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31 Cards in this Set
- Front
- Back
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What are the principal motions of the atlanto-occipital joints (C0-C1)?
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Flexion/extension 15-20
Side flexion 10 Rotation is negligible |
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What function does the alar ligament perform?
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Limit flexion and rotation
Plays a major role in stabilizing C1 and C2, especially in rotation |
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What are the principal motions of the atlanto-axial joints (C1-C2)?
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Rotation 50
Flexion/extension 10 Side flexion 5 |
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What type of joint(s) are at the atlanto-axial (C1-C2) level?
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Pivot (trochoidal) joint
Odontoind process of C2 acts as a pivot point for rotation Plane joints Lateral aa facet joints |
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What are the main supporting ligament at the atlanto-axial joint?
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Transverse ligament of the atlas
Hold the dens of the axis against the anterior arch of the atlas Cruciform ligament Two projections off of transverse ligament one superior to occiput and one inferiorly to axis |
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Explain the two main sources of blood flow in the neck and what motions put the arteries on stress.
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Vertebral artery
passes through the transverse processes of the cervical vertebrae usually starting at C6 but entering as high as C4 Supplies 20% blood supply to brain Internal carotid artery (80%) Compressed: Osteophyte formation Injury to facet joint Atherosclerosis Stressed Rotation Extension Traction |
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What kind of pain can occur in the lower cervical spine (C3-7) cervico bracial area?
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Neck plain
Arm plain Neck and arm pain |
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Facet (apophyseal) joint in the cervical spine (C1-C7)
How many What type of joints How are the oriented, movement |
14
Synovial (diarthroidal) joints, Superior: upward, backward, medially Inferior: downward, forward, laterally Coupled movement Flexion/extension in isolation, but prevents simple rotation or side flexion without both occurring to some degree together |
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Cervical spine:
1) Resting position 2) Close packed position 3) Capsular pattern |
Slight extension
Full extension Side flexion and rotation equally limited, extension |
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What structures does the recurrent meningeal or sinuvertebral nerve innervates?
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Anterior dural sac
Posterior annulus fibrosus Posterior longitudinal ligament |
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What are the facet joints innervated by?
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Medial branch of the dorsal primary rami
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What are the main ligaments of C3-C7?
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Anterior longitudinal ligament
Posterior longitudinal ligament Ligamentum flavum Supraspinal and interspinal ligaments |
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Uncinate joints or joints of Luschka
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Costal or uncovertebral
Uncus gives a "saddle" form to the upper aspect of the cerv Posterolaterally, limit side flexion |
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What do the interverterbal discs do?
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25% height of spine
No disc between C0-C1 and C1-2 Gives cerv spine lordotic Nucleus pulposus Buffer to axial compression, distributes compressive forces Annulus fibrosus Withstand tension in disc |
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How many degrees
Cervical lordosis Thoracic kyphosis Lumbar lordosis |
Cervical lordosis 30-40
Thoracic kyphosis 40 Lumbar lordosis 45 |
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What are some signs of headache having a cerv origin?
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Sub occipital or occipital component to headache
Neck movement alters headache Painful limited ROM Suboccipital or Nuchal tender Abnormal mobility C0-C1 Abnormal neck or head posture Sensory abnormalities in the occipital and sub occipital areas |
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What is Bakody's sign?
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Pain and referred symptoms are decreased or relieved by placing the hand or arm of te affected side on top of the head
Indicative of problems in the C4 or C5 area |
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What are the first movement that are carried out with the patient in a cervical exam?
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Active, sitting
Look for difference in ROM and pt willingness to do the movement Reasons for pain, spasm, stiffness, or blocking |
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What is overpressure used for?
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Helps the examiner to test the end feel of the movement as well as differentiating between physiological (active) end range and anatomical (passive) end range
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What is upper crossed syndrome?
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Tight upper trap and levator scap
Tight pec maj and min Weak rhomboids, SA and lower trap Weak deep neck flexors |
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What ROM in intracervical region (C2-7)
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Flex: 35
Ext: 70 Total 70 Roation 45 Lateral flex 35 |
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Total across craniocervical region
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Flexion 45-50
Ext 85 Total 130-135 Rotation 90 Lateral flex 40 |
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Cue for active flexion
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Nod you head
Place the chin on the Adam's apple Flex 80-90 |
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Cue active extension
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Lift the chin without moving the neck
Ext 70 |
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Cue for side flexion
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Move your ear towards your shoulder
Palpate adjacent transverse process LAt flex 20-45 |
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Cue for rotation
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Look over your shoulder
Rot 70-90 |
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What are some possible causes for movement restrictions in extension and right side bending?
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Right extension hypomobility
Left flexor muscle tightness Anterior capsular adhesions Right subluxation Right small disc protrusion |
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What are some possible causes for movement restrictions in flexion and right side bending?
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Left flexion hypomobility
Left extensior muscle tightness Left posterior capsular adhesions Left subluxation |
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What are some possible causes for movement restrictions in extension and right side bending > ext and left side bend?
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Left capsular pattern (arthritis, arthrosis)
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What are some possible causes for movement restrictions in flexion and right side bending restriction equal to extension and left side flexion?
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Left arthrofibrosis (very hard capsular end feel)
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What are some possible causes for movement restrictions in side bending in neutral, flexion, and extension?
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Uncovertebral hypomobility or anomaly
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