Cervical Spine

• The cervical spine is the most superior portion

of the vertebral column, lying between the
cranium and the thoracic vertebrae.
• primary function:
mobility, support, and protection of spinal
canal and neural structures.
• Vertebrae (7)
• Intervertebral discs (6)
• Pairs of exiting nerve roots (8)

• Cervical lordosis OCC- C7 averages 40°

most of the lordosis occurs at the C1-C2
segment.
• Approximately 50% of flexion extension
motion occurs at occiput-C1.
• Approximately 50% of rotation occurs at C1-
C2.
• Lesser amount of flexion-extension, rotation
and bending occurs segmentally between C2-
C7.
 Characteristic Features

• The cervical vertebrae have three main

features which distinguish them from other
vertebrae:
• Triangular vertebral foramen.
• Bifid spinous process – this is where the
spinous process splits into two distally.
• Transverse foramina – holes in the transverse
processes. They give passage to the vertebral
artery, vein and sympathetic nerves
 Occiput-C1 segment
• The occiput-C1 joints are synovial joints
comprising the convex occiput condyles,
which articulate with the concave lateral
masses of C1.
• flexion extension motion occurs at occiput-C1.
• Due to bony structures, ligamentous
constraints, and absence of IV disc.
 Atlanto axial joint
• The odontoid process of the
• axis(C2) extends cranially to
• form the axis of rotation with
atlas(C1).
• The primary motion at C1-C2
joint is rotation.
 C7 joint
• The vertebra prominens, or C7, has a
distinctive long and prominent spinous process,
which is palpable from the skin surface.
• The long spinous process of C7 is thick and
nearly horizontal in direction. It is not
bifurcated.
 Ligaments
• The cervical spine also features a complex
arrangement of ligaments to supplements its
structures and mobility.
• Anterior longitudinal ligament
• is closely attached to the vertebral bodies, but
not to the discs.
 Posterior longitudinal ligament
• the posterior longitudinal ligament is firmly
attached to the disc and is wider in the upper
cervical spine than in the lower.
 ligamentum flavum
• The lateral and posterior bony elements are
connected by the ligamentum flavum.
intertransverse ligaments
interspinous ligaments
supraspinous ligament
The cervical spinal flexor muscles include rectus capitus
anterior, rectus capitis lateralis, longus capitis, longus colli,
and eight pairs of hyoid muscles
The cervical spinal extensor muscles include splenius capitis
and splenius cervicis, assisted by rectus capitis posterior major
and minor, and obliquus capitis superior and inferior.
The cervical lateral flexor muscles include sternocleidomastoid,
levator scapulae, and scalenus anterior, posterior, & medius.
When developing tension unilaterally, the cervical flexors and
extensors also contribute.
 Neural elements
• 8 pair of cervical nerves.
• Exit the spinal canal supeerior to the
vertebrae for which they are numbered
C1 nerves exit the canal between OCC &
C1.
• C2 nerves exit the canal between C1 & C2.
• C8 nerves exit the canal between C7 & T1.
 Arteries:
• Carotid arteries:
located anterior and
bilateral to the spine.
• Vertebral arteries:
Enter the transverse
foramen at C6 and continue
through C1.
 VEINS:
• Jugular vein:
located bilateral and
anterior to spine.
• Vertebral veins:
located within transverse
foramen of C1-C7.