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C Spine Anat/Kinemat
Cervical Spine Anatomy & Kinematics
Question | Answer |
---|---|
Which joint is the OA joint? The AA joint? | OA- C0-1 AA- C1-2 |
Which segments are "typical" lower C spine segments? | C3-7 |
Which segment has the largest spinous process? | C7 |
Where is the first disc? | C2-3 |
Which segments have bifid spinous processes? | C3-6 |
The dens (odontoid process) is part of which bone? | Axis (C2) |
Joints of Luschka begin at which segment? What to they facilitate/restrict? | C3 Faciliate- flex/ext Restrict- lateral flexion |
Which segment has a posterior tubercle, not a spinous process? | C1 |
The inferior facets of C1 & superior facets of C2 have what type of relationship? | Convex on Convex- most rotation occurs here |
What is the "yes" joint? The "no" joint? | Yes- C0-1 No- C1-2 |
Convex occipital condyles movement on concave superior facets of atlas | MIA has nice LIPS Flexion- Posterior/Superior; Extension- Anterior/Inferior |
With flexion, what direction do occipital condyles roll/slide? Extension? | Flexion- roll anterior, slide posterior Extension- roll posterior, slide anterior |
Which ligament holds the dens in place? | Transverse Ligament |
Spondylolysis is what? | Pars Interarticularis defect |
Orientation of Facet Joints- the joint angle ____ with successive levels? | Decreases; orientation can be thought of passing through pt's eyes. C2-3= 45 deg C7-T1= 10 deg |
Which level does impingement commonly occur? | C7-T1; transitional area, head forward with longer moment arm |
Osteokinematics | Plane & direction of mvmt, physiologic mvmt (flexion/extension, etc.) |
Arthrokinematics | Relative mvmt b/t articular facets of apophyseal joints; Accessory motion (Roll, Slide, etc.) |
Type I coupling? Type 2 coupling? | Type 1- SB/rotation in opp directions (C0-1) Type 2- SB/rotation in same direction (C2-7) |
What is the only ligament on slack with flexion? | Flexion- ALL PLL, ligamentum flavum, ligamentum nuchae, supraspinous, interspinous, intertransverse ligs put on a stretch |
At which joint does the most flexion & extension occur? | C5-6 |
Since the annulus fibrosis doesn't completely encircle the nucleus pulposus in the C-spine, what covers the remainder? | PLL, so herniations will most likely affect the PLL |
What is a burst fracture of C1 called? | Jefferson Fracture |
The atlanto-occipital ligament is continuous with what? The anterior atlantoaxial ligament is a continuation of what? Posterior atlantoaxial ligament is a continuation of what? | A-O ligament is continuous with articular capsule of C0-1 Ant. A-A lig continuous with ALL Post. A-A lig continuous with ligamentum flavum |
Which ligament is thick and runs from the external occipital protuberance to the SP of C7? | Ligamentum Nuchae |
Which ligament is a continuation of the PLL & is posterior to the transverse ligament? | Tectorial Membrane |
Where do the scalenes attach? | Anterior & Middle- 1st rib Posterior- 2nd rib |
What passes between the anterior & middle scalene? | Brachial plexus & subclavan a. (space is the thoracic outlet) |
Scalenes action | Contralateral rotation & ipsilateral side bending |
What occurs with upper crossed syndrome? | Tight- Pecs, Neck extensors Stretched/Weak- Scap/Rhomboids, Deep neck flexors |
Where is the costoclavicular space? Subpectoral tunnel? | Between clavicle & 1st rib Underneath pec minor |