02 Cervical Spine Flashcards Preview

7232 Ortho > 02 Cervical Spine > Flashcards

Flashcards in 02 Cervical Spine Deck (61):
1

What is one of the most important components of spine pain and treatment?

posture

2

What does forward head posture do to the spine?

- increases cervical lordosis
- increases thoracic kyphosis
- decreases lumbar lordosis

3

Which muscles of the cervical often refer pain and produce headaches?

suboccipital muscles

4

Which muscles shorten in forward head posture?

- suboccipital
- pecs

5

Why should you always ask about sleeping position in a patient with cervical spine issues?

too many pillows can make the neck jut forward

6

insidious onset

unknown reason

7

torticollis

contraction of the SCM, seen frequently in babies

8

benefits of using a plumb line

gives better reference than eyes alone

- side to side comparison (shoulder height, head tilting to one side or the other...)
- front to back comparison

9

2 purposes for anterior bony palpations

1. good bony landmarks to know what level you're on
2. get used to touching people's necks

10

The hyoid bone is on what level?

C3 spinous process

11

The thyroid cartilage is on the level of which cervical vertebrae?

C4-C5

12

The first cricoid ring is on the level of what?

C6

13

carotid tubercle

- one on each side
- bony prominence on anterior part of C6 transverse process

14

Why is the carotid tubercle a landmark?

location of C5-6 surgical fusion

15

articular pillar

facet joints

16

pain in palpating facet joints is common in what group of people?

OA or DJD
- tight facet joints

17

Which soft tissue structures do we need to palpate?

ANTERIOR
- SCM

POSTERIOR
- Upper traps
- Middle traps
- Rhomboids
- Suboccipitals

18

reason SCM needs to be palpated

common in MVA (whiplash)

19

goniometry
movements in the sagittal plane

- flexion
- extension

20

goniometry
movements in the frontal plane

lateral flexion

21

goniometry
movements in the transverse plane

rotation

22

goniometry norms
flexion

0-50˚

23

goniometry norms
extension

0-60˚

24

goniometry norms
lateral flexion

0-45˚

25

goniometry norms
rotation

0-80˚

26

3 MMT for cervical spine

1. combined neck extension
2. combined neck flexion
3. combined neck rotation

27

capital =

upper cervical spine

28

What is involved in the upper quarter neurological screen? (4 parts)

1. myotomes
2. dermatomes
3. deep tendon reflexes
4. upper motor neuron screen

29

testing myotomes

- quick strength screen for motor part of the nerve
- follow up with formal MMT if you suspect deficit

30

testing dermatomes

- quick screen for sensory part of the nerve
- bilateral comparison

31

reflexes in radiculopathy vs. myelopathy

- radiculopathy: hyporeflexive
- myelopathy: hyperreflexive

32

symptoms of myelopathy

hoarseness
vertigo
deafness
gait deviations

UPPER

33

upper motor neuron involvement or no?

1. radiculopathy
2. myelopathy

1. NO
2. YES

34

upper motor neurons =

CNS: brain and spinal cord

35

lower motor neurons =

PNS: everything else

36

myotome testing: C1/2

neck flexion

37

myotome testing: C3

neck lateral flexion

38

myotome testing: C4

shoulder elevation

39

myotome testing: C5

shoulder abduction

40

myotome testing: C6

elbow flexion and wrist extension

41

myotome testing: C7

elbow extension and wrist flexion

42

myotome testing: C8

thumb extension

43

myotome testing: T1

hand intrinsics

44

When should you do a neurological exam?

- ALWAYS when there are any distal symptoms from the neck
- get in the habit of doing it on ALL neck patients

45

Why these specific points for dermatome testing?

they're the most sensitive points in the larger dermatome area

46

dermatome testing: C1

top of head

47

dermatome testing: C2

side of head

48

dermatome testing: C3-4

lateral head and top of shoulder

49

dermatome testing: C5

lateral shoulder and arm

50

dermatome testing: C6

- THUMB
- lateral forearm
- index finger

51

dermatome testing: C7

- MIDDLE finger
- ring finger

52

dermatome testing: C8

- LITTLE finger
- ring finger

53

dermatome testing: T1/2

medial forearm and arm

54

deep tendon reflex scale

0 = absent
1 = diminished
2 = normal
3 = exaggerated
4 = clonus (very brisk)

55

deep tendon reflexes: C5

biceps

56

deep tendon reflexes: C6

brachioradialis

57

deep tendon reflexes: C7

triceps

58

What are the upper motor neuron tests?

1. Hoffman sign
2. Babinski
3. Clonus

59

Hoffman sign

- flick distal phalanx of the middle finger
+ sign if thumb flexes in response

60

Babinski sign

- stroke lateral sole of foot firmly proximally to distal
+ sign if great toe extends and other toes splay

61

Clonus sign

- with patient relaxed, quickly dorsiflex the ankle to end range
+ sign if ankle beats repeatedly toward plantar flexion