Upper C spine

Question 1

what ligament becomes the tectorial membrane up at the skull?

Answer 1

PLL

Question 2

what ligament becomes the anterior atlantooccipital membrane?

Answer 2

ALL

Question 3

what ligament becomes the posterior atlantooccipital ligament?

Answer 3

ligamentum flavum

Question 4

what does the alar ligament do?

Answer 4

connects dens to foramen magnum- it resists flexion, contralat. SB and contralat. rot

Question 5

how do u test the alar ligament?

Answer 5

test SB in neutral, flexion and extension, must be lax in all 3 positions

Question 6

what does the transverse ligament do?

Answer 6

holds dens against the atlas and away from the spinal cord, keeps motion between C1 and C2 in rotation, not translation. if dens translates back 3 mm= gross instability, 6-8 mm = cord compression symptoms

Question 7

superior oblique does what motion?

Answer 7

contralateral rotation, extenstion, ipsilat SB

Question 8

inferior oblique does what motion?

Answer 8

ipsilateral rotation

Question 9

what do RCP maj and min do?

Answer 9

extend head, major also does ipsilat. SB and rot

Question 10

rectus capitis anterior

Answer 10

flex head

Question 11

rectus capitus lateralis

Answer 11

ipsilat. SB

Question 12

longus colli

Answer 12

stabilizes vertebrae

Question 13

what NN supply all structures to the upper C spine?

Answer 13

dorsal and ventral rami of C1-C3

Question 14

coupling in upper C spine

Answer 14

opposite

Question 15

OA joint

AA joint

Answer 15

OA= flex/ext
AA= rotation

Question 16

when is soonest u can test VA after an MVA?

Answer 16

6-8 wks

Question 17

differentiate types of headaches

Answer 17

• vascular: pounding, dizziness, visual disturbances
• neurological:intense nerve pain
• ms: posture, position, activity related

Question 18

pt profile: neck pain, shoulder pain, non-throbbing-unilateral headache that changes with positioning or motion, eased with lying down

Answer 18

cervicogenic headache

Question 19

pt profile: pain and headache in base of neck, around cranium, behind ear and on the side of their face

Answer 19

trigeminal headache, bad posture causes disruption to trigeminal nuclei in c spine

Question 20

patient profile: headache on whole forehead or whole back of head (central)

Answer 20

discogenic headache

Question 21

patient profile: stressed out pt who can’t sleep, tightness on cranium and sub occipital regions, bilateral

Answer 21

tension headache,

tx: subocc. release, stretching, pt education

Question 22

whiplash:

Answer 22

gets bad, causes lots of bad things, do an in depth eval of all structures in head and neck, then get imaging to double check

Question 23

what dislocation is 100% fatal

Answer 23

A-O dislocations

Question 24

Jefferson’s fracture

Answer 24

fx of ant. and post. arches of C1, 4 breaks, caused by blow to back of head

Question 25

common in MVAs, pick up in radiography by open mouth x ray?

Answer 25

dens fx

Question 26

hangman’s fx

Answer 26

fracture of the pedicles of C2 with dislocation of the body of C2 on C3= dens into brainstem… yikes, bad but not always fatal

Question 27

what subluxation is also known as the face mask injury?

Answer 27

AA subluxation

Question 28

S&S of cervical myelopathy caused by SC compression

Answer 28

UE/LE weakness
bowel and bladder dysfunction
gait disturbances
*SURGERY!!!

Question 29

acute phase after sx

Answer 29

sleep in recliner
no lifting more than 5-10 lbs. 
collar
no ROM! 
bed mob
stairs
ambulation

Question 30

outpatient after sx

Answer 30

precision of movement

align shoulder girdle and T spine!

Question 31

precautions after lumbar fusion sx?

Answer 31

log roll, hips at bend of bed, no hip flex >90, no twisting, bending, stooping, rotation, no lifting, no sitting >30 mins