Upper cervical applied anatomy
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| 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
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| 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
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| Craniovertebral joints | two atlantooccipital joints, convex on concave and 4 atlanto axial: 2 biconvex and 2 pivot synovial
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| 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
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| Anterior A/O membrane | anterior arch of C1 to anterior rim of foramen magnum
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| posterior A/O membrane | Posterior arch of C1 to posterior rim of foramen magnum
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| Median A/A joint | Dens of C2 to ant. arch of C1 connected by transverse ligament posteriorly and alar ligaments on the sides
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| Alar ligaments | tension with ext or flexion combined with rotation. Restricts rotation and SB to contralateral side
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| 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
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| Ideal posture for C spine | Muscle balance between posteior semispinalis capitis and levator scapulae and anterior SCM and scalenus anterior
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| 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
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| 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
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| Deep anterior neck flexors | rectus capitis anterior, rectus capitus lateralis, longus capitus
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| 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
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| 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
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| 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
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| 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
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Created by:
badkins6
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