principle motion at C1-C2rotation = 50
flex/ext = 10
side flexion = 5main ligament at C1-C2 =transverse ligament of the atlasfunction of transverse ligament of the atlas- holds dens against anterior arch of the atlas
- has superior & inferior projections (crus) that taken together with the transverse ligament = CRUCIFORM ligamentANATOMY PICS look in book-where do the vertebral arteries entertransverse processes at C6 generallywhat motions significantly decrease blood flowrotation & extensionsx due to decreased blood flowvertigo, nausea, tinnitus, drop attacks, visual disturbances
could lead to stroke or deathwhat manipulation can you use to help the cervical region indirectlythoracic manipulationC3-C7 lower c-spine principle motion =flex/extensionfacet orientation results in "___" of rotation & side bendcouplingmain ligaments in cervical spineALL, PLL, LF like L-spineuncinate process goes fromsuperior projection from lateral vertebral bodyuncinate process functionsforms the uncovertebral joint (joint of Lushka) from C3-T1
- limits side flexion
- w/DDD, osteophytes can form & project to IV foramencervical spine characteristics include all except:
a) no IV disc between CO-C1, C1-C2
b) spinous process absent from C1
c) 1st palpable s. process is C2
d) 8 vertebrae, 8 nerve roots
e) C1 nerve root exits between occiput & C1 vertebrae
f) nerve root named for vertebra below
g) switch occurs @ C7/T1 vertebrae8 vertebrae, 8 nerve roots
*** ONLY 7 vertebraelateral foraminal stenosis & herniation affects the ___ nerve rootSAMET/F: there is no cauda equina in the cervical spineTRUEwhere do herniation's occur in the spineC2 belowunless congenitally small spinal canal, spondylosis & stenosis occurs w/increase inageMOI involving MVA can be very __ & potentially have a diverse trauma such that __acute; delayed onset due to lots of microtraumaMOI: lateral flexion to contralateral side causes"burner" or "stinger" stretch of brachial plexushyperflexion injuries you would want to treat it howavoid hyperflexionactivities/postures:
type of work - clerical --> ___
wear bifocals --> ___postural issues
head tiltlocation & boundaries of pain- C4 or above not into armT/F: scapular/upper thoracic pain coming from cervical spine until proven otherwiseTRUEsx to look for cervical myelopathy:
a) spasticity
b) bilateral parasthesia
c) incoordination
d) gait disturbanceall of them
TABLE 3.6 MAGEEhoffman's sign indicatesUMN lesion in cervical spineHA can occur fromcervicogenic, commonly from upper segments
cervical movementsparasthesia: unilateral w/___ & bilateral from __radiculopathy; central stenosisLE symptoms could begait disturbances
bilateral = severe issuesymptoms such as dizziness, fainting, seizures could be fromdizziness --> inner ear or vertebral arteries
drop attacks --> vertebral arteries
visual disturbances --> diplopia, nystagmus, neurologic injury, intracranial pressuredifficulty swallowing from 2 thingsmechanical pressure i.e. vertebral subluxation
neurologic issueis sleep an important issue for cervical painYES
quality, position, number & thickness of pillowsthin pillows causes closing down of __ side, thick pillows causes closing down of __ sideipsilateral, contralateralforward head results in upper c spine __ lower c spine __extension/ flexionpalpation done insupine to cause max relaxation,
sitting with head resting on foreheadbias cervical flexion bynodding v mass flexionPROM greater in seated or supinesupineneck flexion myotome: __
side flexion: __
shoulder elevation: __
shoulder abduction: __
elbow flexion & wrist extension: __
elbow extension & wrist flexion: __
thumb ext: __
finger ab/add: __C1-C2
C3 & cranial nerve XI
C4 & cranial nerve XI
C5
C6
C7
C8
T1ability to turn an automobile requires whatturning their head either waydrinking a glass of water requiresfair amount of extension, can get scapular ache
overhead items also causes painnumerical inventory =neck disability index
