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ecos 1 post-midterm > Cervical Spine complaint > Flashcards

Cervical Spine complaint Flashcards

1
Q

Common traumatic cervical spine injuries?

A

Myofascial and SCIWORA

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2
Q

SCIWORA

A

spinal cord injury with out radiographic abnormality

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3
Q

Describe a SCIWORA

A

Normal CT of cervical spine but presence of neurological symptoms

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4
Q

What must you do with a SCIWORA case?

A

KEEP IN NECK BRACE/IMMOBILIZED until MRI or consult with neurosurgeon

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5
Q

Common atraumatic cervical spine injuries?

A

Musculoskeletal = most common
Neurologic = radiculopathy and myelopathy
Referred pain = thoracic outlet

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6
Q

Most common cause of acute/chronic neck pain in adults???????

A

CERVICAL SPONDYLOSIS

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7
Q

How does cervical spondylosis look on an x-ray

A

Degenerating disks and presence of osteophytes

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8
Q

Any deficit relating to the spinal cord; distal extremity weakness and clumsiness

A

Myelopathy

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9
Q

Any deficit relating to the nerve roots; burning, sharp pain down arm

A

Radiculopathy

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10
Q

Most common level of cervical radiculopathy?

A

C5-C6

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11
Q

How do you diagnose meningitis?

A

Lumbar puncture

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12
Q

Signs of meningitis?

A

Fever, malaise, rash, stiff neck, headache

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13
Q

What is thoracic outlet syndrome?

A

Space between first rib and clavicle is compressing the neurovascular bundles there

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14
Q

Signs of thoracic outlet syndrome?

A

Arm pain, numbness, weakness, gets worse when elevating hands and arms above head and HAND MUSCLE WASTING

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15
Q

Most patients with atraumatic neck pain and no red flag symptoms do NOT need?

A

Imaging

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16
Q

What should you not check on a patient with a traumatic cervical injury until cleared radiographically or by a neurosurgeon?

A

Neck ROM!

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17
Q

Special tests for cervical radiculopathy?

A

Neck compression, neck distraction and spurlings tests

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18
Q

Neck compression test

A

pt is seated and apply a downward force on top of their head while in neutral
(+) = pain, paresthesia, numbness down arm

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19
Q

Neck distraction test

A

One hand under chin, one on occiput and pull up

(+) = ALLEVIATION of symptoms

20
Q

What are the 3 stages to Spurling’s test?

A

Compression
Compression and extension
Compression, extension and side bending towards affected side

21
Q

When should you stop doing the stages of the spurling’s test?

A

If there is reproduction of symptoms:

(+) = pain, paresthesia, numbness down arm

22
Q

Special tests for thoracic outlet syndrome?

A

ROOS, Adson’s, Costoclavicular/military/halstead, Wright’s hyperabduction test

23
Q

ROOS test

A

Have patient Abduct and ER shoulders to 90, flex elbows to 90, then alternately open and close fists slowly for 3 minutes
(+) = pain, paresthesia, weakness, cyanosis down arm, swelling

24
Q

Adson’s test (away)

A 
Patient is seated and stand behind them
Arm is extended, slight abduction and ER
Find radial pulse to monitor 
Have patient extend head and look away from affected side
Inhale and hold breath
25
Q

Where is Adson’s test (away) testing for compression of the neurovascular bundle?

A

Between the scalenes

26
Q

Adson’s test (toward)

A 
Patient is seated and stand behind them
Arm is extended, slight abduction and ER
Find radial pulse to monitor
Have patient extend head and look toward affected side
Inhale and hold breath
27
Q

Where is Adson’s test (toward) testing for compression of neurovascular bundle?

A

Between rib and clavicle

28
Q

Positive test for Adson’s?

A

Loss/change in radial pulse or reproduction of symptoms (pain, paresthesia, numbness)

29
Q

Costoclavicular/military/halstead test

A

Patient is seated and stand behind them
Extend their arm and shoulder towards you
Find radial pulse to monitor
Compress down on their shoulder
(+) = change in radial pulse or reproduction of symptoms

30
Q

Where is the costoclavicular/military/halstead test testing for compression of the neurovascular bundle?

A

Between rib and clavicle

31
Q

Wright’s Hyperabduction test

A

ABduct patient’s arm ABOVE head with some extension and monitor radial pulse
(+) = change in radial pulse or reproduction of symptoms

32
Q

Where is Wright’s Hyperabduction test testing for compression of the neurovascular bundle?

A

Pectoralis muscle

33
Q

What can be seen on a C spine lateral x-ray?

A

Hangman’s fracture

34
Q

What is injured with a hangman’s fracture?

A

Hyperextension causes a fracture of vertebral arch of C2, ligaments and spondylolysthesis of C2

35
Q

What can be seen on an open mouth x-ray?

A

Dens, C1 and C2 facets = jefferson fracture of C1 visualized

36
Q

What can be seen on an anterior AP view x-ray?

A

Facet dislocation or widening of a spinous process of the cervical spine

37
Q

What can be seen on a 45 degree oblique x-ray of the cervical spine?

A

Osteophyte encroachment - spondylosis

38
Q

What 2 joints have different biomechanics in the cervical spine?

A

OA and AA

39
Q

OA

A

Occiput - Atlas (C1)

40
Q

AA

A

Atlas (C1) - Axis (C2)

41
Q

What movements can be expected for C2-C7?

A

Rotation and sidebending in the SAME direction

42
Q

What movements can be expected for OA?

A

Rotation and sidebending in OPPOSITE directions

43
Q

What movement can be expected for AA?

A

JUST ROTATION

44
Q

Major motions of the OA joint?

A

Flexion and extension

45
Q

What is thought to cause C2-C7 motion being in the same direction?

A

Uncinate processes

46
Q

Main contraindications for HVLA in cervical region?

A

Rheumatoid arthritis and Downs syndrome (alar L.)
Vertebral A. disease and Carotid disease (thrombosis)
Radiculopathy, etc.

ecos 1 post-midterm (9 decks)

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