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137 Cards in this Set

  • Front
  • Back
What joints make up the craniovertebral joint?
AO (atlanto-occipital) & AA (atlanto-axial)
______ bear the weight of the skull on the atlas & have CONCAVE tubercles.
2 lateral masses
There are kidney-shaped ____ on the atlas for reception of the occipital condyle.
articular facets
The articular facets of the atlas together with the occiptial condyle form ____.
AO joint
The _____ join the lateral masses of the atlas. They have tubercles as well.
anterior & posterior bony arches
The anterior tubercle serves as the attachment for ____ & _____.
Anterior Longitudinal Ligament & longus colli (uppermost attachment)
The _____ of the atlas has a distinct groove for the Vertebral Artery.
posterior arch
Vertebral artery passes thru _____ foramen of atlas, & then bends medially & lies in groove before it _____.
transverse foramen
ascends through the foramen magnum
The ____ of the atlas projects farther than any other cervical vertebrae.
transverse processes
The 'wide' projection of the transverse processes of the atlas has what advantage?
increased mechanical advantage to some of the muscles that attach there
The ____ aspect of the lateral mass is the part with the tubercle.
medial
The _______ runs from one lateral mass to the other.
transverse ligament of the atlas
The anterior arch of atlas has a facet on its posterior aspect for articulation w/____.
dens
C-__ is the strongest of all vertebrae.
C2--axis
The dens of the axis articulates with ____.
anterior arch of the atlas (via anterior articular facet)
The Tens has a facet posteriorly for ____, which runs from _________.
transverse ligament
side-to-side (medial tubercles of lateral masses)
The superior articular facets (large) articulate with _____.
inferior articular processes of the atlas
The articulation of the sup. art. facets of axis w/inf. art. process of atlas forms _____.
lateral AA joint (atlanto-axial)
The articulation of the dens w/anterior arch of the atlas forms the _____ joint.
median AA joint
Describe the spinous process of the axis.
bifid & strong
What kind of joints are the AO joints?
ellipsiod synovial
Movement of one of the AO joints involves movement of the other, so considered to form ____.
part of an elliptical surface
What are the 2 axes that the ellipsiod joints (AO) move about?
transverse axis
anterior-posterior axis
The transverse axis formed by the AO joints allows ____.
flexion & extension ('yes')
The anterior-posterior axis of the AO joint allows what movement?
lateral flexino (tilting head to the side)
Whast are the 3 AA (atlanto-axial) joints?
2 lateral; one medial
The two lateral AA joints are _____ joints, while the median is a ____ joint.
lateral-gliding synovial joints
median-pivot joint
THe lateal AA joint surfaces are ____ (what shape?).
flat & planar (hence the gliding motion)
As you turn your head, the lateral AA joints glide, one _____ & one ____.
forward & backward
The dens has _____ cavities (lined with _____) anterior & posterior to it.
synovial cavities (synovial membrane)
The synovial cavities on front & back of dens allow for ________.
rotation/PIVOTING
When you shake your head 'no', ______ rotates around the dens-a ____ pivot.
the skull & atlas rotate around dens, a stationary pivot
The AO joint has a ____ capsule, which is loose & lined by a ____ membrane.
fibrious capsule, synovial membrane
The anterior atlanto-occipital membrane stretches b/tw ____ & ____.
anterior arch of atlas & anterior margin of foramen magnum
The AO membrane is located between _____ joints.
AO
The lateral AA joints are rather loose, & b/tw them you can see _____.
ALL (it attaches to anterior tubrecle of the atlas)
The posterior AO membrane stretches from ____ to ___.
posterior arch of atlas to posterior margin of foramen magnum
What structures pierce the posterior AO membrane?
vertebral artery
sub-occipital nerve
The posteror AO membrane blends with _____ laterally.
capsule of the AO joint
The tectorial membrane is a continuation of ____ & is anterior to _____ (surrounding spinal cord).
posterior longitudinal ligament
dura mater
The tectorial membrane runs from ___ to ___.
axis to base of occipital bone
What are the ligaments running deep to the tectorial membrane?
transverse ligament of atlas + sup. & inf. longitudinal bands = cruciate ligament;
alar ligaments
What side of the dens does the transverse ligament cover?
back
The superior longitudinal & inferior longitudinal bands extend up & down from ____.
transverse ligament
The superior longitudinal band attaches to ____ & the inferior attaches to ____.
basilar part of occipital bone
body of axis
The cruciate (cruciform) ligament is formed by what 3 structures?
The superior longitudinal & inferior longitudinal bands;
transverse ligament
The alar ligaments are ___ (where in location?) to cruciate ligament.
anterior ('deep' from posterior view)
The alar ligaments run superiolaterally from _____ to ____.
lateral margin of dens to medial margin of occipital condyle
The alar ligaments are strong and sometims called ___ ligaments. Why?
"check"-they check/limit the amount of rotation of your head
The small apical ligament of the dens extends from ___ to ___.
tip of dens to margin of foramen magnum
Upon cutting one alar ligament, there is a __º increase in lateral rotation.
30
Diving accidents can be the culprits of a ____ fracture.
Jefferson
What is a Jefferson fracture?
compressive forces passed through occipital condyle into atlas
What happens to the lateral masses in a Jefferson fracture?
they are displaced laterally, which fractures one or both of the bony arches
The ____ can be ruptured if the force of a Jefferson fracture is great enough.
transverse ligament of the atlas
What could happen if the transverse ligament of the atlas ruptured?
dens may impinge on spinal cord & cause grave daño o muerte
A hangman's fracture results of ____ of head ON neck.
hyperextension
Hyperextension of head on neck fractures ____ of the axis.
pars interarticularis (b/tw sup. & inf. articular procecces)
About 40% of axial fractures involve ____.
the dens
The dens is usually fractured at its ____ (body or base?). Why is result?
base
blood supply cut off & avascular necrosis occurs
Which is better--fracture of body or base of dens?
body--the 2 fragments still have their own blood supply
Rupture of the transverse ligament of atlas can cause ___ displacement of atlas.
anterior
There is some leeway for anterior displacement of atlas b/c _____.
about 1/3 of it is occupied by soft tissue, meninges, & CSF
What is Steele's Rule of 3rds?
can displace atlas up to 1/3 diam. of ring & s.c. may not be smashed b/c 1/3=dens, 1/3 =s.c., 1/3=soft tissue, etc.
What are the 4 muscles on each side of the prevertebral region ?
longus colli (longus cervicis); longus capitis; rectus capitus anterior & lateralis
The longus colli originates from ____ & attaches into ___.
upper T & lower C vertebrae
C vertebrae (more superiorly)
The highest extent of the longus colli attaches into the _______.
anterior tubercle of the atlas
The longus capitis arises from ___ & inserts into ____.
arises-cervical vertebrae
inserts-basilar part of occipital bone
The rectus capitus anterior runs from ____ to ____.
lateral mass of atlas to basilar part of occipital bone
The rectus capitus lateralis runs from ____ to ____.
transverse process of atlas to jugular process of occipial bone
The scalene muscles are sometimes considered ___, sometimes _____.
lateral vertebral,
prevertebral
The scalenes all originate from _____.
transverse process of cervical vertebrae
What is the insertion point?
anterior scalene:
middle scalene:
posterior scalene:
ant-scalene tubercle of rib 1
mid-upper surface of rib 1
post-outer margin of rib 2
The scalene & prevertebral muscles are innervated by _____.
ventral rami of cervical nerves
What muscles flex the neck?
longus colli-bilaterally
scalene muscles-bilaterally
SCM
The scalenes (bilaterally) can _____ if the neck is fixed, and are hence _____.
elevate the first 2 ribs
muscles of inspiration
If the scalenes contract unilaterally, you get _____.
lateral flexion of the neck (intertransverse also does this)
____ & ____ muscles are responsible for flexion of the head.
Longus capitis & rectus capitis anterior
The SCM & supra/infrahyoid muscles can pull down on hyoid & ____, causing ____.
mandible
indirect flexion of AO joint
Which muscles are responsible for extension of the head?
rectus capitis posterior major & minor
suprior oblique, trapezius
Lateral flexion (tilting of head from side to side) is caused by _______.
rectus capitus lateralis
Turning head left or right is caused by _____.
SCM contraction on opposite side
Which muscles cause rotation to the same side?
rectus capitis posterior major; splenius capitis; longissimus capitis; inferior oblique
What gives mechanical advantage to the inferior oblique to cause lat. rotation?
the transverse process of the atlas extending so far laterally
What structures run anterior to anterior scalene?
phrenic nerve, suprascapular & trans. cervical aa., inf. thyroid a. (& asc. cervical branch), subclavian vein
Which arteries clamp phrenic nerve down to ant. scalene?
suprascapular & transverse cervical
What structures are posterior to anterior scalene?
2nd part of subclavian; brachial plexus (runs b/tw anterior & middle)
What forms the interscalene triangle?
anterior & middle scalene, along with rib 1
What might compromise the triangle & cause lower trunk of brach. plexus or subclav. artery to become compressed?
cervical rib (recuces size of triangle)
The investing fascia is the most 'superficial' and ENCLOSES _____.
SCM & trapezius muscles
The investing layer of cervical fascial is a ___ layer on front & side of neck.
single
The investing layer of deep cervical fascia forms the ____ of the posterior triangle (b/tw SCM & trapez.)
ROOF
The prevertebral fascia covers prevertebral muscles & extends ___ to cover ___.
laterally-scalene muscles
posteriorly-complete tubular investment for prevert. m. & musc. on back of neck
The ____ fascia surrounds the cervical viscera & is divided into 2 components. What?
VISCERAL
pretracheal & buccopharyngeal
The pretracheal fascia forms a sheath for _____.
thyroid gland
The buccopharyngeal layer of fascia covers _____ & ____ (superior) & ____ (inferior).
buccinator & pharyngeal muscles-higher
back of esophagus-lower
Where is the retropharyngeal space found?
behind pharynx/esophagus; bounded anteriorly by buccopharyngeal fascia & post. by prevert. fascia
The retropharyngeal space is filled with __, which allows ___ of pharynx & esophagus (when swallowing).
loose areolar tissue
expansion upon swallowing
The ____ binds the retropharyngeal space on either side.
carotid sheath
Which layers of fascia contribute to carotid sheath?
investing; prevertebral; visceral
The carotid sheath encompasses ___, ____, & ____.
CNX, IJA, CCA
The retropharyngeal space extends from ___ to ___ (superiorly to inferiorly).
base of skull
behind heart into posterior mediastinum
What is clinical significance of inferior border retropharyngeal space?
infection can spread to mediastinum (in chest)
The buccinator & 3 constrictor muscles of pharynx are covered in ____.
buccopharyngeal fascia
The lateral pharyngeal space is ___ filled & has which 2 muscles in it?
fat-filled
styloglossus, stylopharyngeus
The lateral pharyngeal space lies lateral to ___, medial to ____.
lateral-pharynx
medial-pterygoid muscles & parotid gland
The lateral pharyngeal space is continuous with the _____.
retropharyngeal space
A common site for infection, the lateral pharyngeal space houses ___, ___, & ____.
base of Tongue, palatine Tonsils, Teeth (3Ts)
CN ___ descends, loops forward, & is closely related w/vagus.
XII
CN ___ wraps around the stylopharyngeus.
IX
CN __ runs inferolaterally & enters deep side of SCM.
XI
CN ____ descends in the carotid sheath b/tw IJV laterally & ___ medially.
X
internal carotid medially
CN ___ crosses both carotid arteries & innervates ____.
XII;
tongue muscles
The sympathetic trunk lies ___ to carotid sheath & contents.
(just) posterior
The cervical part of the sympathetic trunk has __ ganglia. What?
3-4;
superior, middle, inferior, & sometimes vertebral (b/w middle & stellate)
The ___ ganglia from cervical part of symp. trunk are usually fused (_% of time) with _____.
inferior
80%
1st thoracic
The fusing of inferior cervical ganglion w/ 1st thoracic ganglion is called ___ ganglion.
stellate ganglion/cervicothoracic)
The cervical part of symp. trunk consists 1º of ____ fibers that have entered trunk in ____ region.
PRESYNAPTIC SYMPATHETIC
upper thoraic region
The presynaptic cell bodies lie in ___.
lateal horn of upper thoracic spinal cord
After presynaptic cell bodies enter sympathetic trunk, they synapse ___ (where?).
in any of the 3-4 ganglia
After synapsing in cervical ganglia, postsynap. symp fibers will go to ___ & ___.
head & neck
The postsynap. symp. fibers will go to head & neck 2 ways: ___ & ___.
gray rami comunicantes
post. symp fibers traveling along blood vessels
The grey rami comunicantes connect ___ & ____.
cervical ganglia w/ cervical spinal nerves
There are ___ cervical ganglia but ___ cervical nerves.
3-4
8
All spinal nerves have a ______.
grey ramus
The SUPERIOR cervical ganglion sends gray rami to which cervical nerves?
upper 4 cervical nerves
The MIDDLE cervical ganglion sends gray rami to which cervical nerves?
usually C5-C6
The INFERIOR cervical ganglion sends gray rami to which cervical nerves?
C7-C8
_____ results in 3-4 instead of 7-8 ganglia.
Fusion of ganglia during development (hence you may have some variation)
The ____ is a major nerve coming off sup. cerv. ganglion & traveling along ICA.
internal carotid nerve (it forms a plexus around the artery, up into the skull)
THe ___ forms a pluxus around the ECA & its branches.
external carotid nerve
The ___ forms a plexus around the vertebral artery.
vertebral nerve
Which arteries have sympathetic plexi of nerves around them?
ECA, ICA, VA
The sympathetic fibers travel along arteries & branches to innervate ____.
smooth muscle & glands in head and neck (including blood vessels themselves)
Horner's syndrome is caused by lesions of ____ .
sympathetic trunk causing sympathetic supply to head & neck to be cut off
The ICA plexus is responsible for ___ & ___ in Horner's syndrome. Why?
PTOSIS-superior tarsal
MIOSIS-dilator pupillae
The ECA plexus is responsible for ___ & ___ in Horner's syndrome.
VASODILATION (inc. temp, redness of skin & face)
ANHIDROSIS (lack of sweating)