Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MSK (Spine) > cervical presentations > Flashcards

cervical presentations Flashcards

1
Q

Types of cancer that commonly metastasize to the vertebrae (75%)

A

Lead Kettle (PB KTL)
Prostate, breast, kidney , thyroid, lung

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Types of cancer that commonly metastasize to the vertebrae (75%)

A

Lead Kettle (PB KTL)
Prostate, breast, kidney , thyroid, lung

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

rheumatoid arthritis prevalence and cervical spine complications

A

women>men, prior to 50s
-increased risk for AA instability, basilar invagination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

ankylosing spondylitis definition and sequelae
(chronic inflammatory spondyloarthropathy)

A

def: ~vertebral fusion of spine, IV discs/end-plates, facet structures)
*high risk of SC injury, epidural hematoma,low-impact trauma, and osteoporosis
men>women

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

ankylosing spondylitis presentation (complaints)

A

back pain (worse @ night in morning and improves w/ exercise)-SI>thoracic>cervical
decreased chest wall expansion
back stiffness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

ankylosing spondylitis examination

A

obs: “chin on chest”- flat lumbar+ kyphosis
ROM: multidirectional lim (AROM/PROM)
imaging: radiographic sacroilitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

klippel feil syndrome def and complications

A

persistent fusion of 2 or more vertebrae (2 and 3 most common)
-instability, spinal stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

klippel feil syndrome presentation

A

50% short neck, lower posterior hairline, lim C-spine ROM
50% scoliosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

cervical arterial dysfunction def and pathogenesis

A

internal tear w/in blood vessel wall wherein blood starts to fill in or clot (occluding or dissecting aneurysm)
-predisposition via underlying abnormality in arteries ( vertebral and internal carotid are common)
-trigger of infection (ex: dental abscess) or trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

MOST significant risk factor of cervical artery dysfunction

A

HYPERTENSION +connective tissue disease (see also, high cholesterol, steroids, pregnancy, trx/infection, CVD, DM,etc)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

cervical artery dysfunction presentation

A

severe head, neck and FACE pain
bilateral extremity dysesthesia, motor dysfn, pain
pulsatile tinnitus
horner’s syndrome
CN palsies
5 Ds and 3Ns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

cervical artery dysfunction complications/sequelae

A

retinal or brain ischemia, local symptoms from stretch/compression, subarachnoid or intracerebral hemorrhage (pretty rare, mostly 39-45y/o)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are the 5 Ds and 3 Ns and what do they relate to

A

cervical artery dysfunction
-dizziness,dysarthria, dysphagia,diplopia, drop attacks
-nystagmus,nausea, numbness (face, lip extremity)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are the components of horner’s syndrome?

A

ptosis (droopy eyelid)
miosis (constricted pupil)
enophthalmos (sinking orbit)
anhidrosis (dry eyes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

cervical artery dysfunction exam

A

hx,interview neurologic testing, BP and thennn positional tests

positional:end range rotation, pre-manip positioning, modified sphinx, VBI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

pathophysiology of myelopathy

A

SC compression from impinging structures; related but not synonymous with stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

epidemiology and symptoms of myelopathy

A

present in 90% of ppl by 60 y/o, often PLL is ossified
Imbalance/fall hx, neck pain/stiffness, UE (dysesthesia), may involve LEs first (gait,weakness)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

general cervical spine myelopathy examination

A

s/s: gait impairment, spasticity, pathologic reflexes, hyperreflexia, incoordination, radicular signs that can be sensory and or weakness (unilat/bilat) , balance impairment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

cervical myelopathy CPR (3/5=99%)

A

gait deviation, Hoffmann’s sign, Inverted supinator, Babinksi’s, >45 y/o

20
Q

what are the 2 main contributors to upper cervical instability?

A

ligamentous deficit(concomitant connective tissue dx, trauma) and fracture (fatigue, trauma)

21
Q

Pathogenesis of cervical ligament instability

A

trauma/surgery, and congenital collagenous dx, throat infection, inflammation

22
Q

upper cervical instability symptomatology

A

neck pain, occipital HA/numbness, limited activities @ end range ROM, radicular OR myelopathic s/s, positional intolerance

23
Q

cervical instability examination (minus special tests)

A

ROM: multidirectional lim, w/ potential guarding
potential radicular or myelopathic signs

24
Q

common tests for upper cervical instability (may not even need to perform all of them)

A

Modified Sharp/purser (transverse lig) , alar ligament stability test, lateral shear, tectorial membrane, Posterior A-O

25
Q

jefferson fracture

A

4 part burst of atlas bone (most commonly due to compression), screen other c-spine injuries too!

26
Q

define spondylolysis

A

defect of pars interarticularis (area between sup and inf processes)

27
Q

define spondylolisthesis.What is the most common location?

A

forward/backward translation of one vertebra on another (anterior is most common esp @ c3/4 and c4/5); can be graded I-V

28
Q

what are the Canadian C-spine rules and what do they help us to decide?

A

they help us screen for if we need radiography
High risk? (>65y/o, dangerous MOA, extremity paresthesia)
Low risk? (simple rear-end collision, sitting in ER, ambulation, delayed pain, absent tenderness)
AROM? (at least 45* bilat)

29
Q

what is the NEXUS low risk rule and who uses it?

A

typically immediate post-trauma (think ER and urgent care)
-no midline cervical tenderness
-no focal neurologic deficit (radicular/myelopathic )
-no intoxication
-no painful/distracting injury
-normal alertness

30
Q

define spondylosis

A

when osteophyte complexes form around vertebrae body margins,hence it also affects discs

31
Q

what are the 2 types of degenerative arthropathies?

A

spondylosis and osteoarthritis (typically @ AA and facet joints)

32
Q

what are the 2 types of degenerative spinal stenosis?

A

lateral and central canal

33
Q

describe complications related to central canal stenosis.

A

myelopathy, z-joint hypertrophy, bulging disc, thickening/ossification of ligament, spondylolysthesis

34
Q

describe complications related to lateral canal stenosis.

A

loss ofo disc height, facet and uncovertebral joint hypertrophy, spondylolisthesis, and potential radicular pain or radiculopathy (check sensory AND motor)

35
Q

what is the common MOI for acute z-joint arthropathy? What should we include in an examination for it?

A

Extension MOI
-pain w/ compression ROM (think lat flex, rotation,ext)
-pain w/ segmental provocation (P-As, U-Ps)
-potentially positive cervical compression & Spurling (IF RADICULAR)sd

36
Q

define somatic referred pain

A

relatively localized pain perceived by one anatomic location that is innervated by nerves other than that of the true source (convergenge of 2 CNS regions)

37
Q

define radicular pain

A

pain related to nerve root irritation perceived in dermatome distribution often when closing on foramen, w/ or without radiculopathy, can aso be inflmmed (radiculitis)

38
Q

define radiculopathy

A

conduction block> motor weakness,hyporeflexia, and dysesthesia;

39
Q

what c-spine region is most commonly impacted by radiculopathy?

A

C6 and C7 > spondylosis w/ foraminal encroachment in most cases; can be traumatic or gegenerative

40
Q

what s/s might be present in a pt with cervical radiculopathy?

A

Bakody’s sign, pain/lim ROM w/ compressed foramen or stretched nerve root, positive valsalva, wainner’s cluster

41
Q

what is wainner’s cluster?

A

ipsilateral c-spine rotation<60 deg, + Spurling’s, +Cervical distraction, ULTT

42
Q

describe the 3 main components of the mechanics behind whiplash associated dx

A

trunk thrust upward, lower c-spine rotation, a distracted annulus w/ impaction on facet

43
Q

what are some s/s that might cue you into a whiplash associated dx?

A

HISTORY!, post-concussive sx (ex. tinnitus, visual deficits, dizziness), myotomal weakness, radicular or referred sx, glove like paresthesia, neck or UE pain and limited ROM,

44
Q

what nucleus do cervicogenic headaches originate from?

A

trigeminocervical (frontal, orbital and parietal referral meet C1-C3), over half follow whiplash occurrence.

45
Q

criteria of dx cervicogenic headache
1+5:possible
>/=3: probable

A

1.unilateral HA that doesn’t switch
2. s/s neck involvement
3.fluctuating episodes
4.mod, non-excruciating throb
5. pain from neck»oculo, frontal, temporal
6. anaesthetic bock works
7. ANS s/s + sensory changes (vision, sound)

46
Q

what other dx may need to be tested before confirming a cervicogenic dx?

A

migraine, dissecting aneurysm, posterior cranial fossa lesion, greater occipital neuralgia, neck-tongue syndrome, C2 neuralgia

47
Q

what are the 3 proposed pathophysiologic mechanisms of cervicogenic dizziness

A

ischemic process impacting vertebrobasilar system, irritation of cervical SNS>vasomotor changes, altered proprio from upper c-spine

MSK (Spine) (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions