02 Cervical Pathology Flashcards Preview

7212 Pathophysiology > 02 Cervical Pathology > Flashcards

Flashcards in 02 Cervical Pathology Deck (48):
1

common cervical pathologies

- cervical sprain/strain
- cervical spondylosis
- cervical OA
- cervical spine instability
- facet joint syndrome
- disc herniation
- spinal stenosis

2

Ligaments provide _____. Tendons and muscle provide ________.

- stability
- mobility

3

cervical strain/sprain

- may occur after trauma (i.e. MVA)
- may involve hyperextension and/or hyperflexion injury

4

cervical strain/sprain is generally accompanied and characterized by

- loss of movement
- characterized by pain with/without complaints of headache (limited AROM, ttp over muscles)

5

What category of trx does sprain/strain fall under?

- pain control
- gentle AROM, modalities, etc

6

Would you get insidious onset of cervical strain/sprain?

no - trauma

7

In addition to cervical vertebrae, which others are commonly associated with cervical pathology?

T1-T3

8

MVA often involves

- SCM
- scalenes
- upper traps
- levator scapulae
- suboccipitals
- T-spine

9

Which type of cervical pathology is accompanied by loss of movement and characterized by pain with or without complaints of HA, TTP, and dec. ROM

Cervical Sprain/strain

10

Which type of Cervical pathology is age-related, arises from general wear and tear, and is a degenerative condition that may eventually lead to OA of the C-spine

cervical spondylosis

11

Cervical spondylosis implies a loss of

- mechanical integrity of the IV disc
- may lead to instability and/or nerve root/cord compression

12

Signs and symptoms of cervical spondylosis

- pain
- restriction of motion
- possible radicular symptoms in later stages

*joints become hypomobile and muscles become tight

13

Cervical spondylosis is the precursor to

OA

14

treatment for cervical spondylosis

hypomobile: stretch and mobilizations

15

S/S cervical spondylosis

- pain
- restriction of motion
- possible radicular s/s in later stages

joints become hypomobile - use mobs

16

How does spondylosis happen?

- lose water content in the discs
- with drying out, you disc decreases in height
- develop osteophytes

17

cervical OA

- later stage of spondylosis
- progressive degeneration of the disc and facet joints

18

OA changes

- osteophyte formation
- decreased IV disc space
- hypertrophy of ligamentum flavum
- facet joint degeneration

19

What can osteophytes do in the spine?

encroach on IVF, spinal cord, or vertebral artery

20

symptoms of cervical OA

- vary widely
- commonly aggravated by motion (almost always due to some hypomobility)

21

DDD

degenerative disc disease = wear and tear on the disc

22

DJD

degenerative joint disease = wear and tear on the facet joints (i.e. osteophytes)

23

c-spine instability
true bony/ligamentous instability

transverse or alar ligament

24

c-spine instability
muscular instability

- most common
- muscular weakness, lack of endurance

25

c-spine instability
how does it happen?

- poss. 2˚ to trauma, surgery, systemic disease, or tumors
- most common 2˚ to degenerative changes
- poor motor control a major component

26

name the facet joint disorders

- acute synovitis/hemarthrosis
- stiffness
- capsular entrapment
- degenerative arthrosis

27

facet joint disorders
acute synovitis/hemarthrosis

acute strain to the facet joint may result in effusion and sometimes bleeding into the joint

28

facet joint disorders
stiffness

- can occur after an acute injury
- results from collagen cross binding or laying down of fibrous adhesions following an acute injury

29

Which facet joint disorders are grouped together and why?

acute synovitis/hemarthrosis
stiffness

traumatic

30

facet joint disorders
capsular entrapment

- acute ONE SIDED neck pain that stops the pt from holding their spine erect
-generally from sudden, awkward movement
- sleeping wrong, crick in the neck

31

facet joint disorders
degenerative arthrosis

- wear and tear on the facet joint
- generally stiff and painful, esp in the early mornings

32

IVD
layers

- annular: outermost layer - tough, fibrous
- nucleus pulposus: innermost area

33

nucleus pulposus is made of

protein water complex

34

transition zone

- area between the outermost and innermost areas
- acts as a buffer between the annulus and the nucleus

35

clinical relevance of MRI

- not necessarily relevant because the majority of people have disc abnormalities
- could need if you're getting hard neuro symptoms on clinical exam (myotomal weakness, hypomobility, interference with ADLs, etc.)
- use if it would change trx or if conservative trx are not helping

36

functions of IVD

- provides spacing for the segment to allow the nerve root to pass through the foramen without being compromised
- permits, guides, and restrains motion in all direction

37

disc herniation

non-specific term including
- protrusion
- extrusion
- sequestration

38

disc herniation
protrusion

- intact annular wall
- most common

39

disc herniation
extrusion

- annular wall has been breached
- intra-discal mass protrudes through, but remains in contact with disc

40

disc herniation
sequestration

- annular wall has been breached
- intra-discal mass has separated from disc
- most severe

41

most common space for herniation

two most inferior - true of cervical and lumbar
- C5/6 and C6/7

42

protrusion and nerve involvement

- doesn't necessarily press on a nerve
- if it does, you get nerve compression and unilateral radicular symptoms

43

disc herniation
most common direction

posterior or postero-lateral

44

disc herniation
symptoms

- may be referred or radicular in nature
- commonly display ROM limitations

45

What are the symptoms of anterior herniations?

- only neck pain
- no radicular symptoms b/c not compressing a nerve root

46

stenosis

narrowing

47

spinal stenosis

- generally occurs 2˚ to degeneration or trauma
- may be central or lateral
- due to disc herniation, osteophytes, or hypertrophy of the lamina or facet joints

48

central spinal stenosis

char. by less than 13 mm sagittal diameter of the spinal canal