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MSK > cervical and thoracic spine > Flashcards

cervical and thoracic spine Flashcards

1
Q

cervical disc pathology synonyms

A
  • cervical degenerative disc disease (DDD)
  • Herniated nucleus pulposus (HNP)
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2
Q

the primary cause of cervical disc pathology are degenerative processes and apace-occupying _____ involving the annulus fibrosis of the ______

A

lesions

nucleus pulpous

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3
Q

DDD can include annular tears nuclear disc ____________ ______ and loss of _______ _____.

A

material degradation
disc height

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4
Q

a HNP can occur when disc material material extends beyond the _____________ margin of the ___________

A

posterior
vertebral body

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5
Q

some individuals with DDD or HNP can be _____ but imaging shows degenerative changes within the cervical spine

A

asymptomatic

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6
Q

four common classes of C spine HPN

A
  1. bulge
  2. protrusion
  3. extrusion
  4. sequestration
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7
Q

a _____ is when the nucleus pulpous bulges into the annulus fibrosis and the disc margin extends beyond the endplates of adjacent vertebral levels.

A

bulge

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8
Q

a ____ occurs when the nuclear pulposus from the disc tears through a small portion of the annulus fibrosis.

A

protrusion

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9
Q

Disc ____________occurs when the nucleus pulposus breaks past the outer lamina of the annulus fibrosis and into the space beyond

A

extrusion

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10
Q

Disc ___________ occurs when the nucleus pulposus becomes detached from the annulus
and then usually resides within the spinal cord canal.

A

sequestration

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11
Q

mechanisms of injury (HPN and DDD) are…

A
  • slow progressive
  • annular tears
  • disc herniation
  • late in life
  • circumferential tears with the annulus and repetitive movements
  • neck pain
  • heavy lifting, posture, MVAs
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12
Q

common signs and symptoms of HPN and DDD are

A
  • pain
  • limited cervical ROM
  • limited joint mobility
  • back and neck flexors elongate
  • peck a occiput areas strong and tight (fwd head pos.)
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13
Q

where is pain in DDD and HPN

A

cervical spine, intrascapular area

sometimes down the arm and past the AC joint

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14
Q

aggravating activities for DDD and HPN

A
  • sitting long
  • specific neck motions
  • driving
  • sleeping prone or SL
  • coughing or sneezing
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15
Q

easing activities for DDD and HPN

A

laying down
pain meds
c spine support
sleep w head supported
walking
heat/ice

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16
Q

if a patient has hypomobility at C6 C7 (Cervical spine fixation) , the joint below and above become ______

A

hypermobile; can be a source of pain

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17
Q

surgical options for DDD and HPN

A

discectomy/microdiscectomy
anterior or posterior fusion

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18
Q

treatment for fixed cervical spine and DDD/HPN pain include

A
  • mobilization/manipulation of C or T spine
  • stretching and flexibility in treating anterior chest and local C spine muscle
  • neurodynamic mobilization
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19
Q

thoracic disc pathology synonyms

A

Herniated thoracic disc
Thoracic bulging disc
Thoracic degenerative disc disease 12

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20
Q

T of F: in thoracic disc pathology it is the failure of either the nucleus pulposus or the annulus fibrosis of any of the discs in the thoracic region.

A

T

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21
Q

four classes of thoracic disc pathology

A
  • protrusion
  • prolapse
  • extrusion
  • sequestration
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22
Q

thoracic disc degeneration associated with patient _________ of a fall or MVA

A

history

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23
Q

mechanisms of injury for the thoracic spine include…

A

-Degenerative changes resulting from repetitive flexion-based activities coupled with compressive loading such as bending and lifting objects.
- Increased thoracic kyphosis.
- Traumatic incident such as fall onto the buttock.
- History of sudden strain such as coughing or sneezing.

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24
Q

signs and symptoms for thoracic degeneration

A
  • asymptomatic
  • > 20 min stiffness in am
  • intermittent backache
  • acute thoracic lumbago
  • restricted neck and back ROM
  • positive neural tension tests
  • spinal cord compression symptoms
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25
Q

what is the flexibility of your spinal cord

A

10 cm

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26
Q

aggravating activities for T spine degeneration

A
  • sitting
  • coughing
  • bearing down
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27
Q

easing activities for T spine degeneration

A

standing
supine lying

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28
Q

what is a nerve tension test

A

changing the position of the spine to “shorten” the nerve/spinal cord to see if pain if relieved (positive result if yes)

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29
Q

treatments for surgery in T spine degeneration

A
  • costotransversectomy
  • laminectomy
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30
Q

PT treatments for thoracic degeneration

A
  • manage symptoms
  • frequent walking and avoid lifting
  • thoracic extension while prone
  • thoracic stabilization
  • loading with fctn activities can begin when mobility of pain free
  • core stability
  • breathing
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31
Q

cervical fact dysfunction synonyms

A

 Cervical facet arthropathy
 Cervical spine spondylolysis
 Cervical spine facet joint syndrome

32
Q

______ dysfunction most commonly involves a pain-generating source located toward the posterior elements of the spine behind the intervertebral foramen and
associated nerve roots

A

cervical facet

33
Q

cervical facet dysfunction can be a primary source of pain (_________) or a secondary source of pain ( ____________)

A
  • MVA/trauma
  • resulting from a primary degenerative process or injury to the disc/ligaments/muslces
34
Q

primary facet pathology is more common in ______ and secondary more common in ______

A

older adults
younger adult <40 y/o

35
Q

common signs of cervical facet issues

A
  • diffuse nonspecific neck pain
  • pain in scap that worsens with a “closing pattern”
  • limited C spine ROM and mobility
  • muscular imbalances
36
Q

T or F: neurological clinical findings are usually absent in thoracic degenerative disease

A

T

37
Q

cervical muscle strain synonyms

A
  • cervical strain
  • cervical sprain
  • mechanical neck pain
38
Q

T or F: A soft tissue injury to the surrounding musculature of the cervical spine that can be
caused by a variety of incidents such as a fall, MVA, blow to the head of any type, or
any form of trauma that may cause muscle or ligamentous (cervical sprain) disruption
via an excessive stretch or compressive force through the cervical spine

A

T

39
Q

Individuals may have insidious episodes with _______ and immobility from
sleeping awkwardly or having their head and/or neck in prolonged positions, which
would add a _________ on the muscle or ligamentous structures in the cervical
spine with a cervical muscle strain.

A
  • progressive pain
  • compressive force
40
Q

past history of muscle strain may __________ a patient to subsequent muscle strains because of the muscles weakened state.

A

predispose

41
Q

signs and symptoms of cervical muscle strain …

A
  • neck pain (posterior upper spine, lower spine/shoulder)
  • limited cervical spine ROM
  • tenderness on palpation
  • muscle spasms
42
Q

aggravating activities for cervical muscle strain

A
  • cervical spine ROM in positions that stretch or elongate the tissue in question
  • prolonged periods of sitting or driving
  • specific sleeping positions that aggravate the neck area
43
Q

easing actvities for cervical muscle strain

A
  • supine lying
  • not excessively stretching or compressing the cervical spine
  • ice/heat
44
Q

cervical radiculopathy synonym

A

cervical radiculitis

45
Q

cervical radiculopathy is characterized by _________ __________ __________ dysfunction.

A

spinal nerve root

46
Q

in cervical radiculopathy the degenerative effects are usually a ________ or _______

A

narrowing
inflammation of surrounding structures

47
Q

herniation and acute injury for cervical radiculopathy usually affects ____________ and creates _________________ . this usually happens in populations of younger than _______ y/o.

A
  • foraminal circumference
  • impingement on the exiting cervical nerve root.
  • 40 y/o
48
Q

aggravating activities of cervical radiculopathy

A
  • extension, lateral bending, rotation limitations (ROM)
49
Q

With limitations toward the side of discomfort or pain, the cause may be ______________________,
whereas limitations away from the side of discomfort or pain may be related to a _______ or decreased mobility of the
__________ and/or brachial plexus.

A
  • foraminal impingement
    -disc
  • peripheral nerve trunk
50
Q

what position in the UE “unloads” the nervous system?

A

placing the arm on top of the head

51
Q

cervical degenerative joint disease synonyms

A
  • cervical spine osteoarthritis
  • cervical spine spondylosis
52
Q

what is DJD?

A
  • breakdown of facet joint articular surfaces and a resultant loss of cartilage
53
Q

what is DJD the result of usually?

A

wear and tear

54
Q

there is ________ and _________ of the subchondral bone and development of osteophytes of bone spurs in DJD

A

thickening and sclerosis

55
Q

consequences of DJD

A
  • narrowing of joint space
  • loss of shock absorption
  • pain
56
Q

signs and symptoms of DJD unilateral

A
  • muscular restrictions, guarding, tenderness
  • stiffness may be present the first 10-15 min in the am and in the evening
  • cracking or crunching
57
Q

T or F: spinal curvature is reserved in DJD of the cervical region?

A

F: loss

58
Q

what joint dysfunction might accompany C DJD?

A

TMJ if the injury is upper cervical and close to the trigeminal nucleus

59
Q

whiplash synonyms

A

 Whiplash-associated disorders
 Acceleration flexion-extension neck injury
 Soft tissue cervical hyperextension injury
 Cervical sprain or Cervical strain
 Hyperextension injury

60
Q

is whiplash a pathology? what is whiplash?

A

no
it is the process where the head if forcefully displaced in one or multiple directions resulting in tissue damage

61
Q

T or F: seatbelts increase the likelihood of whiplash in a MVA

A

T; but there is less chance of death so choose your poison

62
Q

what is one thing associated with chronic pain after whiplash?

A

hypersensitivity in the CNS and PNS because of anterior strain and posterior compression

63
Q

top 3 common signs and symptoms for whiplash:

A
  1. neck pain 97%
  2. headache 97%
  3. shoulder pain 65%
64
Q

most commonly in whiplash when do patients begin to experience pain

A

several days later

65
Q

immediate symptoms of whiplash include:

A
  1. ROM limited in all directions
  2. guarding and tenderness in traps and post scalenes
66
Q

24 hour pain/stiffness post whiplash?

A
  1. am stiffness
  2. dissipate during day
  3. increase afternoon and evening (based on usage)
  4. sleep difficulty and may awaken
67
Q

scoliosis aka ______

A

curved spine

68
Q

what degree does a Cobb angle need to be so that it is scoliosis

A

10

69
Q

idiopathic vs infantile idiopathic scoliosis vs juvenile vs adolescent

A

no cause
infantile - onset prior 3 y/o
juvenile - between 3 and 10 y/o
adolescent - 10 + y/o

70
Q

3 types of scoliosis

A
  1. functional
  2. neuromuscular
  3. degenerative scoliosis
71
Q

is the result of abnormalities in the body that secondarily impact
the spine. In the absence of the abnormalities, the spine would be normal. Leg length
discrepancies or protective scoliosis secondary to a lumbar disc herniation are
examples of functional scoliosis

A

functional scoliosis

72
Q

develops secondary to problems during the development of
the spine. Often, the bones of the spine will not form completely or they will fail to
separate from each other and this results in the scoliosis. Scoliosis is caused by actual
alterations in the structure of the spine and occurs in patients with Marfan syndrome,
muscular dystrophy, or cerebral palsy

A

neuromuscular scoliosis

73
Q

occurs as the body ages. Disc herniation, fractures,
osteophytes, and other spinal changes create alterations in the normal spinal
alignment. Unlike functional scoliosis, the spinal curves are a result of actual changes
in the spinal vertebrae or discs

A

degenerative scoliosis

74
Q

 Infantile scoliosis: ____of all cases.
 Juvenile scoliosis: Between __________ of all patients with idiopathic scoliosis.
 Adolescent idiopathic scoliosis: The majority of cases.

A

<1%
12% and 21%

75
Q

 Present in 2% to 4% of children between __________ years of age.
 Prevalence of curves _____ degrees is 0.2%.
 Prevalence of curves ______ degrees is 0.1%.

A

10 and 16
>30
>40

76
Q

when is surgery an option for scoliosis

A

> 45 degrees

-spinal fusion and or release

note: usually they observe, and do PT then surgery if need be. and then rehab again .

76
Q

ratio of Fe:M for 10 degree curves and greater than 10 degree curves

A
  • 1:1
  • 10:1

MSK (19 decks)

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