4. Cervical Spine Flashcards Preview

Physical Assessment > 4. Cervical Spine > Flashcards

Flashcards in 4. Cervical Spine Deck (52):
1

Vertebral body

Weight-bearing portion of vertebra

2

Vertebral arch

Composed of pedicles and lamina; surrounds SC

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Vertebral foramen

Space within vertebral arch

4

Intervertebral foramen

Opening between vertebrae on each side of column, allowing passage of spinal nerves

5

Intervertebral discs

Make up 20-30% of spinal column length; Increase in size from cervical to lumbar; > disc height = > mobility

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Cervical disc thickness

3mm

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Lumbar disc thickness

9 mm

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Cervical Vertebrae - Defining Characteristics

Small body; Spinous processes are short & extend horizontally

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C1

Atlas; no body or spinous process; articulates with occipital condyles superiorly; Facet on internal surface of anterior arch for articulation with dens

10

C2

Axis; Anterior facet for articulation on dens

11

Anterior atlantoaxial lig.

Runs along anterior of body; limits extension of C1-C2

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Anterior longitudinal lig.

runs along anterior of body; limits extension

13

Posterior longitudinal lig.

Runs along posterior of body; limits flexion

14

Ligamentum flavum

Connects lamina to lamina; limits flexion

15

Ligamentum nuchae

Connects tips of spinous processes; limits flexion

16

Alar

CONNECTS ODONTOID TO OCCIPUT; LIMITS ROTATION

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Atlanto-occipital joint

(Occiput-C1); Nodding; NO DISC; flex, lat flex; NO ROTATION

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Atlanto-axial joint

MOST MOBILE JOINT OF SPINE; no disc; flex, lat flex, rotation

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C4-C6

Greatest amount of flexion

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C2-C4

Greatest amount of lateral flexion

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Cervical discs

More fibrous; less likely to herniate

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Rectus capitus action

cervical flexion

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Scalenes

cervical flexion

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Trapezius action

elevation, lat flexion, extension

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Levator scapulae

elevation, lat flexion, rotation, flex

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Splenius

Lateral flexion

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Sternocleidomastoid

Opposite lateral rotation

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Cervical plexus

Gives rise to phrenic n.

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Important Cervical Spine HX Questions

Neck stiffness; headache; vision changes

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Important TMJ Hx Questions

Jaw pain/click/lock; malocclusion; bruxism

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Torticollis

Permanent spasm; slight lat rot and looking up

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Mandibular RoM

Should be able to place 3 fingers in mouth

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Occiput/jaw angle dermatome

C2/3

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Supraclavicular/lateral shoulder dermatome

C4

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Lateral upper arm dermatome

C5

36

Thumb, lat forearm dermatome

C6

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3rd digit dermatome

C7

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5th digit; ulnar forearm dermatome

C8

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Medial arm & elbow dermatome

T1

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Adson Maneuver

Assesses Thoracic Outlet Syndrome; palpate radial pulse while patient abduct, extends, and ER shoulder; pt holds breath; (+) = pulse disappears

41

Thoracic Outlet Syndrome

Involves subclavian a. compression;

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Compression Test

Push down on head to apply pressure to cervical spine; (+) = radiating arm pain from nerve root lesion or disc herniation; OR (+) = local cervical pain from facet joint, transverse process, spinous process

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Valsalva Test

Increases venous pressure and CSF pressure; (+) = pain; herniated disc will most likely radiate

44

Brudzinski's Sign

Tests for meningitis; Passive neck flexion; (+) = Involuntary hip/knee flexion when neck is raised

45

Kernig's Sign

Test for meningitis; Passive flexion of hip/knee, then extension; (+) = Hip/knee resistance with passive flexion; causing neck pain

46

Chvostek Test

Test of facial nerve; Tap parotid gland over masseter; (+) = tetany; twitch if Ca++ levels low

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Jaw Reflex Test

Test of trigeminal nerve; Pt mouth slightly open, provider's finger on chin, tap with hammer; (+) = Mouth clenches tightly or opens dramatically

48

Cervical Disc Herniation

Pain in dermatomal distribution of the arm; numbness & tingling; decrease/alteration in sensation

49

Cervical Stenosis

Narrowing of intervertebral foramen placing pressure on SPINAL NERVE ONLY

50

Hyperextension injury

Whiplash; Injury to sternocleidomastoid strain; Anterior longitudinal ligament strain; possible fx of spinous process; possible disc herniation; due to anterior neck muscles are physiologically weaker than posterior

51

Cervical Strain

Muscle/tendon stretch or tear; Caused by forceful movement; Strain occurs IN MUSCLE THAT DOES OPPOSITE ACTION

52

Cervical Sprain

Ligament or capsule stretch or tear