-
side-bending at C1-2?
NONE! the dens blocks it
-
where is the most sup SP
C2
-
inion aka
external occipital protuberance
-
holes in cervical vertebrae?
- 3
- one for the spinal cord
- one in each TP, the transverse foramen, for the vertebral arteries
-
3 places where atlas interacts with axis
- 2 AA joints (facet joints)
- 1 AO joint between atlas and the ondontoid (the posterior aspect of the ant part of atlas has a litle articular facet for the dens)
-
which are the "typical cervical vertebrae?"
C3-C6
-
in the typical c-vert, where is the most flex/ext?
C5-6
-
uncinate processes - where? joints are called __ or __
- typical verts
- joints of Van Lushka or uncovertebral joints
-
facets in c-spine -- what plane?
~45 degrees up from horiz
-
vertebra prominens
how to be sure you're palpating it
nickname for C7 bc it has the longest SP
put a finger on it and extend the neck. C7 should stay still bc it's blocked by the ribs, while if you're finger's on C6 it'll disappear
-
characteristic of the TPs in typical vert
they have a gutter to protect the nerve root, and run pretty much in the X axis under the nerve
-
special char of SPs in axis and in typical vert
bifid SP
-
cervical facet joints are in the sagital plane at __ angle,
curve of them?
face which way?
- concave on convex
- inf faces down, forward, lat
- sup faces up, post, med
-
what kind of joint is it between the ondontoid, ant arch of C1, and lat masses?
trochoid
-
motions at C1-2?
rotation only! no flex/ext, no SB
-
how many degrees of freedom at A/O joint?
-
paired motions at C0-C1 and C1-C2
SB and rot in opp dir, always!
-
C2-C3, and in the C-spine below, how do SB and rot interact?
always to the same side
(C0-C2 they're in opp dir)
-
cruciform ligament
shape
the two sections
- upside-down cross
- transverse connects two sides of the atlas and keeps the dens in place
- vertical runs from C2 to occiput
-
dentate ligament, its two components run where?
- apical - dens to basiocciput (straight up the Y axis)
- alar - postero-lat dens to occipital condyles (45 up superolat) -- keeps dens centered. in SB, the ipsilat lig gets slack while contral goes tight
-
when are the joint surfaces of the lower C-spine maximally congruent, maximally stable?
in max ext
-
coupled motions with c-spine flex and ext?
none. They're indep, unlike SB and rot
-
how much ext happens at the A/O jt?
15 degrees
-
total c-spine ext?
roughly 70, though dancers can get to 90
15 happens at AO
-
lig nuchae runs where?
inion to C7 along the SPs
-
ligamentum flavum connects what? limits what
-
how much flexion in c-spine?
- about 80-90 (though oatis says 35-70)
- flexion is more unstable than ext
-
SB is ipsi/contralat with rot where?
- above C2 it's contralat rot
- below it's paired with ipsilat rot
-
how much SB in c-spine?
20-45 degrees to each side (just think of it as 45 degrees though)
-
how many degrees of rot at C1-C2?
total c-spine rot?
- 32-45 degrees to each side
- 40-90/side
-
how does the facet glide on side to which you're rotating?
inferior glide
-
amount of rot with SB changes how as you go from C2-7?
the rot decreases as you get lower
-
in L rotation of head and neck, what's happening in upper and in lower c-spine?
- upper -- AO is SB R and slightly flexed
- lower -- SB L and slight ext
-
where is the cartilage lined surface in an uncinate process?
facing med and sup
-
capsule of uncovert jts is continuous with what?
annulus fibrosis of the disc
-
uncovert jt limits what?
SB
-
when do uncinate processes develop? what type of joint?
- 2nd and 3rd decade -- by the time you're in your 40's it's a fully wt bearing jt bc by then you've had degen of disc
- pseudo-synovial
-
role of uncovertebral joints
- limit SB of neck
- protect nerve from being compressed by disc
-
total flex/ext in c-spine, and flex/ext separately
- 150-160 degrees
- flex - 80-90
- ext 70
-
subocciptal (AO) flex/ext
- 20-30 -- total?
- 15 degrees ext
"Lower cervical 100-110 degrees" -- total flex/ext??
-
lat flex at C0-C1, C1-2, C2-C3 and total in rest of c-spine?
- 3
- none
- 5
- 45 degrees to each side below
-
post annulus in c-spine?
there's none - the ring ends at the uncinate process and then there are dense posterior ligaments taking over the role of post annulus
-
rot at AO, AA, and total ROM
- 7 degrees
- 50% of total
- 80-90 total
-
IV discs make up what percent of c-spine ht? do what to the shape of the neck
-
what innervates the outer 1/3 of the IV disc
vertebral and sinuvertebral nerves
-
nociceptors in IV discs?
wide distribution
-
borders for nerve root foramen
- sup -inf pedicle
- inf - sup pedicle
- ant - joints of von luschka
- post - facet jt
-
nerve occupies what % of intervertebral foramen? surrounded by what?
-
why do we rarely find discs in C-spine prolapsing posterolaterally?
- bc of uncinate process protecting the nerve.
- but that leaves space for ant motion, which is common
-
4 risks for c-spine nerves
- osteophytes at uncovertebral joints
- swelling of facet capsule
- venous congestion of dural sleeve
- nerve ischemia
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