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    Cervical Anatomy

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    thwiseman
    The document discusses the anatomy of the cervical spine, including typical vertebral features, cervical ranges of motion, ligaments, and muscles. It describes the atlanto-occipital and atlanto-axial joint complexes in detail. Key potential injuries from trauma like a basketball hit include damage to the transverse ligament, vertebral arteries, or disc/neural structures.

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    Cervical Anatomy

    Uploaded by

    thwiseman
    139 views41 pages
    The document discusses the anatomy of the cervical spine, including typical vertebral features, cervical ranges of motion, ligaments, and muscles. It describes the atlanto-occipital and atlanto-axial joint complexes in detail. Key potential injuries from trauma like a basketball hit include damage to the transverse ligament, vertebral arteries, or disc/neural structures.

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    cervical anatomy -powerpoint

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    The document discusses the anatomy of the cervical spine, including typical vertebral features, cervical ranges of motion, ligaments, and muscles. It describes the atlanto-occipital and atlanto-axial joint complexes in detail. Key potential injuries from trauma like a basketball hit include damage to the transverse ligament, vertebral arteries, or disc/neural structures.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    139 views41 pages

    Cervical Anatomy

    Uploaded by

    thwiseman
    The document discusses the anatomy of the cervical spine, including typical vertebral features, cervical ranges of motion, ligaments, and muscles. It describes the atlanto-occipital and atlanto-axial joint complexes in detail. Key potential injuries from trauma like a basketball hit include damage to the transverse ligament, vertebral arteries, or disc/neural structures.

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    You are on page 1of 41

    The Cervical Spine

    By the end of this topic the student should be able to


    Describe the bony features of a typical vertebrae Differentiate between the features of a typical cervical, lumbar and thoracic vertebrae. Discuss the load bearing joints of the vertebral column Describe the x-sectional features of the vertebral column including bony anatomy, neural and ligamentous tissues. Discuss the movement of the cervical spine, including ranges of motion and musculature involved. Describe the anatomy of the thoracic outlet. Describe the bony features and ligamentous support of the Atlantooccipital (AO) joint complex and the atlanto-axial (AA) joint complex.

    Bony Features of a Typical Vertebrae

    Source: www.accd.edu/.../ LabEx10Week6/vertebrae.htm

    Source: http://webschoolsolutions.com/patts/systems/vertebra.gif

    Range of Movement
    See table 9-10 in Neumann for breakdown of ranges of movement available for the AO, AA, and C2-C7 regions of the cervical spine.

    Total Cervical ROM


    Flexion 45-50 Extension 85 Axial Rotation 90 Lateral Flexion 40

    Cervical Musculature
    Cervical Flexion Longus Coli SCM Scalenus Anterior Longus Capitus Cervical Extension Levator Scapula Splenius cervicis Splenius capitis Trapezius Erector Spinae

    Cervical Musculature
    Lateral Flexion Scalenes Splenius Cervicis Levator Scapula SCM Splenius capitis Trapezius Erector Spinae Rotation Semispinalis cervicis Multifidus Scalenes anterior Splenius cervicis SCM Splenius capitis

    Sternocleidomastoid
    Mastoid process to manubrium and clavicle Unilaterally it results in lateral flexion to same side and axial rotation to opposite side. Bilaterally they flex the head and neck. Also has the potential to extend the cervical spine. Very important in whiplash and can cause severe headache referral

    Scalenes
    3 separate sections anterior, medius, posterior. Anterior TPs of C3 C6 to inner first rib Medius TPs of C1 C2 plus posterior tubercles of C3 C7, down to upper surface of first rib. Posterior TPs of C4 C6 to the outer surface of the second rib behind serratus anterior attachment.

    Scalenes
    Movements All produce lateral flexion to the same side (medius the strongest) Bilaterally scalenes anterior can produce flexion of the neck Bilaterally scalenes posterior can produce extension of the neck All scalenes assist with respiration by elevating the ribs.

    Splenius Capitis
    Lower half of ligamentum nuchae and SPs of C7 T4. Attaches to posterior aspect of mastoid process. Bilaterally they extend the neck. Unilaterally they extend but also rotate and sidebend to the same side

    Splenius Cervicis
    SPs of T3 T6 to TPs of C1 C3/4 Bilaterally they extend the head Unilaterally each one laterally flexes and rotates to the same side.

    Longus Colli
    Consists of multiple fascicles that closely adhere to the anterior surfaces of the upper three thoracic and all cervical vertebrae. The muscle ascends the cervical region through multiple attachments between the vertebral bodies, transverse processes and anterior arch of the atlas. Action: The main action of this muscle is flexion of the cervical spine. The more lateral fibres act is conjunction with the scalenes to vertically stabilise the region.

    Semispinalis muscles
    consist of semispinalis capitis and semispinalis cervicis Semispinalis cervicis attaches from upper thoracic transverse processes to the sps of C2 C5 The semispinalis capitis runs from the TPs of T1 T6 and articular processes of C4 C7 to attach to the occipital bone between the nuchal lines.

    Atlanto-occipital (AO) joint


    Convex condyles of occipital bone with concave superior articular facets of atlas Joints are symmetrical and can be considered as one. Two membranes connect arches of atlas with occipital bone anterior and posterior atlanto-occipital membranes Movements Flexion - 5 Extension - 10 Lateral flexion approx 5 in each direction Rotation is minimal

    Atlas

    Atlanto-axial (AA) joint complex


    Two locations of bony congruence Lateral joints formed by inferior facets of atlas and superior facet of axis designed to maximise rotation Median joint formed by anterior aspect of dens and posterior aspect of anterior arch of atlas.

    Axis

    Axis

    Atlanto-axial joint complex


    Tectorial membrane Broad sheet continuous with the PLL. Extends from back of the axis to anterior edge of the foramen magnum. It covers the posterior aspect of the dens, cruciform and alar ligaments Limits extremes of flexion and extension Alar Ligaments Pass obliquely upwards and laterally from each side of apex of dens to medial side of occipital condyle. Short strong ligament limits axial rotation of the head and atlas. Also limit lateral flexion.

    Cervical Ligaments
    Ligamentum Flavum (Yellow ligament) Between lamina of adjacent vertebrae from between C1 and C2 down to between L4 and L5. Front of superior lamina to back of inferior lamina. Elastic ligament assists in keeping upright posture, also helps in return spine to upright position following flexion Passive tension limits flexion helps control compression on discs.

    Cervical Ligaments
    Ligamentum Nuchae Spine of C7 to occipital bone, attaches to spinous processes of all cervical vertebrae Provides a midline attachment for muscles such as trapezius splenius capitis and cervicis. Aids in controlling flexion

    Ligaments of the Vertebrae


    Anterior Longitudinal Ligament Posterior Longitudinal Ligament Interspinous ligament Inter transverse ligament

    Source: http://www.spineuniverse.com

    Red Flag Injuries


    Dens
    fracture due to fall on head (diving) Displacement of fractured dens may injure the spinal chord leading to quadraplegia. Or injure the medulla of the brainstem causing death

    Transverse Ligament
    Rupture resulting in AO subluxation. Complete dislocation may lead to paralysis or death

    Vertebral Arteries Disc / Nerural issues

    Class Task
    Q1: The new GP in your clinic sticks her head around the door and tells you she is examining a patient with neck pain. She wants to know what the typical range motion is available across the cervical region for
    flexion extension lateral flexion rotation

    She also wants to know how much the atlanto-axial joint (C1-C2) contributes to each of these movements.

    She leaves happy with your answers. Five minutes later, she is back in your room describing the case. The patient whose head was rotated to the left, was hit on the right side of her neck with a basketball.
    Describe briefly the three most likely structures implicated.

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