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45 Cards in this Set

  • Front
  • Back
what nervous system is the cauda equina part of?
peripheral nervous system.
therefore it has hope of regen if injured
why is the vertebral canal large in cervical vertebrae?
to house the brachial plexus, large spinal cord, and sympathetic nerves
which cervical vert are bifid?
C3-6
are C1/2 non disc segments?
yes
does c1 have a spinous process?
no
cervical transverse foramen are large and contain?
the vertebral artery
It is vulnerable here
another name for uncovertebral joints
joints of luschka
what type of joint are uncovertebral joints?
saddle
which cervical segments have unicinate processes?
C3-7
function of uncinate processes?
guide flexion/extension
hook cranian vert to caudal vert
concave in one direction/convex in another
larger in lower segments
convex/concave of uncinate processes
SB - concave/convex (named cranial to caudal)
flex/ext - convex/concave (??)
why do cervical discs split?
-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
when does the cervical disc become fibrocartilage?
by teens
ant/post annulus in cervical discs
anterior annulus = thick
posterior annulus = thin
what direction will most problems occur in cervical discs?
posteriorly - there is nothing else to support it
it will hernaite to the posterior-lateral corners of the disc
C1 atlas characteristics
-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
atlanto-occipital joint - c0/1
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
C2 - axis
dens = body
-large spinous process
-huge, nearly flat facets
-made for rotation
atlanto-axial joint = c1/2
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
C3-6 superior facets
posteriorly superiorly
c3-6 inferior facets
aneteriorly inferiorly
cervical facet angle
45*
alar ligament
-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
cruciform or transverse ligament of atlas (TLA)
-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
tectoral membrane
-con't of PLL
-posterior to cruciate ligament
-strengthens skull and spine connection
-limits: extremes of flex/ext
total combined flex/ext craniocervical region movement?
120-130*
atlanto-occipital movements
nodding = 20* flex/ext
slight lat flex
no rot
osteokin of neck flex
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
atlanto-axial joint
-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
total rot in cervical spine?
80*

c1/2 gives 45* of this
cervical ext
initial lordosis is already extended

total ext = 85*

-facets slide down and back
cervical flex
end @ about 45*

-facets slide up and forward
cervical rot
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
where is the instantaneous axis of rotation in the cervical spine for flex/ext?
inferior vert, just anterior to vert body (ext about flex)
cervical SB
40* in each direction
cervical protraction
extension upper cervical
flexion lower cervical
cervical retraction
flexion upper cervical
extension lower cervical
what dictates how the cervical spine moves?
orientating sense organs to the world
cervical facet closed pack position?
neutral/slightly extended (max contact w/in apophyseal joints)
cervical facet open pack position?
moderate flexion

-stretches capsule of apophyseal joints and red. area of contact
cervical spinal coupling
-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
cervical pathology:nerve entrapment
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%
thoracic outlet syndrome
scalene mm presses on brachial plexus
headaches into ear/eye
=aurical nerve entrapment in the suboccipital and occipital mm.
postural syndrome
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