Flashcards in 02 Cervical Spine Deck (61):
What is one of the most important components of spine pain and treatment?
What does forward head posture do to the spine?
- increases cervical lordosis
- increases thoracic kyphosis
- decreases lumbar lordosis
Which muscles of the cervical often refer pain and produce headaches?
Which muscles shorten in forward head posture?
Why should you always ask about sleeping position in a patient with cervical spine issues?
too many pillows can make the neck jut forward
contraction of the SCM, seen frequently in babies
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
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
The hyoid bone is on what level?
C3 spinous process
The thyroid cartilage is on the level of which cervical vertebrae?
The first cricoid ring is on the level of what?
- one on each side
- bony prominence on anterior part of C6 transverse process
Why is the carotid tubercle a landmark?
location of C5-6 surgical fusion
pain in palpating facet joints is common in what group of people?
OA or DJD
- tight facet joints
Which soft tissue structures do we need to palpate?
- Upper traps
- Middle traps
reason SCM needs to be palpated
common in MVA (whiplash)
movements in the sagittal plane
movements in the frontal plane
movements in the transverse plane
3 MMT for cervical spine
1. combined neck extension
2. combined neck flexion
3. combined neck rotation
upper cervical spine
What is involved in the upper quarter neurological screen? (4 parts)
3. deep tendon reflexes
4. upper motor neuron screen
- quick strength screen for motor part of the nerve
- follow up with formal MMT if you suspect deficit
- quick screen for sensory part of the nerve
- bilateral comparison
reflexes in radiculopathy vs. myelopathy
- radiculopathy: hyporeflexive
- myelopathy: hyperreflexive
symptoms of myelopathy
upper motor neuron involvement or no?
upper motor neurons =
CNS: brain and spinal cord
lower motor neurons =
PNS: everything else
myotome testing: C1/2
myotome testing: C3
neck lateral flexion
myotome testing: C4
myotome testing: C5
myotome testing: C6
elbow flexion and wrist extension
myotome testing: C7
elbow extension and wrist flexion
myotome testing: C8
myotome testing: T1
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
Why these specific points for dermatome testing?
they're the most sensitive points in the larger dermatome area
dermatome testing: C1
top of head
dermatome testing: C2
side of head
dermatome testing: C3-4
lateral head and top of shoulder
dermatome testing: C5
lateral shoulder and arm
dermatome testing: C6
- lateral forearm
- index finger
dermatome testing: C7
- MIDDLE finger
- ring finger
dermatome testing: C8
- LITTLE finger
- ring finger
dermatome testing: T1/2
medial forearm and arm
deep tendon reflex scale
0 = absent
1 = diminished
2 = normal
3 = exaggerated
4 = clonus (very brisk)
deep tendon reflexes: C5
deep tendon reflexes: C6
deep tendon reflexes: C7
What are the upper motor neuron tests?
1. Hoffman sign
- flick distal phalanx of the middle finger
+ sign if thumb flexes in response
- stroke lateral sole of foot firmly proximally to distal
+ sign if great toe extends and other toes splay