli?

Answer 27

Nodding and support of cervical lordosis

Question 28

Which muscles provide vertical stability to the cervical region?

Answer 28

Longus colli and longus capitis

Question 29

What is the nickname for the longus colli and longus capitis?

Answer 29

"Dynamic" anterior longitudinal ligament

Question 30

What are the 4 suboccipital muscles?

Answer 30

Rectus capitis posterior minor Rectus capitis posterior major Obliquus capitis superior Obliquus capitis inferior

Question 31

What motion does the alar ligament prevent?

Answer 31

Contralateral head rotation | Contralateral lateral flexion

Question 32

Where does the alar ligament originate?

Answer 32

Lateral side of the apex of the dens

Question 33

Where is the transverse ligament located?

Answer 33

On the posterior aspect of the dens

Question 34

What will happen if the transverse ligament is compromised?

Answer 34

The atlas will move anteriorly

Question 35

Which test to you use to test the integrity of the transverse ligament?

Answer 35

Sharp purser test

Question 36

What is a positive result of the sharp purser test?

Answer 36

Cardinal signs occur during flexion but go away when you applly posterior pressure

Question 37

What membrane is the continuation of the posterior longitudinal ligament?

Answer 37

Tectorial membrane

Question 38

What motion does the tectorial membrane limit?

Answer 38

Flexion of the upper cervical spine

Question 39

When is the tectorial membrane injured?

Answer 39

During forceful flexion injuries

Question 40

What are the 5 cardinal signs/symptoms?

Answer 40

``` Nystagmus Facial paraesthesias Profuse sweating Nausea, vomiting Difficulty swallowing ```

Question 41

In what direction do the occipital condyles move during flexion?

Answer 41

Anterior roll | Posterior glide

Question 42

To assess maximum posterior glide of the left occipital condyle, what 2 movements could you ask the patient to do?

Answer 42

Flexion with left rotation OR Flexion with right lateral flexion

Question 43

In what direction do the occipital condyles move during extension?

Answer 43

Posterior roll | Anterior glide

Question 44

To assess maximum anterior glide of the right occipital condyle, what 2 movements could you ask the patient to do?

Answer 44

Extension with right lateral flexion OR Extension with left rotation