anatomy of lumbar spine, biomechanics of lumbar spine, movements at lumbar region, muscles of lumbar region, lumbar vertebra, kinetics and kinematics of lumbar spine
Functional Anatomy of the Spine for Anesthesiaperezjohnangelo
A discussion I prepared on the anatomy of the spine for my anesthesia rotation during clerkship. It looks at the spine from an anesthesiologist's perspective and how it relates to spinal and epidural anesthesia.
this slideshow describes about the hip joint anatomy, biomechanics and its pathomechanics along with angles of hip joint. the slide show also briefs about the pelvic femoral rhythm in daily activities
this is a slide show which gives in brief about anatomy and detailed description about biomechanics as well as pathomechanics of shoulder joint. various rhythms of shoulder complex are discussed as well along with the stability factors
Thoracic and rib cage anatomy, biomechanics, and pathomechanicsRadhika Chintamani
This slide show describes about thoracic and rib cage in detail with its anatomy, kinetics and kinematics along with force couple. the slideshow also describes about the pathology and pathomechanics related to the topic
anatomy of lumbar spine, biomechanics of lumbar spine, movements at lumbar region, muscles of lumbar region, lumbar vertebra, kinetics and kinematics of lumbar spine
Functional Anatomy of the Spine for Anesthesiaperezjohnangelo
A discussion I prepared on the anatomy of the spine for my anesthesia rotation during clerkship. It looks at the spine from an anesthesiologist's perspective and how it relates to spinal and epidural anesthesia.
this slideshow describes about the hip joint anatomy, biomechanics and its pathomechanics along with angles of hip joint. the slide show also briefs about the pelvic femoral rhythm in daily activities
this is a slide show which gives in brief about anatomy and detailed description about biomechanics as well as pathomechanics of shoulder joint. various rhythms of shoulder complex are discussed as well along with the stability factors
Thoracic and rib cage anatomy, biomechanics, and pathomechanicsRadhika Chintamani
This slide show describes about thoracic and rib cage in detail with its anatomy, kinetics and kinematics along with force couple. the slideshow also describes about the pathology and pathomechanics related to the topic
Conference of the Tense Active Motor Control in the Shoulder. XIVth Federation of European Societies for Surgery of the Hand, FESSH Congress 3rd to 6th of June 2009 Poznan, Poland. The author explain how the connective system is determinant to control the motions in the shoulder, an special joint deeply dependent of the tissue deformation of the connective and sof tissues to build the adequate movements. Are the connective tissues a passive sub system? Dr. López proposed a new vision how understand the role of Fascias, ligaments, Capsules and other connective tissues during the movements and posture.
Also visit: http://www.ineuro.be/Welcome.html - A must have for every osteopath and health care provider. Simple to use and no unnecessary information. It keeps your knowledge sharp for daily patient care!
Also look for iBooks in the iBook store from Luc Peeters and Grégoire Lason.
Cervical Arthritis, Cervical Spondylotic Myelopathy by Pablo Pazmino MDPablo Pazmino
This video explains Cervical Stenosis and Cervical Spondylosis/Arthritis. When stenosis begins to affect the spinal cord this is called Cervical Spondylotic Myelopathy. This video highlights the history, epidemiology, and treatment options both conservative and surgical. If you or someone you know needs to be seen in regards to Cervical Stenosis/Arthritis feel free to look us up online www.beverlyspine.com or www.santamonicaspine.com OR call toll free 1-8SPINECAL-1
This video explains Cervical Stenosis and Cervical Spondylosis/Arthritis. When stenosis begins to affect the spinal cord this is called Cervical Spondylotic Myelopathy. This video highlights the history, epidemiology, and treatment options both conservative and surgical. If you or someone you know needs to be seen in regards to Cervical Stenosis/Arthritis feel free to look us up online www.beverlyspine.com or www.santamonicaspine.com OR call toll free 1-8SPINECAL-1
Locomotion which means gait is controlled by various systems. Janda described these systems in three different linkages; articular, muscular and neural. The slide show also, describes in the same the locomotion control as described by Janda in brief.
Lubar Arthritis : Lumbar Stenosis by Pablo Pazmino, MDPablo Pazmino
This video explains Lumbar Stenosis. When arthritis begins to encroach around the spinal cord and neural elements this is called Lumbar Stenosis. This video highlights the history, epidemiology, and treatment options both conservative and surgical. If you or someone you know needs to be seen in regards to Lumbar Stenosis/Arthritis feel free to look us up online www.beverlyspine.com or www.santamonicaspine.com OR call toll free 1-8SPINECAL-1
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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38. What is the coupled physiological effect of the cervical spine with left lateral flexion? (Hint: think facet, VB, Disc, SP)
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Editor's Notes
The occipital bone , a bone situated at the back and lower part of the cranium , is trapezoid in shape and curved on itself. It is pierced by a large oval aperture, the foramen magnum , through which the cranial cavity communicates with the vertebral canal .
Localization of the occipital nerve. The nerve is positioned medial to the pulse of the occipital artery; approximately one third of the distance from the occipital protuberance to the mastoid, whereas the lesser occipital nerve is more lateral, approximately two thirds of this distance. The greater occipital nerve arises from the posterior primary ramus of the second cervical nerve root deep (Figure 18–8). It travels deep to the cervical paraspinousmusculature and to the cervical paraspinousmusculature and becomes superficial just inferior to the superior nuchal line and lateral to the occipital protuberance of the skull; at this point, the nerve is just lateral to the occipital artery. The lesser occipital nerve and greater auricular nerve are terminal branches of the superficial cervical plexus. Both arise from the posterior primary ramus of the second and third cervical nerve roots, travel through the cervical paraspinousmusculature, and become superficial over the inferior nuchal line of the skull, just superior and medial to the mastoid and just inferior to the tragus of the ear, respectively. The lateral section of the posterior scalp is supplied by the lesser occipital and great auricular nerves
Cutaneous innervation of the head and neck. The trigeminal nerve, the fifth cranial nerve, supplies the majority of sensory innervation to the face (Figure 18–1). Preganglionic fibers exit the brainstem and travel anteriorly to synapse with second-order neurons within the trigeminal (gasserian) ganglion (Figure 18–2). The ganglion lies within the cranial vault at the base of the petrous portion of the temporal bone in a dural invagination containing cerebrospinal fluid known as Meckel’s cave. Postganglionic fibers exit the ganglion to form the ophthalmic (V1), maxillary (V2), and (V3) nerves
The most common early presenting symptom is occipital pain referred to the vertex of the head and ipsilateral shoulder and arm pain, exacerbated by head movement. Presence of neurological signs are associated with lesions of the 9th, 10th, 11th, and 12th cranial nerves. Horner's syndrome is seen because of the proximity of the cervical sympathetic chain to the jugular foramen. Pain Type : Neuropathic Cause : Invasion of Bone By Tumor or Metastasis Effects : Neurological Signs Clinical Signs: Occipital Pain Referred to the Vertex of the head and Ipsilateral Shoulder and Arm Pain, Exacerbated by Head Movement, Horner's Syndrome , ( ptosis , miosis , anhidrosis )
Trauma to the scalp fascia or the occipitalis at the back of the skull can transmit pain through the head and into the eye. Trauma may include a blow to the back of the head, strain from a tight ponytail or bun, or the weight of long, heavy hair. In one case I know of, a man struck the top of his head on the corner of a cabinet. Result: a slight puncture wound in the scalp, a brutal pain in the eye . Frontalis helps open the eyes, raises the eyebrows, and wrinkles the forehead into "worry lines."It is commonly used by biofeedback practitioners to monitor muscle tension. Trauma to frontalis (whether a blow to the forehead or habitual frowning) can cause severe frontal headache often diagnosed as "migraine." Frontalis is one of the muscles that definitively proved the muscle-migraine connection. Botox injections paralyzed the frontalis, eliminating "worry lines" but they also had the surprising side effect of halting chronic "migraines". Or maybe not so surprising, as frontalis entraps the supraorbital nerve. The related corrugator supercilii (at the top of the nose between the eyebrows) compresses branches of the supraorbital nerve along with the supratrochlear nerve and branches of the supraorbital nerve. Your frown may be giving you a migraine!
(headpain and occipital neuralgia) Injured in whiplash and involved in "tension" and "cervicogenic" headache. Semispinalis capitis is commonly injured in auto accidents. You can injure it more slowly but just as effectively with a chronic head-forward position. When tight semispinalis entraps the greater occipital nerve which in turn causes numbness, tingling and/or burning pain extending over the back of the head to the top (vertex) of the head. It may be difficult to touch chin to chest, and sufferers may be unable to lay back of head on pillow. Relieve nerve pain with cold. Relieve muscle pain with moist heat. In either case, look for the origin of the pain which is rarely the spot where it hurts. Semispinalis Cervicis (even more head pain). Typically produces a vague band of pain from occiput along side of head to just behind orbit (similar to suboccipital pain pattern).
The four pairs of suboccipital muscles cause deep aching pain running in a band from the back of the head to the orbit of the eye, possibly with balance problems and dizziness. One of these (the rectus capitis superior minor) attaches directly to the dura mater of the spinal cord. When traumatized it can produce odd visual and neurological symptoms to the point of seizures. Pain in the angle of the neck and along the vertebral border of the scapula may be so severe that patient cannot move the neck at all. Suboccipitals are often strained in persons who wear bifocals, children who watch TV lying with chin propped on hands, and anyone who holds the head in position with chin up and neck flexed backward.
Small muscles below the occiput set off referred pain. One-sided headaches, which radiate from the occiput to the eye and forehead, can often be traced back to spasmodic contraction of one or more of four small (suboccipital) muscle pairs. These four small cervical vertebrae muscles are located at the deepest point inside the neck. They contain so-called trigger points which when activated by local spasmodic muscle contraction - usually in combination with the neck muscles located directly over them - set off the above-mentioned referred pain. The person experiencing the pain finds it difficult to define. Often it is termed a "ghost headache". These four small cervical vertebrae muscles are especially important to the movement of the two upper cervical vertebrae joints. The muscles execute a bending-stretching movement in the uppermost joint (between the atlas and head) as well as lateral tilting of the head to the left and right (10-degree bending and 25-degree stretching). The joint between the atlas and axis allows a 45-degree rotation to the left and right.
The cervical spine has the precarious task of maintaining head posture while allowing for a great deal of mobility The c/s must balance the weight of the head atop a relatively thin and long lever, making it quite vulnerable to traumatic forces Vulnerability due to high level of mobility produced by its triplanar motion, this mobility provides those in manual therapy with a tremendous opportunity to correct postural and articular faults in the neck Corrective care that centers around early movements and aggressive restoration of joint mobility is the hallmark of treatment for mechanical disorders of the cervical spine The cervical facets allow movement in all directions, the c/s is therefore the most vulnerable portion of the vertebral column
Typical cervical vertebrae posses same structural parts as all the other true vertebra, plus some distinct and unique physical features: SP’s are bifid which allow for better attachment of the ligaments and muscles , foramen transversarium, broad VB that are small, oval and wide transversely, superior margin of the VB is lipped for the uncinate processes, *** joints of Luschka are pseudojoints that have a synovial membrane but no joint capsule which serve as tracts that glide the motion of lateral flexion and coupled rotation, Sup and Inf articulating process and each transverse process from C6 upward has a foramen for the vertebral artery. ***Articular Facets are teardropped shape with Superior facing up and posteriorly and inferior facing down and anteriorly, placing the joint space at 45 degrees angle midway b/w coronal and transverse planes ***The disc-height to body height ratio is greatest 2:5 in the c/s therefore allowing the greatest possible ROM Atypical – C1 no VB and spinous process, C2 has a dens or odontoid process and C7 prominent SP, not bifid and vertebral artery does not enter the foramen transversarium at this point
Typical vertebrae – bifid spinous process, foramen transversarium, broad VB, Sup and Inf articulating process and a foramen for the vertebral artery
Intricate anatomic configurations of nerves, vessels, joint structures , ligamentous network tat provides vital support to mobile osseous structures The cervical spine forms a lordotic curve that develeps to secondary to the response of upright posture, the functions of the cervical curve and the A-P curves throughout the spine are to add resiliency to the spine in response to axial compression forces and to balance the center of gravity of the skull over the spine, the COG for the skull lies anterior to the FM Cervical lordosis is a convex curve anteriorly and is known as a compensatory or secondary curvature
Flexion, extension, lateral bending and rotation Rotation pivotal role in degenerative process of the disk and it is the disk were cervical dysfunction and pain are prevalent
OA C0-C1 provides extensive motion flexion/extension AA C1-C2 functions as a pivot point for PA rotation
Middle region of the cervical vertebrae
Primary Source Pg. 195 Fig 5-48, 5-49
Bergman and Peterson pg 194-5 lateral flxn and rotation fig.5-48, 5-49
