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Ortho II Quizes > Quiz1 > Flashcards

Quiz1 Flashcards

1
Q

What is the purpose of the scanning exam?

A

Helps determine whether the injury or pathology occurs in the cervical spine or in a portion of the upper limb

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2
Q

What are the two areas of the cervical spine?

A

Cervicoencephalic or cervicocranial (upper cervical spine C0-C2) &
cervicobrachial (lower cervical spine)

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3
Q

Injuries to the cervicocranial region can potentially involve what three structures?

A

The brain, brainstem, and spinal cord

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4
Q

Patients with injuries to the cervicocranial region may present with what symptoms? (6)

A

IF PH VH

Irritability, fatigue, poor concentration, headache, vertigo, and hypertonia of the sympathetic nervous system

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5
Q

What is the total range and primary motion of the Atlanto-occipital (C0-C1) joint?

A

Principal motion: flexion – extension (15° – 20°)

Side flexion approximately 10°

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6
Q

What are the attachment sites for the alar ligament?(2) what motions does the alar ligament limit? (2)

A

Attachment sites: attached to each side of the upper dens and pass upwards and laterally to attach onto the medial side of the occipital condyles

Limits:
-flexion & rotation

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7
Q

The alar ligament plays a major role in? Especially in?

A

Plays a major role in stabilizing C1 and C2, especially in rotation

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8
Q

The Atlanto-axial (C1-C2) joint is the most _ articulation in the spine

A

Most mobile

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9
Q

What is the primary motion of the atlantoaxial joint? Range?

A

Primary movement is rotation

Approximately 50°

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10
Q

What is the main stabilizing ligament for the C1 – C2 joint? Holds the dens?

A

Transverse (cruciform) ligament of the atlas

Which holds the dens of the axis against the anterior arch of the atlas

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11
Q

What effects of RA are seen on the transverse cruciform ligament? (Two)

A

RA can weaken or rupture the transverse ligament

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12
Q

What percentage of blood flow to the brain is supplied by the vertebral artery? Internal carotid artery (ICA)?

A

Vertebral artery: 20%

Internal carotid artery: 80%

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13
Q

The vertebral artery lies close to the_ _ and_ _ where it may be compressed by? (Two)

A

Lies close to the facet joints and vertebral body where it may become compressed by osteophyte formation or injury to the facet joint

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14
Q

What can contribute to altered blood flow in older individuals? (Two)

A

Arthrosclerotic changes and vascular risk factors (examples: HTN, high fat or cholesterol levels, diabetes, smoking)

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15
Q

The vertebral an internal carotid artery’s are stressed primarily by? (3) But other movements may also?

A

Rotation, extension, and traction

But other movements may also stretch the artery

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16
Q

What are the four areas where the greatest stresses are put on the vertebral arteries?

A
  1. Where it enters the transverse process of C6
  2. Within the bony canals of the vertebral transverse processes
  3. Between C-1 & C-2
  4. Between C1 and the entry into the skull
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17
Q

What are five common symptoms of vertebral artery insufficiency? In rare cases? (Two)

A

VT v. ND
-vertigo, tinnitis, visual disturbances, nausea, and drop attacks (falling without fainting)

Rare cases: stroke or death

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18
Q

Where does the lower cervical spine commonly referred pain/symptoms? Common signs and symptoms? (6)

A

Commonly referred pain to the upper extremity

Signs/symptoms: (HARPAR)
-headaches, neck and/or arm pain, restricted ROM, paresthesia, altered myotomes & dermatomes, and radicular signs

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19
Q

According to Ishii et al, in which region of the cervical spine do the couple motions of rotation and lateral flexion occur in the same direction? opposite directions? (2)

A

Same direction: between C2 and C7

Opposite direction: between C0 and C2, and C7 and T1

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20
Q

Which facet joints does the greatest flexion – extension occur? (3) also are most likely to have?

A

Facet joints: C5 and C6, C4 and C5, and C6 and C7

Also are most likely to have facet joint degeneration

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21
Q

What is the closed packed position of the cervical spine?

A

Full extension

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22
Q

Which joints of the cervical spine do not have an inter-vertebral disc? (Two)

A

C0 and C1

C1 and C2

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23
Q

Which cervical vertebrae does not have a vertebral body?

A

C1

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24
Q

The spinous process of C1 is_ to palpate.

A

Difficult to palpate (absent or rudimentary spinous process)

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25
Q

How many cervical nerve roots are present on each side of the cervical spine? What nerve root exits between C0 and C1?

A

Eight cervical nerve roots

C1 nerve root exits between the Occiput in C1

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26
Q

Differential diagnosis of cervical spondylosis, spinal stenosis, and disc herniation: pain (unilateral and/ or bilateral), pain distribution?

A

Pain:

  • unilateral only= cervical spondylosis
  • Maybe unilateral or bilateral = cervical spinal stenosis, and cervical disc herniation (unilateral most common)

Pain distribution:

  • Into affected dermatomes = cervical spondylosis and cervical disc herniation
  • usually several dermatomes affected = cervical spinal stenosis
27
Q

Differential diagnosis of cervical spondylosis, spinal stenosis, and disc herniation: pain on extension increases with? Pain on flexion decreases with? Exception?

A

All three (cervical spondylosis, spinal stenosis, and disc herniation)

  • pain increases on extension
  • pain decreases with flexion

Exception: with cervical disc herniation pain may increase on flexion but decreasing is more common

28
Q

Differential diagnosis of cervical spondylosis, spinal stenosis, and disc herniation: which condition is relieved by rest? Which condition causes possible instability? Which condition has a sudden onset?

A

Cervical spinal stenosis pain is relieved with rest

Instability is possible with cervical spondylosis

Onset of cervical disc herniation is sudden

29
Q

With which the cervical spinal condition affects people ages 11 to 70 but most commonly occurs in the 30–60 age range?

A

Cervical spinal stenosis

30
Q

Which cervical spinal condition affects people 17 to 60 years old?

A

Cervical disc herniation

31
Q

cervical spondylosis commonly affects:_ of those older than 45 years,_ of those older than 65 years?

A

60% older than 45

85% older than 65

32
Q

Which cervical spinal condition commonly affects C5 – C6, and C6 – C7?

A

Cervical spondylosis

33
Q

The area commonly affected by cervical spinal stenosis?

A

Varies

34
Q

Which cervical spinal condition usually affects C5- C6?

A

Cervical disc herniation

35
Q

Minor trauma in an elderly patient, pain that’s worse at night, unexplained weight loss, fever, chills, night sweats, changes or dysfunction of the bowel and bladder, ataxia, severe headache, limited ROM, dizziness, drop attacks, dysphasia, dysarthria, double vision, high temp or BP or pulse are all?

A

Warning signs and symptoms of serious cervical spine disorders (red flags)

36
Q

Eight potential causes of red flag signs and symptoms in the cervical spine?

A

FUCk VINNI

Fracture, upper cervical ligamentous instability, cervical myelopathy, vertebral artery insufficiency, infection, neoplasm, neurologic injury, inflammatory or systemic disease

37
Q

_ _ _ _ can be caused by disc herniation, stenosis, osteophytes, swelling with trauma, spondylosis.

A

Cervical nerve root lesion

38
Q

A brachioplexus lesion can be caused by: _ & _ of the cervical spine and_ of the_.

A

Stretching and compression of the cervical spine

And depression of the shoulder

39
Q

What are the contributing factors of cervical nerve root lesions? Brachioplexus lesions?

A

Cervical nerve root lesion: congenital defect

Brachioplexus lesion: thoracic outlet syndrome

40
Q

Differential diagnosis of cervical nerve root and brachioplexus lesions: pain? Paresthesia?

A

Cervical nerve root:

  • sharp, burning pain in affected dermatomes
  • numbness, pins and needles in affected dermatomes

Brachial plexus lesion:
– Shark, burning pain in all or most of arm dermatomes and pain in the trapezius
– Numbness, pins and needles in all or most arm dermatomes (more ambiguous distribution)

41
Q

Differential diagnosis of cervical nerve root and brachioplexus lesions: tenderness? Range of motion?

A

Cervical nerve root:
– Tenderness over affected area of posterior cervical spine
– Decreased range of motion

Brachioplexus:
– Tenderness over affected area of brachial plexus or lateral to cervical spine
– ROM is decreased but usually returns rather quickly

42
Q

Differential diagnosis (cervical nerve root lesion): transient _ usually, and myotome?

A

Transient paralysis usually

Myotome may be affected

43
Q

Differential diagnosis (brachioplexus lesions): transient _ _, _affected.

A

Transient muscle weakness

Myotomes affected

44
Q

Differential diagnosis of cervical nerve root and brachioplexus lesions: deep tendon reflexes?

A

Cervical nerve root lesion:
– Affected nerve root may be depressed

Brachioplexus lesion:
-maybe depressed

45
Q

With a cervical nerve root lesion( provocative tests) _ , and_ with_ increases symptoms._ _ Decreases symptoms. Upper limb tension test will be?

A

Side flexion, rotation, and extension with compression increased symptoms

Cervical traction decreases symptoms

Upper limb tension test will be positive

46
Q

With brachial plexus lesion (provocative test):_ _ with_(same side) or_(opposite side) may increase in symptoms. Upper limb tension test?

A

Side flexion with compression (same side) or stretch (opposite side) may increase symptoms

Upper limb tension test may be positive

47
Q

Spastic paraparesis, stiffness and heaviness, scuffing of the tow, difficulty climbing stairs, weakness, spasms, cramps, easily fatigued, decrease in strength (especially of flexors), hyperreflexia of the knee & ankle jerks with clonus, positive Babinski sign, extensor hypertonia, decreased or absent superficial abdominal and cremasteric reflexes, drop foot and crural monoplegia are all initial signs and symptoms of? Predominately affect?

A

Initial signs and symptoms of cervical myelopathy

Predominately affects the lower limbs

48
Q

Later symptoms (an order of occurrence) in cervical myelopathy: various combinations of_ and_ _ involvement. Mixed picture of upper and lower_dysfunction. _, _, _, _ to _, and absent _ _ _.

A

Various combinations of upper and lower limb involvement

Mixed picture of upper and lower motor neuron dysfunction

Atrophy, weakness, hypotonia, hyperreflexia to hyporeflexia and absent deep tendon reflex is

49
Q

Occipital or sub-occipital component, altered with neck movement, painful limitation of neck movements, abnormal head or neck posture, suboccipital or unchallenged tenderness, abnormal mobility at C0-C1, and sensory abnormalities in the occipital or suboccipital area are all signs of?

A

Headaches that have a cervical origin

50
Q

Dizziness, giddiness, drop attacks, fainting, stroke, double or blurred vision, hallucinations, tinnitus, Flushing, sweating, tearing, runny nose, hiccups, myotonic jerks, tremor & rigidity, disorientation, vertigo, schomata, photophobia, numbness & tingling, quadriparesis, dysphasia, dysarthria, photopsia, nystagmus, ataxia, and visual anosognosia are all signs and symptoms of?

A

Vertebrobasilar artery insufficiency

51
Q

Difficulty swallowing can be caused by_problems,_ _ or_in coordination. Pain on swallowing may indicate _ _ swelling in the throat, vertebral _, _ projection, or disc _into the esophagus or pharynx.

A

Neurological problems, mechanical pressure, or muscle in coordination

Pain on swallowing may indicate soft tissue swelling in the throat, vertebral subluxation, osteophyte projection, or disc protrusion into the esophagus or pharynx

52
Q

Upper cross syndrome (described by Janda): what muscles are typically tight? (4) what muscles are typically weak? (4)

A

Tight: Pectoralis major and minor, upper trapezius, and levator scapulae

Weak: deep neck flexor’s, rhomboids, serratus anterior, and lower trapezius (DR. StrangeLove)

53
Q

AROM for Atlanto- occipital joint: flexion, extension, lateral flexion?

A

Flexion: 5°

Extension: 10°

Lateral flexion: 5°

54
Q

AROM for Atlanto-axial joint complex: flexion, extension, axial rotation?

A

Flexion: 5°

Extension: 10°

Axial rotation: 40–45°

55
Q

AROM for intracervical region (C2-C7): flexion, extension, axial rotation, lateral flexion?

A

Flexion: 35°

extension: 70°

Axial rotation: 45°

Lateral flexion: 35°

56
Q

AROM total across craniocervical region: flexion, extension, axial rotation, lateral flexion?

A

Flexion: 45- 50°

Extension: 85°

Axial rotation: 90°

Lateral flexion: about 40°

57
Q

Normal end feel for passive movements of the cervical spine: flexion, extension, side flexion (right and left), rotation (right and left)?

A

Normal end feel for all is tissue stretch

58
Q

Cervical flexion tests which myotomes? (Two) and?

A

Tests the C1 and C2 myotomes

And also test cranial nerve XI

59
Q

Neck side flexion tests which myotome and cranial nerve?

A

C3 myotome and cranial nerve XI

60
Q

Shoulder elevation tests which myotome and cranial nerve?

A

C4 myotome and cranial nerve XI

61
Q

Shoulder abduction/lateral rotation tests which myotome? Elbow flexion and/or wrist extension?

A

Shoulder abduction/lateral rotation: C5 myotome

Elbow flexion and/or wrist extension: C6 myotome

62
Q

Elbow extension and/or wrist flexion test which myotome? Thumb extension and/or ulnar deviation? Abduction and/or adduction of hand intrinsics?

A

Elbow extension/wrist flexion: C6 myotome

Thumb extension/owner deviation: C8 myotome

Abduction/add duction of hand intrinsics: T1 myotome

63
Q

Scoring ranges for neck disability index (NDI)?

A 
0-4: no disability 
5-14: mild disability
15-24: moderate disability
25-34: severe disability
35+: complete disability
64
Q

Normal range and positive test/finding for the deep neck flexor endurance test?

A

Normal range = 39+/-26 seconds

Those with neck pain average 24 seconds

Ortho II Quizes (4 decks)

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