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Bones and Bony Anatomy of the Neck and Cervical Spine

The first seven verterbrae of the vertebral column are known as the Cervical Verterbrae. These verterbrae are the most moblie out of the segements of the verterbral column, causing them to also be the least stable. 

 

The first and second vertebrae of the cervical spine are referred to as the Atlas and the Axis respectively. Their main purpose is to support the head on the spinal cord and initiate cervical rotation. 

 

The cervical vertabrae are smaller than the vertebrae of the throracic or lumbar segements. They are characterized by enlongated spinous processes, smaller bodies and the presence of the transverse foramen for passage of the cervical nerves and blood vessels.

 

Between each of the cervical vertebrae is a cervical disc. The cervical discs act as shock absorbers and aid in mobility of the neck. Like the other spinal discs, they are made up of a tough exterior (annulus fibrosus) and a soft, jelly interior (nucleus pulposus). 

Bony Landmarks of the Cervical Vertebra (C3-C7)

 

 

 

 

 

  • Body

  • Transverse Process (2)

  • Pedicle (2)

  • Superior articular process (Facet) (2)

  • Inferior articular process (Facet) (2)

  • Lamina (2)

  • Lamina groove (2)

  • Vertebral Foramen

  • Spinous Process

  • Transverse Foramen (Foramen Transversarium) (2)

 

 

Bony Landmarks of the Cervical Vertebra (C1-C2)

Atlas (C1)

 

  • Body

  • Transverse Process (2)

  • Pedicle (2)

  • Superior Articular Process (Facet) (2)

  • Inferior Articular Process (Facet) (2)

  • Posterior Tubercle

  • Vertebral Foramen

  • Transverse Foramen (Foramen Transversarium) (2)

  • Lamina

  • Groove for vertebral artery

  • Articular facet for odontoid process

 

Axis (C2)

 

  • Body

  • Transverse Process (2)

  • Odontoid process (Dens)

  • Superior articular process (Facet) (2)

  • Inferior articular process (Facet) (2)

  • Lamina (2)

  • Vertebral Foramen

  • Spinous Process

  • Transverse Foramen (Foramen Transversarium) (2)

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Hyoid Bone- The Lingual Bone

The hyoid bone is an important bone in vocalization. The primary fuction of the hyoid bone is to anchor the tounge and serve as an attachment for the suprahyoid and infrahyoid muscles. It is the only bone in the human body invovled in linguistics. It is attached to the trachea via the thyroid cartilage (Adam's apple) and the cricoid cartilage (the larger ring of the trachea above the thyroid gland). The main bony landmark of the hyoid are:

 

  • Greater horns (2)

  • Lesser horns (2)

  • Body

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Cervical Fracture (Broken Neck)

  • A fracture to one or multiple vertebrae in the cervical spine.

  • MOI: Direct trauma to the cervical neck from a high impact hit. For example, spearing in football or diving head first into shallow water.

  • S/S: Severe pain in the neck, radiating pain down body, paralysis, brusing and swelling around neck area, hesitation or apprehension to move. If injury occur above C5, damage to respiratory or circulatory systems is possible. 

  • Treatment: Immediate emergency care and immoblization are necessary for a cervical fracture. Spine boarding should be initated in the event of a suspected fracture or injury. EMS should be activated, and monitoring of vitals initiated to prevent death.

  • Diagnostic Tools: X-rays are useful in identifying possible fractures. CT or MRI scans can identify further damage to the cervical spine.

  • Participation is not advised until complete healing can occur. A physician must clear the athlete before returning to play.

 

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Cervical Disk Herniation

  • A herniated disk in the cervical spine. Herniated disks are when the jelly disk is pushed through the cracks of the exterior portion of the disk.

  • MOI: Gradual wearing of the disk, or disk degeneration. As they age, they lose flexibility and can rupture with small movements such as lifting heavy objects with your back instead of your knees.

  • S/S: Arm or leg pain, numbness or tingling, and weakness in the muscles. Some herniated disks may cause pain, while others pass unnoticed.

  • Treatment: Medication to manage pain if surgery is not an option. Exercise can also help with management. Therapy using heat and ice, traction, ultrasound, IFC, and a brace is often the course taken. Surgery should only be used if pain increases or becomes chronic.

  • Diagnostic Tools: CT scans, MRIs and a Myelogram that uses special dye to show pressure on the spinal cord or nerves on an x-ray. Regular x-rays can also be used to rule out bone damage. Nerve tests may also be done to assess the spinal cord.

  • Effect on Athletic Performance: May participate if they can handle the pain. A doctor should assess first and monitor if pain appears or increases.

 

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Facet Syndrome

  • The articulation between the vertebrae in the spine are inflamed or stiff.

  • MOI: A result of arthritis or secondary injury to the spine. Repetitive stress and osteoarthritic change to the facet join can lead to fact hypertrophy.

  • S/S: Pain, stiffness, headaches, difficulty with ROM of the neck and low back pain.

  • Treatment: Physical therapy. Exercise, modalities and pain relief are the main goals in treating a patient in therapy. Bed rest for more than 2 days is not advise as it can lead to more problems.

  • Diagnostic Tools: X-rays and CT scan. MRIs are not quite as useful, but they can be used to rule out other conditions.

  • Effect on Athletic Performance: People with facet syndrome should remain active in moderate exercise. If it is cause from an injury, a doctor should be seen to assess the severity.

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Information retrieved from:

Biel, A, (2012). Trail Guide to the Body. A.B. Boulder, CO: Books of Discovery 

Krali, J. (2013). Head Injury Notebook. Retrieved November 14th, 2014.

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