Anatomy and PE of the Spine Lecture Powerpoint

Question 1

Majority of rotation of the head occurs at the ___ junction

Answer 1

Atlanto-Axial joint (C1-C2) held in place by the transvere ligament but can be loose or lax in individuals with trisomy 21 (not the cervical vertebrae)

Question 2

Sneeze, laugh, cough causing pain in cervical spine assessment indicates….

Answer 2

….disc problem

Question 3

__side shoulder level tends to be lower

Answer 3

Dominant

Question 4

Acute torticollis

Answer 4

Facet dysfunction, inability to move head from one side to another, limitation in rotation and side bending

Question 5

Neurologic reflex exams and what myotomes do they assess?

Answer 5

C5 and 6 - biceps
c6 and 7 - Brachioradiais
C7 - triceps
L3-4 - patellar
L4-5 - posterjior tibial
L5-S1 - medial hamdstrings
S1-2 - lateral hamstrings and achillles

Question 6

Assessment of posture

Answer 6

Ear hole should be in line with acromion process

Question 7

Cervical flexion corresponding myotomes

Answer 7

C1 and C2

Question 8

Lateral cervical flexion corresponding myotome

Answer 8

C3

Question 9

Scapular elevation corresponding myotome

Answer 9

C4

Question 10

Shoulder abduction corresponding myotome

Answer 10

C5

Question 11

Elbow flexion and wrist extension corresponding myotome

Answer 11

C6

Question 12

Elbow extension and wrist flexion corresponding myotome

Answer 12

C7

Question 13

Thumb extension corresponding myotome

Answer 13

C8

Question 14

Abduction/adduction of fingers corresponding myotome

Answer 14

T1

Question 15

Top of head corresponding dermatome

Answer 15

C1 and C2

Question 16

Neck corresponding dermatome

Answer 16

C3

Question 17

Top of shoulder corresponding dermatome

Answer 17

C4

Question 18

Deltoid region corresponding derrmatome

Answer 18

C5

Question 19

Lateral wrist corresponding dermatome

Answer 19

C6

Question 20

Posterior digit 2-4 corresponding dermatome

Answer 20

C7

Question 21

Medial hand corresponding dermatome

Answer 21

C8

Question 22

Medial forearm corresponding dermatome

Answer 22

T1

Question 23

Vertebral artery test

Answer 23

Lay supsect patient (dizzy, nystagmus, etc) supine, extend cervical spine, laterally flexing and rotate spine to close off vertebral artery on corresponding side looking for nystagmus or nausea

Question 24

Spurlings (foraminal compression test)

Answer 24

Gently compress C spine from top of head and try to elicit radiation of pain in suspected disc herniation patient, follow up with lifting mastoid process to see symptoms alleviate (distraction)

Question 25

3 most common lumbar spine spondylopathies

Answer 25

Spondylosis - disc degeneration Spondylolysis - stress fracture in defect in pars interarticularis Spondylolisthesis - forward displacemenet of one vertebrae on another

Question 26

Disc prolapse vs extrusion

Answer 26

Prolapse sees nucleus pulposis herniating into annulus fibrosis, extrusion is full rupture into the external space of the nucleus pulposis (more severe, see foot drop and muscle atrophy)

Question 27

Hip flexion corresponding myotome

Answer 27

L2

Question 28

Kknee extension correpsonding myotome

Answer 28

L3

Question 29

Anlke dorsiflexion corresponding motome

Answer 29

L4

Question 30

Great toe extension corresponding myotome

Answer 30

L5

Question 31

Ankle plantar flexion and eversion corresponding myotome

Answer 31

S1

Question 32

Knee flexion corresponding myotome

Answer 32

S2

Question 33

Proximal anterior thigh corresponding dermatome

Answer 33

L2

Question 34

Distal anterior thigh corresponding dermatome

Answer 34

L3

Question 35

Medial ankle/foot corresponding dermatome

Answer 35

L4

Question 36

Lateral leg/mid anterior foot corresponding dermatome

Answer 36

L5

Question 37

Lateral plantar foot corresponding dermatome

Answer 37

S1

Question 38

Posterior thigh corresponding dermatome

Answer 38

S2

Question 39

Straight leg raise (lasegue's) test

Answer 39

Supine with hip medially rotated and knee extended, flex hip, positive is reproduction of symptoms indicating nerve compression/tension, can modify by stretching spine further by having them put chin to chest

Question 40

Slump test

Answer 40

A way to test for fake back pain that is same as straight leg raise but sitting upright, should cause symptoms same as straight leg raise

Question 41

Stork test

Answer 41

A way to test for spondylolysis, have take a single leg stance extend lumbar spine, positive test is reproduction of symptoms (sharp localized L spine pain)

Question 42

Hoover test

Answer 42

A way to test for fake or "conversion" disorder that asks patient to do a straight leg raise in supine while feeling for downward pressure under opposite heel if genuinely trying to raise leg but cannot vs if exaggerating symptoms