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45 Cards in this Set
- Front
- Back
what nervous system is the cauda equina part of?
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peripheral nervous system.
therefore it has hope of regen if injured |
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why is the vertebral canal large in cervical vertebrae?
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to house the brachial plexus, large spinal cord, and sympathetic nerves
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which cervical vert are bifid?
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C3-6
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are C1/2 non disc segments?
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yes
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does c1 have a spinous process?
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no
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cervical transverse foramen are large and contain?
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the vertebral artery
It is vulnerable here |
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another name for uncovertebral joints
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joints of luschka
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what type of joint are uncovertebral joints?
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saddle
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which cervical segments have unicinate processes?
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C3-7
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function of uncinate processes?
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guide flexion/extension
hook cranian vert to caudal vert concave in one direction/convex in another larger in lower segments |
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convex/concave of uncinate processes
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SB - concave/convex (named cranial to caudal)
flex/ext - convex/concave (??) |
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why do cervical discs split?
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-there is more translational form here than anywhere else in the spine
-it is due to mechanics and instantaneous axis -the split becomes another joint: should have a lot of motion b/c annulus is split it will allow more translation -it is better to get whiplash at 6 than 16 -this impacts mobilization/manipulation of the cervical spine -- you will need to be careful b/c you already will get more mobilization with age |
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when does the cervical disc become fibrocartilage?
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by teens
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ant/post annulus in cervical discs
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anterior annulus = thick
posterior annulus = thin |
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what direction will most problems occur in cervical discs?
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posteriorly - there is nothing else to support it
it will hernaite to the posterior-lateral corners of the disc |
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C1 atlas characteristics
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-supports head
-superior articular facet = concave -inferior facet = flat -no vert body -no spinouse process -largest vert foramen = to accommodate the dens -longest transverse process in cervical spine |
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atlanto-occipital joint - c0/1
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yes joint = flex/ext movement
-provides ind. movement of the cranium rel. to the atlas -b/w the protruding convex condyles of the occipital bone and the concave superior articular facets of the atlas |
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C2 - axis
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dens = body
-large spinous process -huge, nearly flat facets -made for rotation |
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atlanto-axial joint = c1/2
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No joint
-c1/2 = large flat plates sliding on eachother "pivot joint" -50% of total horizontal plane rotation w/in craniocervical region occurs at atlanto-axial joint -2* degree of freedom here is flex/ext |
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C3-6 superior facets
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posteriorly superiorly
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c3-6 inferior facets
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aneteriorly inferiorly
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cervical facet angle
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45*
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alar ligament
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-stabilizes C0-2
-pair of tough, fibrous cords -passes laterally/slightly upward from apex of dens to the medial sides of the occiptal condyles -resist (or check) axial rot of the head/atlas rel to the dens and SB -loose in neutral -taunt in rot. --contralateral side exhibits greaters resistance than ipsilateral side in rot -test w/ SB to contralateral side - if SB is stopped, alar lig is intact |
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cruciform or transverse ligament of atlas (TLA)
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-3 bands
--superior, transverse, inferior -stabilizes c1/2 and c0-2 -runs posterior to dens:makes firm contact -transverse/vertical fibers = prevents dens from traveling into the spinal cord at the base of neck -synovial joint where TLA and dens articulate -down's syndrome = unfused dens, TLA is lax (less stable cervical spine) -Pt. w/ RA = softening of ligaments = dens poking into spinal cord/brainstem -ligament and anterior arch articulations = pivot point for dens |
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tectoral membrane
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-con't of PLL
-posterior to cruciate ligament -strengthens skull and spine connection -limits: extremes of flex/ext |
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total combined flex/ext craniocervical region movement?
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120-130*
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atlanto-occipital movements
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nodding = 20* flex/ext
slight lat flex no rot |
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osteokin of neck flex
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roll forward, slide backward
-what part of the capsule is tight? posterior -students posture - head forward, what part is tight? posterior -what limitation is likely with students posture? flexion why? b/c of adaptive shortening |
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atlanto-axial joint
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-3 joints:
2 facets and median joint (dens+atlas) -flat facets -50-60% of cervical rotation -a little flex/ext -no SB -Alar ligament limits rot |
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total rot in cervical spine?
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80*
c1/2 gives 45* of this |
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cervical ext
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initial lordosis is already extended
total ext = 85* -facets slide down and back |
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cervical flex
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end @ about 45*
-facets slide up and forward |
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cervical rot
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80* in each direction
-rot from c3-7 -spinous process goes in opposite direction from rotation (thumb out model) -half axial rot occurs at AA joint (atlanto-axial) - R rot = r facet "ext" down/back, L facet "flex" up/forward (looks the same at SB) -extremes of rot limited by: contralateral alar lig, lig tension in facets, mm that cross craniocervical region -full rot stretches: vertebral arteries |
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where is the instantaneous axis of rotation in the cervical spine for flex/ext?
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inferior vert, just anterior to vert body (ext about flex)
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cervical SB
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40* in each direction
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cervical protraction
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extension upper cervical
flexion lower cervical |
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cervical retraction
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flexion upper cervical
extension lower cervical |
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what dictates how the cervical spine moves?
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orientating sense organs to the world
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cervical facet closed pack position?
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neutral/slightly extended (max contact w/in apophyseal joints)
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cervical facet open pack position?
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moderate flexion
-stretches capsule of apophyseal joints and red. area of contact |
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cervical spinal coupling
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-due to 45* facet angle
-SB/rot = simultanously --in mid-low cervical region = coupled in ipsilateral fashion -SB c2-7 R during active motion = AA joint contalateral spinal coupling to the L to help eyes fixate on station object during SB of neck -contralateral coupling w/ atlanto-occipital joint = min undesired SB of head during rot of neck |
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cervical pathology:nerve entrapment
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full flex inc cervical intervertebral foramen by 31%
SB/rot = inc contralateral intervert foramen space -compression against spinal nerve root can result in radiculopathy down ipsilateral arm -disc hernation can also press on spinal cord/nerve: --guess disc problem if mm weakness is seen --guess facet problem if tingling on one side --herniation will occur in post/lateral --pt w/ nerve root probs will have more issues w/ ext b/c ext dec. vertebral foramen space by 20% |
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thoracic outlet syndrome
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scalene mm presses on brachial plexus
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headaches into ear/eye
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=aurical nerve entrapment in the suboccipital and occipital mm.
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postural syndrome
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head forward posture
--allows for tighening of suboccipital mm in back --adaptive shortening of occipital mm --adaptive shortening of facet joint capsule in back/lengthening of facet joint capsule in front --changes WB through neck --axis of head on neck/body changes = creates longer moment arm, therefore inc force = inc compressive load on spinse |