Cervical anatomy & biomechanics
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| Craniovertebral Region | - Occipute, atlas, axis & supporting ligs
- 25% of vertical height
- Injuries here can involve brain, brainstem, spinal cord
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| C-S region (vertebrae #s) | C3-C7
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| Facet alignment: C-S | - 45 degrees from frontal & horizontal planes
- Allows Flex/Ext
- Coupling (SB & Rot) always ipsilat
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| Facet alignment: T-S | - 20 to 30 degrees off frontal plane
- Allows for side Flex & Rot (less for Flex/Ext)
- T10-12: aligns more in sagittal plane allows more flex/ext
- Varied coupling
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| Facet alignment: L-S | ◦ L-shaped facets
◦ Ideal for Flex/Ext
◦ Resist Rot
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| C-S variations bc of diff needs and stresses | - 1st C&T, 5th L, & sacral vert have adaptations needed to join to adjacent structures
◦ Transitional vert: CT, TL, L-S junction (qualities common in 2 regions)
- Incr size from cephalad to cauda = need for incr WB
- C1 described as a washer
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| Typical vs Atypical C vert | - Typical C3-C6
- Atypical C1,C2,C7
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| Articular facets are oriented __________ and permit a ______ ROM. | obliquely, large
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| Facet jt: classification & capsular pattern | - Synovial plane jt (diarthrodial)
- C,T,L: Side Flex & Rot equally limited, Ext
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| OA jt: classification & capsular pattern | - True synovial, with fibroadipose meniscoid. Nearly in horizontal plane
- Ext & Rot equally limited (?)
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| Ligamentum Nuchae: | -Not really a lig
-Powerful anti-shear mechanism due to fiber arrangement
-C-S: it's an extension of supraspinous lig
-Attachment for post neck mms
-Elastic component -> passively assist in head control and return energy to the system
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| Cruciate ligs | maintain stability at the occipital-C1-C2 articulations
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| Transverse lig | has a thin layer of articular cartilage for dens
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| Alar ligs | - Limit Flex & axial Rot of C1 on C2
- Runs sup & laterally attaches med to occipital condyle
- Taut in Rot, contralat taut in SB, & resists distraction
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| C1 - Atlas | - Meant to transmit forces occiput to rest of spine
- No body
- No SP -> incr in potential for craniovertebral Ext
- Acts as washer: no ms attachment, less lig attachment
- Glides contralat with Rot, ipsilat with SB of head
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| OA jt | -Nearly horiz, few mm mvt
-Kidney shape concave facet for convex occ condyle
-Only 1 glide: diagonal
-Flex/Ext: Ant roll, post glide (B condyles)
◦ SB/Rot: always contralat coupling. With R Rot, R condyle glides post & L ant, and L SB (never alone)
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| AA jt | - Dens pivots on post arch Atlas
- Lat facets are biconvex (C1/C2), tilt with Flex/Ext, inf glide of C1 on C2 with Rot
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| Mvt range of nodding motion | 10-30 degrees
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| Rot biomechanics | - AA ROM in ipsilat Rot = 45 (32–47)
- AA Rot contributes ~55% of total ROM of C region.
- Dysfunction of 1st vert will present as significant loss of C Rot
- With R Rot, R condyle of C1 glides post & inf, L condyle glides ant & inf (Both inf)
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| Lower Cervical Biomechanics | -C IV disc is unique
- Clefts in disc develop into Unncovertebral joints (U-Joints)
-Both translation and sagittal plane Rot occur in lower C region
-C2-6 ipsilat coupling of SB&Rot
-Flex: B upslide
-Ext: B down slide
-R SB: R down slide & L upslide
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| OA jt ROMs (Flex, SB, Axial Rot) | - Flex: 15-20 degrees
- SB: 9 degees to B sides
- Axial Rot of 0 (8 degrees if forced)
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| AA jt ROMs (Flex, Ext-limited, SB) | -With Rot, ipsilat condyle slides post, contralat condyle moves ant. Both slide inf along convex surface telescoping head downward
-Flex variable. ~10 degrees
-Ext limited by ant arch of C1
-Flex limited by tectoral membrane
-SB is ~5 degrees
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| Rotexion biomechanics | - OA contralat coupled
- AA ipsilat coupled
- C2/3 ipsilat coupled
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| Latexion biomechanics | - OA contralat coupled
- AA contralat coupled
- C2/3 ipsilat coupled
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