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Applied anatomy

Upper cervical applied anatomy

Features of atlas 1. no spinous process 2. widest of all C vertebrae 3. posterior arch=spinous process 4. lateral masses=body 5. 2 superior biconcave facets and 2 inferior biconvex
Features of Axis 1. Strongest vertebra 2. Odontoid process 3. Axis for rotation of head and C1 (most in C spine) 4. 2 superior biconvex facets
Craniovertebral joints two atlantooccipital joints, convex on concave and 4 atlanto axial: 2 biconvex and 2 pivot synovial
A/O joint 1. biconvex condyles of occiput on biconcave facets of C1 2. Extension of 25 degrees and flexion of 10 degrees and SB of 5 degrees 3. connected by anterior and posterior atlantooccipital membranes
Anterior A/O membrane anterior arch of C1 to anterior rim of foramen magnum
posterior A/O membrane Posterior arch of C1 to posterior rim of foramen magnum
Median A/A joint Dens of C2 to ant. arch of C1 connected by transverse ligament posteriorly and alar ligaments on the sides
Alar ligaments tension with ext or flexion combined with rotation. Restricts rotation and SB to contralateral side
ADI Atlanto Dental Interval. Anterior: shift of 3.5mm of C1 on C2 means transverse ligament injury and >5mm includes alar ligament too Posterior: <14mm there is a chance of cord compression
Ideal posture for C spine Muscle balance between posteior semispinalis capitis and levator scapulae and anterior SCM and scalenus anterior
Foreward head stress on spleneus capitis and levator. Rectus capitis posteior major contracts to keep extension. increased scalene tension elevates ribs. there is a flexion torque on c spine. cause could be TOS, headache, midcervical instability, TMD, disc derangement
Suboccipital triangle 1. Suboccipital nerve--> rim of foramen magnum and posterior arch of C1. motor innervation to occipital muscles Vertebral A. Greater occipital N--> between posterior arch of atlas and lamina of C2. Sensory to scalp and susceptible to compression
Deep anterior neck flexors rectus capitis anterior, rectus capitus lateralis, longus capitus
sinuvertebral nerve sensory nerve that branches from ventral aspect of spinal nerves and turns back into IV canal. Innervates PLL, ant. dura mater and facet capusule, and vascular structures
Segments of vertebral artery 1. Proximal: Subclavian A to C6 TP 2. Transverse:C6-C2 TP 3. Suboccipital: C2 to foramen magnum 4. within the skull from foramen magnum
VBI Suboccipital 4 curves: 1. within transverse forament of C2 2. between C2 and C1 3. within C1 transverse foramen 4. between posterior arch of atals and foramen magnum
should a person who has no history of VBI ever be tested for it? yes, any time the treatment of choice is traction, mobilization, or manipulation it is a good idea to do sustained extension, rotation, simulated manipulation position, and ask a thorough history about diziness
Created by: badkins6
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