cervical and thoracic ortho

atlas vertbrae

C1; flexion, extension

axis vertebrae

C2; rotation

cervical disc characteristics

• Cervical discs are smaller.

• Less weight to support

• No discs at C0–C1 and C1–C2

ALL- limits ext

PLL- limits flec

LF and IL- limits rotation and lateral movement

how many pairs of nerve roots are present for the cervical spine

8 pairs of nerve roots; Roots come together and divide into two rami

what is the role of rami (both ant/post ramus)?

carry sensory and motor info

these muscles are correlated with c4/c5

Splenius capitis
• Splenius cervicis
• Semispinalis capitis
• Semispinalis cervicis

these muscles are correlated with c7

Longissimus capitis
• Longissimus cervicis
• Longus capitis
• Longus colli

what two cervical neck muscles assist in a little both of rotation and flexion?

scalene and sternocleidomastoid

what is thoracic outlet syndrome

compression of the brachial plexus causing nerve dysfunction

upper trap location and muscle action

skull to superior angle of scapula; elevation of shoulder

middle trap location and muscle action

superior angle of scap to inferior angle of scap; scapular retraction

lower trap location and muscle action

inferior angle of scap to distal end of the trap; depression of shoulders

brachial plexus

C5–C8
‒ C4–T2 (may also contribute)
Innervates part of the shoulder, arm, and hand

cervical plexus

C1–C4

Innervates occipital, supraclavicular, shoulder, and upper thoracic region

c spine past history

History of spinal
pathology
▪ Recurrent brachial
plexus trauma
▪ Chest or breast pain
▪ Headaches or other
head pain
▪ Eye examination
▪ Psychosocial factors

History of the present
condition

Location of the pain
▪ Mechanism and onset of
injury
• Insidious onset
• Acute onset
▪ Consistency of the pain
▪ Postural influences
▪ Other symptoms

what is the most important first thing to ask a suspected neck injury athlete

does your neck hurt?

true ribs contain the least anmount of what

articular cartilage

which ribs are most likely to dislocate

floating

with pain over xiphoid process, what ribs should we think can be a part of the problem

floating

with pain over the body of the sternum, what ribs should we think can be a part of the problem

true

rib fractures are most likely caused from what

lateral load

what makes the cervical spine different

< weight, more mobility

extensors are located on the back of the spine where?

transverse processes

functional assessment

• describe/reproduce motions that increase symptoms

• work environment

• sport position

• cervical flexion and extension

neck MMTs need to fight gravity, these are the positions for each

flex= supine

ext= prone

lateral flexion= side lying

rotation= supine or side lying

what is torticollis

lack of lateral flexion/rotation

Cervical myelopathy s/s

Sensory disturbance of
the hands
▪ Muscle wasting of hand
intrinsic muscles
▪ Unsteady gait
▪ Hyperreflexia
▪ Bowel or bladder
disturbance
▪ Multisegmental weakness
or sensory changes

neoplastic conditions to consider for cervical spine conditions

▪ Age older than 50
▪ Previous history of cancer
▪ Unexplained weight loss
▪ Constant pain; no relief
with bedrest
▪ Night pain

vertebral nerve dysfunction can be caused by muscles from 1 or 2 things

1) the muscle of loose

2) muscle/tendon is angry and is compresses the nerve

flip over side for part 2