Cervical Region Anatomy and Kinesiology Review

Flashcards covering the functional anatomy, ligamentous structures, musculature, and kinesiological principles of the cervical spine based on Dr. Daniel Maddox's review.

Craniovertebral / Upper Cervical Zone

The region of the cervical spine spanning from $C0$ to $C3$.

Mid-Cervical Zone

The region of the cervical spine spanning from $C3$ to $C6$.

Cervicothoracic Zone

The region of the cervical spine spanning from $C6$ to $T1$.

Zygapophyseal / Facet Joints (Orientation)

Joints angled at approximately $45^\circ$ between the frontal and transverse planes; they are more horizontal ($\sim 35^\circ$) in upper segments and more frontal ($\sim 65^\circ$) in lower segments.

Uncovertebral Joints

Joints that help guide flexion/extension, limit lateral flexion, prevent posterior translation, and reinforce the posterolateral aspect of the intervertebral discs (IVDs).

Cervical Intervertebral Discs (IVDs)

A series of 5 discs beginning at $C2-C3$, named for the vertebra lying immediately superiorly.

Cervical Nucleus Pulposus (NP)

The inner part of the disc which is smaller in the cervical spine ($25\%$ at birth) compared to the lumbar spine ($50\%$) and typically undergoes fibrosis by the mid-teens.

Intervertebral Foramina

Tunnels that contain the spinal nerve roots; they narrow during extension, ipsilateral lateral flexion, or ipsilateral rotation, and open during flexion, contralateral lateral flexion, or contralateral rotation.

Vertebral Canal

The passageway within the spinal column that contains the spinal cord.

Transverse Foramina

Passageways containing the vertebral artery, which typically enters at the level of $C6$.

Nuchal Ligament

An external, continuous ligament of the cervical spine stretching from the external occipital protuberance to the spinous process of the $C7$ vertebra.

Deep Musculature

Muscles suited to control segmental movement and provide dynamic stability, such as the Longus Coli/Capitis (anterior) and Semispinalis/Multifidus (posterior); activity often decreases with ongoing pain.

Superficial Musculature

Muscles that often show increased activity in a "fight or flight" response to pain, such as the Scalenes/SCM (anterior) and Upper Trap/Splenius Capitis (posterior).

Type 1 Coupling

A kinesiology principle where lateral flexion (LF) and rotation occur to opposite sides; traditionally considered to follow this pattern at the OA and AA joints during lateral flexion initiation.

Type 2 Coupling

A kinesiology principle where lateral flexion (LF) and rotation occur to the same side; this is followed by the cervical spine from $C2$ to $C7$.

Upglide

The movement of facets occurring bilaterally during flexion ($B$ upglide) or unilaterally on the contralateral side during lateral flexion and rotation.

Downglide

The movement of facets occurring bilaterally during extension ($B$ downglide) or unilaterally on the ipsilateral side during lateral flexion and rotation.

Atlanto-odontoid Interval (ADI)

The space between the atlas and the dens, which increases during flexion of the $AA$ joint and reduces during extension.

OA Joint (C0-C1) Flexion Mechanics

Characterized by a bilateral anterior roll and a bilateral posterior glide.

AA Joint (C1-C2) Rotation

A spin movement around the dens/atlas articulation that accounts for approximately $50\%$ of all cervical rotation.