Question | Answer |
C0-1
What motion does is promote? | OA jt (occipital atlas joint)
"yes" jt- nodding joint flex/extension |
C1-2
What motion does it promote? | AA jt (atlanto axial jt)
"no" jt rotation 55-58% rotation |
C3-7 | "typical" lower cervical spine |
How many jt are in the cervical spine? | 37 jts |
What are the most mobile areas of the spine? | Cervical |
What vertebrae typically has the largest spinous process? | C7 |
Where is the 1st disc located? | between c2-c3 |
What is another name your synovial , planar, diarthrodial? | Zygapophyseal (facet) Joints |
All cervical jts are weight-bearing in the what position? | Upright postures |
What vertebrae is shaped like a ring/washer? | Atlas |
Which SP are bifid?
What age does this occur? | c3-c6
10 yrs old |
Where is den located? | on the axis |
Uncovertibro joints (Joints of Luschka) start where? | C3 |
Where is 1st disc located at? | C2-C3 |
What is located between C1-C2? | psuedo disc |
There are troughs in the cervical spine. They are open in_____and closed in _______. | open: flexion
closed: extension |
Joint of Luschka restrict what?
they promote what?
What happens when you get older? | SB
Promote: flexion/ extension
SB decrease bc of the jts of Luschka |
Btwn post and ant tubercle where the nerve root run through is called what? | uncinate process |
What is the articular relationship between C1-C2?
What does this relationship promote? | convex on convex
rotation |
What is the articular shape of the occipital condyles?
What is the of the superior facets of the atlas ? | convex
concave |
What is the only cervical segment with convex on concave relationship?
How many DOF? | OA jt
2 (no rotation) just nodding yes |
Mia has nice lps | Medial inferior anterior
Lateral Posterior Superior |
What occurs at the OA jt during flexion? | ROll anterior
Glide posterior (convex on concave rule) |
What occurs at the OA jt in extension? | Roll posterior slide ant |
Where is the longitudinal ligament located? | |
What does the ligamentum flavum turn into at C1? | |
Posterior LL turns into what at C1 and C2. | |
How many jts are between the AA jt?
What are they? | 3
1-median jt formed by the dens of C2 (synovial jt) & the ant arch of atlas(held by the transverse ligament)
2- lateral jts, the jt surfaces are nearly flat to allow sigROTATION |
What is the articulating surface between the AA jt | convex on convex(promotes rotation) |
Why is the transverse ligament so important? | Prevent the den from protruding on the spinal cord. |
Is the cavity btwn the dens and the ant tubercle a true jt? | No |
Jts of Luschka are what type of jt?
Why do some not consider them a jt?
So what do they call it if its not a jt? | Synovial jt
bc there is a jt capsule , there is no synovial sheath
Pseudo-jt (motion does occur between the two bony surfaces) |
Spondylosis: | cervical OA
or narrowing of the spinal canal |
Spondylolysis | defect in the pars articularis |
Spondylolathesis | slippage |
Obliques jt angles increase or decrease with successive levels? | c2-c3 45 degrees
c7-t1 10 degrees
angle decrease |
What are the facet (apophyseal) jt angle orientation of
Cervical
Thoracic
Lumbar | 45
60
90 |
Transitional area is located where?
What is it prone to? | C7-T1
dysfxn: w/ forward head posture you continue to move the head foward creating a hinge forward |
describes the plane and direction of movement
physiological movement | osteokinimatics |
describes the relative mvnt btwn articular facets of the apophyseal its
accessory motion | Arthrokinematics |
In cervical jt what does the facet jt guide?
what does it limit | SB and rotation
extension |
Which mvnts are pure mvnts in the cervical spine?
Why? | Flexion and extension
no secondary motion occurs with them like in SB and rot |
Can you have pure rotation? | no
sidebending will always occur with it |
Type I arthrokinematics of the cervical spine: | C0-C1
SB and rot occur in opposite directions |
Type II | C2-7
SB and rot occur in the same direction |
What occurs at C1-C2?
Why is it just this? | Rotation
bc the are convex on convex |
What ligament become tight in cervical Extension?
Loose? | ALL
PLL, Ligumentum Flacum, lig nuchae,, supraspinous, interpinous |
In cervical extension what are C3-C4 doing?
What is the superior articulating facet doing> | Slide down and back
also sliding down and back |
What does the OA jt do in extension? | rolls back and slides forward |
When you go into flexion what is on slack and what is tight? | ALL is slack the rest are tight |
What happens in SB to the right what occurs? | Right side down like in ext closes off
and left opens like in flexion up and forward |
OA jt has little bit of of SB what saying helps remember the direction of mint? | Mia has nice Lps
SB to the right the the R side goes medial, inferior, anterior |
Where do you see the most rotation | C1-C2 |
Rotation in the typical causes | |
• with R S.B. and L rotation: R occipital condyle moves what direction | MIA (medial, inferior, and anterior) while L occipital condyle moves LPS (lateral, posterior, and superior) |
What occurs to the neural foramen with
flexion
extension
rotation | flexion: increase
extension: decrease
Rotation: decrease on the same side
increases on the opposite side |
Why are C6-c7 not as mobile as the rest of the cervical spine? | B/c of the intimate relationship with the thoracic spine |
Is cervical and lumbar disc the same? | no |
Herniations will most like involve what? | strain of PLL |
What is the disc composed of? | Less soft nuclear material
it only exist in young adults
as we age the nuclear material migrates through horizontal fissures in the annulus |
3-dimensional architecture of the cervical annulus fibrosus is more like ______ ___________ ___________ __________
than a ring of fibers surrounding NP | anterior interosseous ligament |
What are strongly attached to annulus fibrous, weakly attached to the vertebral body | Vertebral end plates
(sometimes considered part of the disc) |
How vertebral bodies similar to the disc
what makes the different? | chemically similar
they have less water |
Where is the water located in the end plates? | centrally |
How does a disc get its nutrients? | through the endplates |
Lamellae | collagen oriented in opposite directions in sheet or bands
(lumbar and thoracic spine) |
What is the progression of a healthy disc? | healthy--> loss of hght/loosening of log--> disc protrusion-->
disc degeneration/ osteophytes formation |
WHy is ligamentum flavum yellow? | has elastin in it to stretch and recoil |
Name all the Ligament | ALL
PLL
suprapinous lig
ligamentum flavum
intertransverse lig |
Jefferson's Fx | atlas C1 |
A0 ligament is continuous with | articular capsule of c0-c1 |
Anterior alantoaxial lig continuation of what | ALL |
Posterior alantoaxial continuation of | ligamentum flavum |
Ligamentum nuchae | thick lig running from the ext occipital protuberance to the SP of C7 |
Tectorial membrane
-continuation of the what | posterior to the transverse ligament
continuation of PLL |
Action of the SCM | Contralateral rot
ipsalateral SB |
What scalene mm attach the 1st rib?
what attaches to the 2nd rib
what is its insertion
what are there actions? | Anterior and middle
posterior scalene
transverse process
contralateral rotation (they go in the direction the Vertebral body rotates)
ipsalateral sb |
What runs through the anterior and middle scalene mm? | Brachial Plexus & subclavian artery |
What are the deep local neck mm that contribute to spine stability | long collie (anterior)
long capitus (anterior)
semispin cervical (post)
multifidis (post) |
What the local stabilizers responsible for? | control of external loads and ROM |
what is the role of the Global mobilizer mms? | control of spinal orientation
they produce ROM |
What is weak in Upper Crossed syndrome | deep neck flexors
scapular retractor, stabilizer & depressors |
What is tight in Upper crossed syndrome? | upper trap
levator scap
pecs |
segmental nerve root levels
for cervical
for thoracic and lumbar | cervical : above
thoracic : below
(b/c of C8 nn) |
what are the three critical zone in upper thoracic? | 1. Interscalene triangle
2. Costoclavicular space
3. subpectoral triangle |
WHat could thoracic outlet be cause from? | scalenes or pec minor |