Cervical spine

• Classification of joints according to the tissue

  • Non synovial
  • Fibrous (e.g. Fibrous)
  • Cartilaginous (Pubic symphysis)
  • Synovial Joints
• Synovial Joints

  • Capsule
  • Synovial membrane / Synovium
  • Synovial Fluid
  • Nourishes joint
  • Lubricates the articular cartilage
  • Pressure distribution
  • Articular cartilage
• Planes of Movement

  • Frontal/ Coronal
  • Sagittal
  • Transverse
• Planes

  • Coronal (frontal)
  • Sagittal (median)
  • Transverse (horizontal)
• Axes

  • Frontal (coronal)
  • Sagittal
  • Vertical
• Movement

  • Abduction/adduction
  • Flexion/ extension
  • Rotation
• The spinal column

  24 vertebrae + 5 fused (sacrum) + 4 fused (coccyx)
• Curves

  • Cervical Lordosis
  • Thoracic Kyphosis
  • Lumbar Lordosis
  • Sacro-coccygeal kyphosis
• Function of the spinal column

  Dissipates vertical compressive forces so provides shock absorption
• Cervical and Thoracic Movements

  • Flexion
  • Extension
  • Lateral flexion to left
  • Lateral flexion to right
  • Rotation left
  • Rotation right
• Typical cervical vertebra

  • Vertebral Body
  • Short, slender, bifid spinous process
  • Pedicle
  • Lamina
  • Transverse process
  • Transverse Foramen (for vertebral artery)
  • Round triangular spinal canal
  • Intervertebral Foramen
• Atypical Vertebrae – C1 / Atlas

  • No vertebral body or spinous process
  • Strong transverse processes
  • Superior facets articulate with the occiput
  • Posterior tubercle
  • Facet for the dens / odontoid process (Anteriorly)
• Atypical Vertebrae – C2 / Axis

  • The C2 / axis provides a pivot around which the atlas and head rotate
  • Has a small vertebral body
  • Transverse processes are small and rounded projections
  • A strong, stout spinous process
  • Odontoid process / dens
• Vertebral Artery

  1. Arises from subclavian artery

  2. Enters through transverse foramen C6, continues to C2

  3. At C2 curves backwards behind lateral mass of C1

  4. Enters spinal canal through foramen magnum

  5. Unites with other VA to form basilar artery supply brain

  6. Potential compression by osteophytes
• Facet joints/Zygapophyseal joints

  • These are articulations between the right and left superior articulating facets and the right and left inferior facets of the adjacent vertebra
  • They are plane diarthrodial joints
  • Control movement at the intervertebral segment. Resist shear, compression and tensile forces
• Orientation of the Facet Joints

  • Cervical facet joints: Superior facet face superiorly/medially, Inferior facet face anteriorly and laterally
• Typical thoracic vertebra

  • Vertebral body
  • Small, circular spinal canal
  • Spinous process long & slope
  • Demi facets for articulation with ribs
  • Transverse process -costal facets
• Thorax

  • Limited mobility in the upper thorax - ribs 1-7 are attached directly to both sternum & spine
  • The joints involved are: Costovertebral, Costotransverse, Sternocostal, Costochondral, Interchondral – ribs 6-10
• Intervertebral Disc

  • Annulus Fibrosis: Concentric lamellae, Oblique fibres, run opposite directions
  • Nucleus Pulposus: Soft hydrophilic substance in the centre of the disc
  • End Plate: Protection for the vertebral body, Confines the annulus fibrosis and nucleus pulposus, Facilitates fluid exchange
• Ligaments

  • Anterior longitudinal
  • Posterior longitudinal
  • Ligamentum flavum
  • Ligamentum nuchae
  • Interspinous
  • Supraspinous
  • Intertransverse
• Muscles Around Cervical Spine- Posterior Aspect

  • Trapezius: Upper, Middle, Lower
  • Rhomboids
  • Levator Scapulae
  • Erector Spinae
  • Splenius capitis
  • Splenius cervicis
  • Semispinalis capitis
  • Mulifidus
• Muscles Around Cervical Spine- Anterior Aspect

  • Sternocleidomastoid
  • Scalenes: Anterior, Middle, Posterior
  • Pectoralis major
  • Pectoralis minor
  • Intercostals
  • Longus coli
  • Sternohyoid
  • Sternothyroid
  • Omohyoid