Neck Bones & Joints Flashcards

Terms Definitions
1) lateral flexion (clavicular plane)2) Flexion/Extension (occlusal plane)3) Rotation (sagittal plane)
what are the 3 motions of the head and neck? what planes do these motions occur in?
this motion is not a real thing, lateral flexion however, would be tilting your head to the side.
describe lateral extension of the neck
is tucking your chin flexion or extension?
what is the normal curvature of the spine?
how many cervical vertebrae are there in mammals(humans)?
just below the mandible and anterior to the spinal column is a u shaped bone, name it
hyoid bone
the main function of this bone is to suspend the cartilage of the larynx and trachea beneath it
1) small bodies(don't support much weight)2) articular facets are designed for a lot of mobility 3) bifid spinous process (for ligament) 4) foramina in transverse processes
describe the 4 special features of cervical vertebrae
atlantoocciptal joint (AO joint)
name the joint where the atlas articulates with the skull
no, no, yes
does C1 have a body? a spinous process? foramina in it's transverse processes?
instead of a body, an anterior archinstead of a spinous process, a posterior arch
what does the atlas have in place of a body or spinous process?
c2: Axisc1: Atlas (remember atlas holds up the world, which is round like your skull)
name C2, name C1
yes, yes, no
does the axis have a body? a spinous process? foramina in its transverse processes?
the dens
what special structure projects off C2 that might have been C1's body?
transverse ligament
name the ligament that straps the dens to the anterior arch of C1
occipital condyles
the skull's kidney shaped articulations with C1 are called what?
atlantooccipital joints (there are 2 one on each side)yes = pure flexion and extension
name the "yes" joints
through someone's open mouth, because they are in the back of the pharynx with no bone (except teeth) in the way)
how can you get a radiograph of C1 & C2?
atlantoaxial jointsno = rotation
name the "no joints"
3 articular surfaces1 & 2) the normal superiorr facet of the axis to the facet of the atlas3) the dens to the anterior arch of C1the joints are practically horizontal to allow rotational movement
how many articular surfaces are there in the AA joint? describe them
alar ligament
crosses C1, doesn't touch it, but holds skull, C1, C2 together. connects the dens to the medial occipital condyle thick as a pencil
the cruciate ligament
the transverse ligament is part of another ligament, name it
upper band of the cruciate ligament
this attaches the dens to the front margin of the foramen magnum
lower band of the cruciate ligament
connects the dens to a lower part of C2 (the body)
posterior longitudinal ligament
this ligament starts on the occipital bone, goes through the foramen magnum, and lies on the posterior side of the vertebral bodies, connecting them together, and faces into the vertebral canal
tectoral membrane
name the posterior longitudinal ligament superior to the foramen magnum
AO joint capsule
this fibrous structure lies around the AO joints, and is really strong to keep the joints together
vertebral arteries
these arteries pass on the lateral sides of the foramen magnum
AO membrane
this ligament goes from C1 to the skull, around the foramen magnum and both arches of the atlas to enclose the vertebral canal
AA membrane
this ligament goes all the way around the vertebral canal and holds the atlas and axis together
anterior longitudinal ligament
this holds the vertebral bodies together anteriorly and runs the whole length of the spine
the vertebral arteries
what is the hole in the AO membrane for?
1) anterior longitudinal ligament2) AO membrane3) upper band of the cruciate ligament4) posterior longitudinal ligament5) dura
if you were to stick a needle above the anterior arch of the atlas and below the foramen magnum, name the ligaments/layers you would hit until you hit dura.
atlantoaxial subluxation, causing the atlas to move excessively possibly damaging the spinal cord/brainstem via compression ->paralysis or death
what happens if the transverse ligament of the atlas is ruptured, or the dens is avulsed?
excess mobility turning the head to the OPPOSITE SIDE of the ruptured ligament (up to 30 degrees beyond normal) not as dangerous as the transverse ligament ruptureex: if the right side ligament is ruptured, the head can move too far left
what happens if there is a rupture of the alar ligament?
down's syndrome (trisomy 21) is associated with increased laxity of the craniovertebral ligament
why can't down's syndome patients play contact sports?
the nuchal ligament
what ligament only exists in the neck that attaches spinous processes of cervical vertebrae together?
infraspinous ligaments (there is one between each vertebra)
name the ligaments that connect spinous processes together below the cervical spine
supraspinous ligament (just one long ligament)
below the cervical spine, just under the skin this continuous ligament connects spinous process to spinous processes
nuchal ligament
specialized ligament in the neck for attachment of neck muscles, fills the lordosis curvature of the cervical spine out to the skin
superiorly: external occipital protuberence on the superior nuchal line(posterior to foramen magnum)inferiorly: C7 spinous process
where does the nuchal ligament attach at its beginning and end?
trapezius - CN XI, Accessory N. + some random C2-C3 possibly for proprioception
most superficial posterior neck muscle, name it and give it's innervation
primarily, moves the pectoral girdle (RED), in neck is primarily and extensorbilaterally: extends head and neckunilaterally: flexes neck toward active side
what does trapezius do?
splenius capitus & splenius cervicis
these 2 muscles lie just deep to trapezius and have perpendicularly oriented fibers
epaxial - intrinsic back muscles, innervated by dorsal rami of spinal nerves
are splenius muscles epaxial or hypaxial? what does this mean about their innervation?
o: cervical spinous processes and upper thoracic spinesi: capitus -skull, cervicis -cervical transverse processes
name the origin/insertion of the splenius muscles
capitis does head and neckcervicis is neck only
how do the actions of the splenius muscle differ?
bilateral: extension of neck(and head)unilateral: lateral flexion to SAME side of muscle activityrotation toward side of muscle activity
what are the actions of the splenius muscles
1) erector spinae2) transversus spinalis
name the intrinsic back muscle groups
transversus spinalis (intrinsic/epaxial)
what group of back muscles does semispinalis belong to?
semispinalis capitis
most powerful/important head & neck extensor
longissimus, and iliocostalis
which of the following muscle are part of the erector spinae group:longissimus capitis, iliocostalis cervicis, semispinalis capitis
iliocostalis cervicis
most lateral of the erector spinae muscle group, inserts on transverse processes of cervical vertebrae
bi: extensors o fhead and neckuni: flex toward the active side
what do semispinalis, longissimus capitis, and iliocostalis do when active bilaterally? unilaterally?
no, longissimus and semispinalis do though
does iliocostalis cervicis insert on the skull?
capitis-attaches to head, extensorcervicis- landmark musclethoracis- not important
what are the 3 groups of semispinalis?
semispinalis capitis
what muscle lies deep to the splenius muscles?
1) trapezius2) splenius3) semispinalis4) rectus posterior major/minor & oblique capitis superior/posterior
list the posterior neck muscles from superficial to deep
intrinsic back muscles(epaxial): dorsal rami1) obliquus capitis superior2) obliquus capitis inferior3) rectus posterior major4) rectus posterior minor
list the suboccipital muscles from most lateral to most medial, what is their innervation?
they are small and weak, but do fine, controlled movement (mostly extension) of the AA and AO joints-the oblique kind of turn/flex the head to side of muscle activity
what are the motions of the suboccipital muscles?
major: C2 spinous process to occipital boneminor: (deeper and more medial) posterior arch of C1 to occipital bone
give the origin and insertion of rectus posterior major and rectus posterior minor
superior: transverse process of C1 straight up to occipital boneinferior: spine of C2, to transverse process of C1 (DOESN'T attach to the skull)
give the origin and insertion of obliquus captitis superior and inferior
it is made by the suboccipital musclessuperiorly/medially: rectus posterior majorinferiorly: obliquus capitis inferiorlaterally: obliquus captis superior
describe the borders of the suboccipital triangle
c1: suboccipitalc2: greater occipital nc3: third occipital nerve
name the dorsal rami of C1, C2, and C3
suboccipital nerve
this nerve comes out right beneath the occipital bone ABOVE the posterior arch of the atlas and wraps around the vertebral arteries
C1- motor only to suboccipital musclesC2- purely sensory between C1 and C2
what kinds of innervation is provided by the dorsal rami of C1 and C2?
the suboccipital nerve (as it goes horisontal along the C1 posterior arch) and the vertebral artery
what is found in the suboccipital triangle?
beneath obliquus capitis inferior, over the posterior arch of C2 -the greater occipital n is C2 dorsal rami
where does the greater occipital nerve emerge?
used to find the suboccipital triangle
seminspinalis cervicis ends at the C2 spine, what is this used for?
what is the purpose of the communication between C1 and C2?
1) longus capitis2) scalenus anterior/medius/posterior3) rectus capitis anterior4) rectis capitis lateralis5) longus colli
name the pre-vertebral muscles (they only really come in 1 layer)
ventral rami of cervical spinal nerves (no names)
what rami innervates the pre-vertebral muscles?
longissimus capitis
originates at trasnverse processeS of cervical verterbrae and inserts on the occipital bone anterior to the spinal canal
head/neck flexion
what is the main action of the prevertebral muscles?
longus colli
this 3 part muscle lies just deep to longus capitis
superior: trasnverse processes of upper cervical vertebrae to vertebral bodies abovemiddle: lower vertebral bodies to upper vertebral bodiesinferior: vertebral bodies of lower cervical vertebrae to transverse processes above
describe the origins and insertions of the 3 groups of longus colli fibers
rectus capitis anterior (more medial and superior)rectus capitis lateralis (inferior and lateral)
name the anterior equivilents of the suboccipital muscles, that are innervated by ventral rami (instead of dorsal)
scalene muscles
muscles that can help with respiration in the anterior neck
originate on transverse processesinsert on ribes 1 & 2anterior = most anteriortriangle (brachial plexus + brachial artery)medius: rib 1 insertionposterior rib 2 insertion
name the origins and insertions of the scalene muscles
the prhenic nerve runs on the surface os scalenius anterior
what is scalenius anterior a landmark for?
it has 2 heads, 1 on the manubrium of the sternum(sterno), 1 on the clavicular head (cleido)inserts behind the ear on the mastoid process
where does the sternocliedomastoid originate? insert?
most poserful neck flexor when active bilaterally
since it pulls on the back of the skull, it turns the head to the OPPOSITE side of muscle activity
what does sternocleidomastoid do when active unilaterally?
if you are riding your bike and keeping your neck down(flexed) but tilting your head up (extending it) what muscle allows this?
this is like tilting your head and turning your chin up a littlethis is sternocleidomastoid
if you flex your neck, extend your head, and turn your head to opposite side of muscle activity, what movement do you make? what muscle does this?
what divides the anterior and posterior triangles?
dran a line from the jugular notch of the manubrium to the chin, to the mastoid process, back to the notchthe upper boder is the jaw, the lateral border is the anterior border of SCM, and the anterior/medial border is the midline/imaginary
describe the borders/corners of the anterior triangle of the neck
superior/medial border: SCMposterior/lateral border: trapeziusinferior: part of the clavicle with no muscle attachment
describe the boders/corners of the posterior triangle of the neck
1)accessory N, CN XImuscles forming the floor(superior to inferior):2) semispinalis capitis3) splenius capitis4) levator scapulae5) scalenes6) omohyoid (crosses superficial to scalenes)
what is found in the posterior triangle & the floor of it?
between longus colli, scalenius anterior, and the first rib
describe the boders of the vertebral triangle
the cupela (pleura of the lung)vertebral artery
what is found in the vertebral triangle that Cole mentioned so far?
scalenius anterior, & medius/posteriorinferiorly: first rib
describe the borders of the scalene triangle
1) brachial plexus roots2) subclavian artery
what is found in the scaline triangle?
platysma: facial n. CN VII
this muscle is paper thin and is a superifical face muscle that extends into the neck, name it and its innervation
in superficial fascia just beneath the skinpulls down corners of the mouth and tenses the skin of the neck
what is the action of the platisma? what layer is it in?
suprahyoid muscles:1) digastric (anterior and posterior)2) myelohyoid3) stylohyoidinfrahyoids:4) omohyoid5) sternothyroid 6) thyrohyoid7) sternohyoid
name the anterior neck muscles that don't attach to vertebrae
supra: innervated by cranial nervesinfra: innervated by spinal nerves
compare the innervation of suprahyoid muscles to infrahyoid muscles
aid swallowing by pulling the thyroid cartilage and hyoid together to pull the larynx down
what do the infrahyoid muscle do?
they are named for their origin and insertion (origin, then insertion)
what is special about the infrahyoid muscles naming?
omo = scapula
what does the prefix "omo" mean?
omohyoid - the sling divides it into superior and inferior hyoid muscles
which infrahyoid muscle has a sling?
sternohyoid (omo has the sling and originates on the scapula (omo) which is more lateral than the sternum
which is the more medial muscle of the superficial infrahyoid muscles, sternohyoid or omohyoid?
thyrohyoid and sternothyroid are deeper
which muscles are deeper: thyrohyoid & sternothyroid, OR omohyoid and sternohyoid?
stylohyoid is a posterior suprahyoid muscle
this muscle runs from the styloid process to the hyoid bone, name it and say if it is infra or suprahyoid
the posterior ones: stylohyoid & posterior digastric
what suprahyoid muscles are innervated by CN VII (facial n)?
the anterior ones:anterior digastric and myelohyoid
what suprahyoid muscles are innervated by CN V (trigeminal n)?
they both go through a sling
how are the digstrric and omohyoid muscles related?
1) suboccipital triangle2) anterior triangle3) posterior triangle4) scalene triangle5) vertebral triangle6) digastric triangle7) submental triangle8) muscular triangle9) carotid tirangle
list all 9 of the triangles of the neck that we talked about
the anterior and posterior digastric muscle + the mandible
describe the boundaries of the digastric triangle
superiorly: the mandible (chin)laterally: the anterior digastrics on each sideinferiorly: hyoid bone
describe the boundaries of the submental triangle
medially: posterior digastriclaterally: sternocleidomastoidinferiorly: superior belly of the omohyoid
describe the boundaries of the carotid triangle (with the carotid arteries in it)
medially: sternohyoidsuperiorly/laterally: omohyoid superiorlaterally/inferiorly: SCM
describe the boundaries of the muscular triangle
1) digastric2) submental partially3) carotid4) muscular
what triangles make up the anterior triangle?
ventral rami of C1-4 or 5 if you include the phrenic nerve
what forms the cervical plexus?
1) somatic sensory2) somatic motor3) sympathetics (to sweat glands and superficial vasculature)
what information is carried in the cervical plexus nerves?
-sensory/sympathetics to the skin of the anterior neck (jaw line to jugular notch anterior to SCM)-motor to neck muscles: infrahyoid, prevertebral (except SCM, trapezius, and the suprahyoid muscles)
what does the cervical plexus provide innervation to?
no, they are either sensory or motor
are their mixed nerves in the cervical plexus?
1)the sternohyoid muscle2) the sternothyroid muscle3) the omohyoid muscle
what is innervated by the ansa cervicalis?
what are the 2 major bundles of nerves in the cervical plexus?
entirely motor C1 + C2 + C3 ventral rami
what is the ansa cervicalis?
hypoglossal n, CN XII
this nerve comes down from the skull then makes and L that loops forward to the tongue near the ansa cervicalis
hypoglossal nerve
what nerve do the C1 fibers travel with?
descendens hypoglossi
the front half of the ansa cervicalis is ventral rami C1 fibers, also known as the:
this is a branch off of the descendens hypoglossi (C1)
what does the nerve to thyrohyoid branch off of?
most of the infrahyoid muscles are innervated by what spinal level?
the descendens cervicalis
ventral rami of C2 & 3 join together and form the back half of the ansa cervicalis also known as:
descendens cervicalis (posterior part of ansa cervicalis aka C2-C3)
innervates the inferior belly of omohyoid
lateral (towards the skin)
where is the descendens hypoglossi compared to the jugular vein?
the all come out midway down the posterior edge of the SCM and radiate out like a starburstCN XI(motor) comes out also with them
how do the cutaneous/sensory nerves (from ventral rami) come out of the cervical plexus? what nerve comes out with them?
C2 & C3
most of the cutaneous nerves of the anterior neck come from what spinal level(s)?
its dorsal root ganglion goes to supply dura in the head
does C1 have sensory innervation?
lesser occipital nerve (C2-3)
this nerve supplies sensory to the scalp just behind the external ear and travels up the back edge of SCM to the peak of the posterior triangle
Great auricular n (C2-3)
this nerve comes out from behind SCM and goes straight up to the ear lobe, supplying the overlying strip of skin
external jugular vein
what vessel does the great auricular n. travel right next to that helps to locate the nerve?
transverse cervical n. (C2-3)
this nerve supplies sensory to the skin over the anterior triangle of the neck
supraclavicular nerve
this nerve is supplied by C3-4 and supplies skin to the inferior posterior triangle and down to the shoulder and acromion, also skin just below the clavicle
the supraclavicular nerve comes up the same spinal levels as the phrenic nerve (c3-4)
why is pericarditis,visceral parietal pericadiam pain, or diaphragm pain referred to the shoulder?
it goes down and lateral, deep to trapezius
describe the path of the acessory nerve from where it enters the posterior tirangle
motor: suboccipital musclessensory: dura in posterior cranial fossa
what does the suboccipital nerve innervate?
sensory: to scalp and skin of neck
what does the greater occipital nerve innervate?
sensory to posterior scalp and skin of neck
what does the third occipital nerve innervate?
where are cervical spinal nerves in relation to the vertebrae?
C2, greater occipital n.
what nerve runs alongside the occipital artery?
1) cranial nerves (trigeminal)2) ventral part of cervical plexus (lesser occipital)3) dorsal rami of the cervical spinal nerves (greater occipital/third occipital n)
what does cutaneous innervation to the scalp?
transverse cervical n.
what innervates sensory over the anterior triangle?
greater occipital on posterior scalp, third occipital on neck
what innervates the posterior scalp and neck?
great auricular n.
what innervates skin below and posterior to the ear?
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