1. Cervico-brachial neuralgia Anatomy Iraj Salehi-Abari MD
Cervico-brachial neuralgia Anatomy Iraj Salehi-Abari MD., Internist Rheumatologist

2. Introduction: Neck pain: Common Common causes:
Cervical spondylosis (OA)
Disc herniation
Cervical disc-arthrosis  Cervical radiculopathy
Today, Cervical radiculopathy is a common source of arm pain + sensory and motor dysfunction
Diameter of cervical canal is a little more than cervical cord: Myelopathy is common

3. Anatomy of Cervical spine:
Seven Vertebral bodies:
C1 to C7

4. Anatomy of Cervical spine:
C1 or Atlas:
Circular ring of bone

5. Anatomy of Cervical spine:
C2 or Axis:
Odontoid process

6. Anatomy of Cervical spine:
C1 – C2:
No intervertebral disc
Odontoid-Ring articulation

7. Anatomy of Cervical spine:
C3 – C7 are joined by:
Zygapophysial (Facet) joints
Uncovertebral (Luschka) joints
Intervertebral discs

9. Anatomy of Cervical spine:
Upper cervical spine:
Rotation of head
Lower cervical spine:
Flexion & Extension of head

10. Anatomy of Cervical spine:
Disc-arthrosis: common in C3 – C7
Intervertebral foramina:
Anteromedial:
Lower Uncinate processes
Superior: upper Pedicles
Posterior: Facet joint
Inferior: lower Pedicles
Dorsal (sensory) and ventral (motor) roots fuse to form the spinal nerve in the intervertebral foramen

11. Anatomy of Cervical spine:
Spinal nerve separates into ventral and dorsal rami
Dorsal rami divide into lateral (motor) and medial (sensory) branches that supply the muscles and skin of the back of the neck
Dorsal ramus of C1 innervates the deep muscles of the neck, it isn’t sensory
Dorsal ramus of C2  greater occipital nerve

13. Anatomy of Cervical spine:
Ventral rami of C1 – C4 n.  Cervical plexus
Ventral rami of C5 – T1 n.  Brachial plexus
Ventral C5 r.  Dorsal scapular n.:
Rhomboids muscle
Levator scapulae muscle
C5, C6, C7 ventral r.  Long thoracic n.:
Serratus anterior muscle

14. Anatomy of Cervical spine:
The cervical nerve roots exit through the intervertebral foramen above the corresponding vertebral body
As an example:
C7 n. root:
C6 – C7 intervertebral foramen
C8 n. root:
C7 – T1 intervertebral foramen