Podcast
Questions and Answers
How many cervical nerve roots are there compared to the number of cervical vertebrae?
How many cervical nerve roots are there compared to the number of cervical vertebrae?
- There are 8 cervical nerve roots and 7 cervical vertebrae. (correct)
- There are 8 cervical nerve roots and 8 cervical vertebrae.
- There are 7 cervical nerve roots and 8 cervical vertebrae.
- There are 7 cervical nerve roots and 7 cervical vertebrae.
Where does the C8 cervical nerve root exit in relation to the cervical vertebrae?
Where does the C8 cervical nerve root exit in relation to the cervical vertebrae?
- Below the C7 vertebra (correct)
- Above the C8 vertebra
- Below the C6 vertebra
- Above the C7 vertebra
Which anatomical feature is unique to the axis (C2) vertebra?
Which anatomical feature is unique to the axis (C2) vertebra?
- Anterior tubercle
- Posterior tubercle
- Transverse foramen
- Dens (odontoid process) (correct)
What is the primary orientation of the facet joints in the upper cervical spine (C1-C2)?
What is the primary orientation of the facet joints in the upper cervical spine (C1-C2)?
In which plane are the facet joints of the mid to lower cervical spine (C3-C7) oriented?
In which plane are the facet joints of the mid to lower cervical spine (C3-C7) oriented?
Which of the following muscles is located in the posterior triangle of the neck?
Which of the following muscles is located in the posterior triangle of the neck?
The dorsal scapular nerve, which innervates the rhomboids and levator scapulae, originates from which cervical nerve root?
The dorsal scapular nerve, which innervates the rhomboids and levator scapulae, originates from which cervical nerve root?
Which nerve from the cervical plexus is known to innervate the diaphragm?
Which nerve from the cervical plexus is known to innervate the diaphragm?
What is the approximate range of motion for cervical flexion, according to normative values?
What is the approximate range of motion for cervical flexion, according to normative values?
Approximately what percentage of total cervical flexion and extension occurs at the atlanto-occipital (OA) joint?
Approximately what percentage of total cervical flexion and extension occurs at the atlanto-occipital (OA) joint?
What is the approximate range of motion for lateral flexion in each direction in the cervical spine?
What is the approximate range of motion for lateral flexion in each direction in the cervical spine?
Roughly what percentage of cervical rotation occurs at the atlantoaxial (AA) joint (C1/2)?
Roughly what percentage of cervical rotation occurs at the atlantoaxial (AA) joint (C1/2)?
During cervical extension at the atlanto-occipital (OA) joint, what arthrokinematic motion occurs according to roll/glide mechanics?
During cervical extension at the atlanto-occipital (OA) joint, what arthrokinematic motion occurs according to roll/glide mechanics?
During cervical flexion at the OA joint, in which direction does the occiput roll and glide?
During cervical flexion at the OA joint, in which direction does the occiput roll and glide?
What arthrokinematic movement primarily occurs at the atlantoaxial (AA) joint?
What arthrokinematic movement primarily occurs at the atlantoaxial (AA) joint?
In the C2/3 to C7/T1 segments during cervical motion, what is the primary arthrokinematic movement at the facet joints?
In the C2/3 to C7/T1 segments during cervical motion, what is the primary arthrokinematic movement at the facet joints?
What happens to the facet joints on the side of lateral flexion in the C2/3 to C7/T1 segments?
What happens to the facet joints on the side of lateral flexion in the C2/3 to C7/T1 segments?
During cervical flexion in the C2-C7 region, in which direction do the inferior facets of the superior vertebra glide on the vertebra below?
During cervical flexion in the C2-C7 region, in which direction do the inferior facets of the superior vertebra glide on the vertebra below?
In cervical lateral flexion, if you laterally flex to the right, what happens to the right facet joint in the C2-C7 region?
In cervical lateral flexion, if you laterally flex to the right, what happens to the right facet joint in the C2-C7 region?
During cervical rotation to the right in the C2-C7 region, what is the motion of the right superior facet?
During cervical rotation to the right in the C2-C7 region, what is the motion of the right superior facet?
What is the coupled motion typically observed in the cervical spine (C2-C7)?
What is the coupled motion typically observed in the cervical spine (C2-C7)?
What compensatory motion occurs at the C1/2 segment during lateral flexion of the lower cervical spine to maintain horizontal gaze?
What compensatory motion occurs at the C1/2 segment during lateral flexion of the lower cervical spine to maintain horizontal gaze?
Which of the following structures is typically palpated posteriorly in the midline of the neck?
Which of the following structures is typically palpated posteriorly in the midline of the neck?
Which muscle listed below is NOT typically palpated in the cervical region?
Which muscle listed below is NOT typically palpated in the cervical region?
To palpate the transverse processes of C1-C7, where would you typically locate them relative to the spinous processes?
To palpate the transverse processes of C1-C7, where would you typically locate them relative to the spinous processes?
The suboccipital muscles are located in which region?
The suboccipital muscles are located in which region?
Which muscle is a prominent palpable structure in the anterior lateral neck, running diagonally?
Which muscle is a prominent palpable structure in the anterior lateral neck, running diagonally?
Which of the following muscles is primarily involved in mastication and can be palpated in the face?
Which of the following muscles is primarily involved in mastication and can be palpated in the face?
Along with the masseter, which other muscle of mastication can be palpated on the lateral aspect of the skull?
Along with the masseter, which other muscle of mastication can be palpated on the lateral aspect of the skull?
The alar ligaments primarily limit which motion at the atlantoaxial joint?
The alar ligaments primarily limit which motion at the atlantoaxial joint?
The transverse ligament of the atlas plays a critical role in preventing which motion or instability?
The transverse ligament of the atlas plays a critical role in preventing which motion or instability?
Which cervical nerve roots primarily contribute to the suprascapular nerve?
Which cervical nerve roots primarily contribute to the suprascapular nerve?
The long thoracic nerve, known to innervate serratus anterior, originates from which cervical nerve roots?
The long thoracic nerve, known to innervate serratus anterior, originates from which cervical nerve roots?
Which nerve root primarily contributes to the axillary nerve, which innervates the deltoid and teres minor muscles?
Which nerve root primarily contributes to the axillary nerve, which innervates the deltoid and teres minor muscles?
The musculocutaneous nerve, innervating muscles in the anterior compartment of the arm, is formed from which cord of the brachial plexus?
The musculocutaneous nerve, innervating muscles in the anterior compartment of the arm, is formed from which cord of the brachial plexus?
Which cord of the brachial plexus gives rise to the radial nerve, which innervates posterior arm and forearm muscles?
Which cord of the brachial plexus gives rise to the radial nerve, which innervates posterior arm and forearm muscles?
The ulnar nerve, innervating intrinsic hand muscles and some forearm flexors, is a continuation of which cord of the brachial plexus?
The ulnar nerve, innervating intrinsic hand muscles and some forearm flexors, is a continuation of which cord of the brachial plexus?
Flashcards
How many cervical vertebrae are there?
How many cervical vertebrae are there?
There are seven cervical vertebrae in the neck.
How many cervical nerve roots are there?
How many cervical nerve roots are there?
There are eight cervical nerve roots.
Where do C1-C7 nerves exit?
Where do C1-C7 nerves exit?
C1-C7 nerves exit above their respective vertebrae.
Where does the C8 nerve exit?
Where does the C8 nerve exit?
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What is the orientation of the upper C-spine facet?
What is the orientation of the upper C-spine facet?
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What is the orientation of the mid/lower C-spine facet?
What is the orientation of the mid/lower C-spine facet?
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What is cervical flexion?
What is cervical flexion?
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What is cervical extension?
What is cervical extension?
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What is lateral cervical flexion?
What is lateral cervical flexion?
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What is cervical rotation?
What is cervical rotation?
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Atlanto-occipital (OA) joint function
Atlanto-occipital (OA) joint function
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Atlantoaxial (AA) joint function
Atlantoaxial (AA) joint function
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What do C3-C7 joints do?
What do C3-C7 joints do?
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How does the OA joint move?
How does the OA joint move?
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How does the AA joint move?
How does the AA joint move?
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How do C2/3-C7/T1 joints move?
How do C2/3-C7/T1 joints move?
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Cervical extension arthrokinematics
Cervical extension arthrokinematics
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Cervical flexion arthrokinematics
Cervical flexion arthrokinematics
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Lateral flexion arthrokinematics
Lateral flexion arthrokinematics
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Cervical rotation arthrokinematics
Cervical rotation arthrokinematics
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Compensatory counter-rotation
Compensatory counter-rotation
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Key cervical structures to palpate
Key cervical structures to palpate
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Muscles to palpate in the neck
Muscles to palpate in the neck
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Anterior neck muscles to palpate
Anterior neck muscles to palpate
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Study Notes
- The presentation is about the anatomy and kinematics of the cervical spine
- The objectives are to understand cervical anatomy (bones, joints, muscles, nerves, connective tissues) and the normal osteokinematic and arthrokinematic motions of the cervical spine
Cervical Anatomy
- There are 7 cervical vertebrae
- There are 8 cervical nerve roots
- The C1-7 nerves exit above their respective vertebrae
- The C8 nerve exits below the C7 vertebra
- Cervical facet (zygapophyseal joint) orientation includes:
- Upper C-spine with horizontal plane
- Mid/Lower C-spine midway between horizontal and coronal
- Muscles of the neck include:
- Semispinalis capitis
- Splenius capitis
- Sternocleidomastoid
- Levator scapulae
- Splenius cervicis
- Serratus posterior superior
- Rhomboideus minor (cut)
- Rhomboideus major (cut)
- Muscles of the neck
- Digastric muscle
- Mylohyoid muscle
- Stylohyoid muscle
- External Carotid artery
- Hyoid bone
- Thyroid Cartillage
- Scalene Muscles
- Clavicle
- Pectoralis major muscle
- Sternocleidomastoid muscle
- Sternothyroid muscle
- Manubrium of sternum
- Components of the brachial plexus
- Dorsal scapular nerve (C5)
- Phrenic nerve
- Musculocutaneous nerve (C5, 6, 7)
- Axillary nerve (C5, 6)
- Radial nerve (C5, 6, 7, 8, T1)
- Median nerve (C5, 6, 7, 8, T1)
- Ulnar nerve (C7, 8, T1)
- Lateral pectoral nerve (C5, 6, 7)
- Long thoracic nerve (C5, 6, 7)
- Upper subscapular nerve (C5, 6)
- Thoracodorsal (middle subscapular) nerve (C6, 7, 8)
- Lower subscapular nerve (C5, 6)
- Medial pectoral nerve (C8, T1)
- Medial brachial cutaneous nerve (C8, T1) -Contribution from T2
- The Cerivcal Plexus Consists of:
- Great auricular nerve
- Lesser occipital nerve
- Greater auricular nerve
- Transverse cervical nerve
- Supraclavicular nerve
Cervical Osteokinematics
- Flexion: 45 degrees
- Extension: 45 degrees
- Lateral flexion: 45 degrees each side
- Rotation: 60 degrees each side
- Approximately 20% of total flexion and extension happens at the atlanto-occipital (OA) joint
- 5-6 degrees of lateral flexion can occur
- 50% of rotation occurs at the atlantoaxial (AA) joint (C1/2)
- C3-7 facet and intervertebral joints supply the rest of the motion
Cervical Arthrokinematics
- OA joint follows roll/glide rules
- AA joint is only rotation with minimal to no glide
- C2/3 through C7/T1 involves:
- Sliding at facet joints
- Sliding and tilting at intervertebral joints
- Results of movement are "opening" and "closing" of facet joints
- Opening: distance between facet surfaces increases
- Closing: distance between facet surfaces decreases
- Cervical Arthrokinematics - Extension
- OA Roll/ Glide
- C1/2: Posterior Tilt
- C2-7: Facets glide inferior and there is closing
- Cervical Arthrokinematics - Flexion
- OA: Roll/glide
- C1/2: Anterior Tilt
- C2-7: Facets glide superior, and there is opening of facets
- Cervical Arthrokinematics – Lateral Flexion
- Superior facet glides inferior and slightly posterior
- Closing on side of movement, opening on opposite
- Example: right lateral flexion = right facet closing and left opening
- OA: Roll and glid according to convex/concave rules
- Cervical Arthrokinematics - Rotation
- OA: Almost no rotation
- AA joint: Glide with pure rotation
- C2-7: Superior facet glides posterior and slightly inferior
- Coupled motions
- Orientation of the facets at C2-7
- Coupled ipsilateral rotation and lateral flexion
- Compensatory counter-rotation at C1/2 during lateral flexion
- Keeps eyes pointed forward
- Palpation involves palpating:
- Occiput
- Spinous processes C2-7
- Transverse processes C1-7
- Suboccipital muscles
- Upper trapezius
- Levator Scapulae
- Sternocleidomastoid
- Masseter
- Temporalis
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