Cervical Spine Dysfunction. CRANIOFACIAL PAIN OF CERVICAL ORIGIN Recognize craniofacial pain of cervical origin Understand basic anatomy and physiology of the upper cervical spine Overview of craniovertebral testing and treatment. Occipital/supraorbital syndrome (C1).
OA unilateral lesion, unilateral pain, retroorbital nausea
Unilateral Pain from posterior rami C2, sharp shooting attacks of pain, pain at posterior neck to vertex, pain at retromastoid region
Otic Syndrome- Ventral Rami C2-lesser occipital nerve and greater auricular nerve
Pain, buzzing, vertigo symptoms related to ears without ear pathology
Auriculomandibular Neuralgia - C3 greater auricular nerve
Pain corresponds to C3, occipital headache, pain radiating to auricular lobe and angle of mandible, generally unilateral
Facet Joint Referred Pain Patterns greater auricular nerve
C2 - C3 and C3 - C4 refer pain into head
The cervical spine connection greater auricular nerve
Trigeminal system and C1-C3 nerves along with CN VII, IX,X
Pain fibers descending from the brain stem converge in the posterior horn of the upper cervical spine. This convergence gives an anatomical basis for pain referral from the neck to the head.
A Single Combined Nucleus-Trigeminocervical Nucleus greater auricular nerve
“terminals of the trigeminal nerve and the upper three cervical nerves ramify in a continuous column of grey matter formed by the par caudalis of the spinal nucleus of the trigeminal nerve and dorsal horns of the upper three cervical segments”
Transmits PAIN greater auricular nerve
Nociceptive information from cervical spine tissues is transmitted to the trigeminocervical nucleus, which in turn gives the patient the perception of symptoms in the head, face and jaw area.
spinous process C2