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a. Yr 2 Athletic Training & Functional Rehab > C-spine > Flashcards

C-spine Flashcards

1
Q

What is the pathology and etiology of cervical spine pain

A

Can be myogenic, neurogenic, mechanical or psychosomatic

Etiology is acute or chronic

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2
Q

What are are common pathology for old people

A

Cervical spondylosis - disc degeneration
Spinal stenosis - narrowing of the spinal canal
Facet syndrome

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3
Q

What are common pathology in young people

A

Mechanical and myogenic - like ligament sprains or muscle strains

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4
Q

What is general anatomy of the C spine

A

7 vertebra
C1 = atlas - no body, 2 large articular facets that provide surface for the skull
C2 = axis - atlas rests on top of and slides over
C7 - very prominent, allows attachment of Ligamentum nuchae and passage that protects the arteries that supply blood to the brain

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5
Q

What’s the difference between men and women cervical vertebra

A

Women have smaller vertebral widths, disc facet depth and segmental support
Males have more stable intervertbral coupling

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6
Q

What are the articulations of the C spine

A

Cranium and atlas = Atlanto-occipital
Allows rotation

Body to body articulations
Making fibrocartilaginous intervertebral discs

Atlas and axis has 2
Lateral atlantoaxial joint
Median atlantoaxial joint

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7
Q

Why is it common for pain in the synovial joints of the C spine

A

The lordotic curve of the c spine makes small synovial joints, over degeneration from age and contact sport

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8
Q

What are the ligaments of the C spine

A

Ligamentum nuchae
Interspinosus ligament
Ligamentum flavum
Intertransverse ligament

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9
Q

What is the adontoid peg

A

A protrusion from the Axis, which provides a pivot point and Allows rotation of the head and neck
It fits into the anterior arch of the atlas
Has a tendency to be severely damaged in traumatic injuries from contact or collision sports

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10
Q

What are the main muscles for the active system of the C spine

A

Deep stabilisers
global and local mobilisers

Scales
Sternocloidmastoid
Upper fibres of trapezius

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11
Q

What structures are vulnerable of the c spine
What structure help protect the c spine vunerability

A

C5 and C6 degenerate most frequently as they have the greatest ROM
Posterior longitudinal ligaments protect the discs
7 bones but 8 nerve roots for more bony protection

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12
Q

Why is posture and stress a factor for making the c spine vulnerable

A

Poor posture = from prolonged sitting causes upper crossed syndrome
Stress, links to emotional triangle whic causes muscles in c spine to be very tense and stiffens c spine

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13
Q

What are cervicoencephalic injuries

A

Upper injuries of the c spine from occiput to C2
They can involve the brain, brain stem and spinal cord

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14
Q

What are spine pathology symptoms that shouldn’t be missed

A

Cognitive dysfunctions in the brain
Sympathetic dysfunctions from ANS
Cranial nerve dysfunctions
Vascular Dysfunctions

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15
Q

What are some examples of sympathetic symptoms caused by cervical pathology

A

Tinnitus
Postural dizziness
Blurred vision
Photophobia
Abnormal sweating
Lacrimation
Weakness

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16
Q

What are common symptoms of cognitive dysfunction caused by cervical pathology

A

Head injuries / concussion
Memory dysfunction
Concentration difficulties
Disorientation
Balance problems
Dizziness
Increased emotionally

17
Q

What are 5 Ds and 3 Ns

A

Dizziness
Diplopia - double vision
Drop attacks
Dysarthria - speech
Dyphagia -

Nausea
Numbness
Nystagmus

18
Q

What injuries can occur from cervical spine

A

Contusions
Sprains
Strains
Fractures
Compressions
Degenerative
Nerve

19
Q

What are some key subjective examinations for c spine pain

A

Precise mapping of symptoms
Ask about headaches
Aggs - note cervical posture
Eases - do movements open or close inter-vertebral foramen, facet joints or stretch muscles
What are night symptoms
Consider age of patient for AM symptoms - stiffness in morning suggests spondylosis

20
Q

What are key things to observe in objective examination for c spine injury

A

Spinal curves in standing and sitting
Poking chin
Pelvic levels
Any increased theistic kyphosis

21
Q

What nuerodynamic tests can be done for c-spine injury

A

ULTT
Slump test
SLR
Passive neck flexion

22
Q

What is cervical spondylosis

A

Bony sclerosis at vertebral end plates and disc degeneration, the site of intervertebral discs are reduced
Wear and tear is pathology and you may see some small bony outgrowths

Can develop into cord root which is a red flag

23
Q

How can you treat cervical spondylosis

A

Change ergonomics of ADL
Manual therapy
Exercise for short and long term
Surgery

24
Q

What is cervical nerve root neuropathic
MOI?
Symptoms?
Special test?

A

Stingers or burners
Nerve root compression in neck that can radiation into shoulder and arm
A transient episode of shooting pain or parathesia radiating down arm

Moi = compressive mechanism

Symptoms = intense burning dissipates in 30 seconds
Test strength and it should improve.

Special tests = spurlings manoeuvre

25
Q

What is whiplash associated disorder
Moi?
Symptoms

A

An acceleration deceleration injury, you can get whiplash without head impact

Moi is S shaped curve followed by C shaped curves, occurs within 200ms

Symptoms = local pain, stiffness and spasm, loss of AROM, headaches, sore throat, nausea, sleep disturbance

26
Q

What is the Quebec classification

A

Classify WAD
0 - no signs of symptoms
1 - pain, stiffness, tenderness but no signs
2 - neck symptoms and musculoskeletal-skeletal signs
3 - neck symptoms and nuero signs
4 - neck symptoms and fracture or dislocation

27
Q

What is management for acute whiplash syndrome

A

Will last 3 months
Use pain control like manual, exercises, advice on meds
Long term - Full ROM and muscle function

28
Q

What mobilisations can be done for C spine treatment and assessment

A

PA ON C1 to C3
Unilateral on C1 to C3
Tranverse on C1 to C3

Apply grades 1-5 for 30 seconds
Can do in extension, side flex and flex

29
Q

What are the 2 special tests for the cervical spine assessment

A

Cranio cervical flexion test
Vertebral artery test

30
Q

What is the cranio cervical flexion test

A

Tests the neuromuscular control of the deep cervical flexor muscles and endurance of them
Can be a clinical indicator of impaired activation of these muscles

Neutral position of the neck
Put an uninflated pressure sensor beneath the neck so it abuts the occiput
Inflate sensor to stable baseline pressure of 20mmHg

31
Q

What is vertebral artery testing

A

Use questioning of the 5 Ds is a patient has vertebrobasilar insufficiency ( reduced or stopped blood flow to back of brain) symptoms

32
Q

What PAIVMs can be used for cervical spine assessment

A

C0-C2 levels -
PA C1 - pressure directed to patients eyes
Transverse PA pressure over TP of C1 with csp rotated
PA on C2
Unilateral PA on C2

C3-T3 levels -
PA
Unilateral PA
Transverse PA

a. Yr 2 Athletic Training & Functional Rehab (17 decks)

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