CERVICAL SPINE

what are functions of the cervical spine 

• supports the head and links it to the thoracic spine 

• protects the spinal cord

what are features of the cervical spine

• highly mobile so facilitates the visual fields

• 7 vertebrae 

• 8 nerves

• lordotic curve

what are features of the typical cervical vertebrae 

• small vertebral body

• small and bifid? spinous process 

• transverse process perforated by the foramen transversarium - for the passage of the vertebral artery and veins 

• vertebral foramen is large and triangular 

where are occipital condyles 

at the base of the skull - are on the inferior surfaces of the occipital bone and lateral to the foramen magnum

describe the occipital condyles

• oval and convex in all planes

• the long axis is directed antero-posteriorly and slightly medially 

• the articular surface faces laterally 

• it articulates with the superior articular facets on C1

describe C1 - atlas

differs from the typical vertebrae as it has 

• no body or spinous process

• anterior and posterior arches 

• has a lateral mass on each side 

• articulates with the skull 

what is the atlanto-occipital joint

the superior articular facet + occipital condyles from the atlanto-occipital joint 

C2 =

axis

what are C3-6

joints of luschka / uncovertebral joints

describe C3-6

• have synovial articulations that articulate with the body of the vertebrae above 

• inter-vertebral disc doesn’t extend the full width of the vertebral body 

• uncinate processes develop on lateral borders

describe C7

• longest spinous process 

• largest transverse process 

• small foramina transversarium

what are the joints between the cervical vertebrae

facet/zygappphyseal joint

describe the facet/zygapophyseal joint

plane synovial joints that articulate the inferior facets of one vertebrae with superior facets of subjacent vertebra 

the facet plane is approx 45 and varies from 55 in the upper cx?? to 25 in lower 

what are features of inter-vertebral discs

• to allow and restrain movement

• to transmit load and shock absorption 

• males up 20-33% of the length of the vertebral column 

• varies from 3mm of thickness in the cervical region to 9mm in the lumbar region 

describe the inter-vertebral discs in the cervical spine

thin, approx 5 mm = ¼ of the vertebral body height and the nucleus pulposus is less distinct and has lower water content 

describe the inter-vertebral discs in the lumbar spine

approx 10mm = 1/3 of vertebral body height 

what are the different ligaments of the cervical spine

• anterior longitudinal ligament

• posterior longitudinal ligament

• ligament nuchae

• ligament flavum

• interspinous ligament

describe the anterior longitudinal ligament

starts at the base of the skull and to the anterior surface of the sacrum

it attaches to the vertebral bodies and inter-vertebral discs 

describe the posterior longitudinal ligament

lies on the posterior surface of the vertebral bodies and lines the anterior surface if vertebral canals 

it attaches to the vertebral bodies and inter-vertebral discs 

becomes the tectorial membrane which links C2 to the base of the skull 

describe the ligament nuchae

is the continuation of the supraspinous ligament and is thickened and very strong 

it extends upwards from C7 to external occipital protuberance and crest 

describe the ligament flavum

is yellow due to the elastic tissue

connects the laminae of adjacent vertebrae

prevents folds forming on return from flexion which could get caught or impinge spinal cord 

describe the interspinous ligament

is less significant in Cx?? as it is a weak, thin, membranous (its stronger and longer in the Lx?/)

what are the ligaments of C1 and C2

• cruciate/cuniform ligament 

• alar ligament 

describe the cruciate/cuniform ligament

attaches to the inner margin of atlas on both sides

connects the body of axis to the foramen magnum 

describe the alar ligaments

connects the odontoid to the tubercles on the medial sides of the occipital condyles 

limits rotation 

what is the ROM of flexion in C1 at the atlanto-occipital joint and what is it limited by

15-20

limited by

- joint capsule

- posterior atlanto-occipital membrane

- ligamentum nuchae

- sub-occipital muscles

what is the ROM of extension in the atlanto-occipital joint and what is it limited by 

15-20

limited by the contact of the occiput and posterior arches of the atlas and axis

what is the ROM of side flexion in the atlanto-occipital joint and what is it limited by 

5

limited by the joint capsule and contralateral alar ligaments

what is the ROM of rotation in the atlanto-occipital joint and what is it limited by 

is very limited

what is the ROM of flexion in the atlanto-axial joint and what is it limited by 

5-10

limited by the transverse ligaments

what is the ROM of extension in the atlanto-axial joint and what is it limited by 

5-10

limited by the contact of posterior arches of atlas

what is the ROM of - in the - and what is it limited by 

what is the ROM of side flexion in the atlanto-axial joint and what is it limited by 

ROM is very limited

what is the ROM of rotation in the atlanto-axial joint and what is it limited by 

30-45

limited principally by the alar ligaments 

what is the ROM of flexion in C2-T1 and what is it limited by 

50

limited by

- posterior longitudinal ligament

- ligamentum flavum 

- facet joint capsule

- ligamentum nuchae

- posterior vertebral muscles

what is the ROM of extension in C2-T1 and what is it limited by 

60

limited by the anterior longitudinal ligaments and the contact of posterior bony structures 

what is the ROM of lateral flexion in C2-T1 and what is it limited by 

40 on each side

limited by 

- the opposition of the ipsilateral articular facets

- the contralateral facet joint capsule

- torsion of the intervertebral disc