Cervical Flashcards
(105 cards)
1
Q
Head arcs posterior and the flexor muscles contract. ?
A
Hyperextension
2
Q
Head rebounds anterior, anterior structures compress and extensor muscles stretch. ?
A
Hyperflexion
3
Q
Most superficial back muscles _________ and extends from _____ to _____?
A
Trapezius, EOP, T12
4
Q
Innervation for trapezius comes from _____ Nerve
A
Spinal Accessory (CN XI)
5
Q
Spinal N fibers from _____ rami of ___&____ cervical spinal nerves
A
Ventral, C2 and C3
6
Q
Largest muscle in the anterior neck?
A
SCM
7
Q
SCM is attached ______ by 2 heads from the _____ aspect of the medial 1/3 of the ____ and the manubrium of the sternum
A
inferiorly, posterior , clavicle
8
Q
SCM attaches?
A
mastoid process
9
Q
enlarged lymph nodes may indicate infection from respiratory tract and can cause ______
A
Torticollis
10
Q
In lymph are infected, should feel like?
A
tender, big, soft, mobile and Symmetrical
11
Q
Torticollis aka?
A
Wry neck
12
Q
torticollis etiology?
A
unknown
13
Q
torticollis is often associated with injury to ______ on same side at time of birth
A
SCM
14
Q
Muscles transformation into a fibrous cord that cannot lengthen with the growing neck?
A
torticollis
15
Q
Both sexes are affected _____ in torticollis
A
equally
16
Q
Torticollis occurs most frequently in _____ between ___&____ decades
A
Adults, 5th and 6th.
Aquired
17
Q
Considered a problem with the child - torticollis
A
Congenital torticollis
18
Q
SCM muscle contraction causes _____ of the head to the _______ side and flexion of the neck to the same side.
A
rotation , opposite
19
Q
Major stabilizer and elevator of the superior angle of the scapula
A
levator scapulae
20
Q
with scapula stabilized, the levator produces _____&_____ of the neck to the ____ side;; while acting _____, cervical extension is produced
A
rotation & side bending, same side, bilaterally
21
Q
Rhomboid _____ attaches to SP of C7 and T1
A
Minor
22
Q
Rhomboid Major attaches from SP of ___ through ____.
A
T1, T5
23
Q
Rhomboid _____ is inactive during ___ head and neck movements
A
major, isolated
24
Q
Clay shovelers fx is a type of ______ avulsion injury
A
hyperflexion
25
Clay shovelers fx is most common at __ & __ & __
C7, C6 & T1
26
If avulsion fx not limited to SP but extends into ______, there is greater potential for ________ injury
lamina, spinal cord
27
Scalenes extend obliquely and share a relationship with _____ artery?
subclavian
28
Scala = ______ in latin?
ladder
29
Adaptive shortening of the scalenes will affect the ______ of the upper _______. Due to?
mobility , their distal attachments.
30
Scalenes attach into?
1st and 2nd ribs.
31
If in spasm, scalenes elevate the _____ and can be implicated in __________________.
Ribs, thoracic outlet syndrome.
32
TOS occurs when the _____&_____ of the outlet is _____&______.
size & shape, compressed & narrowed.
33
TOS can happen because of ?
1. posture
2. muscle tightness
3. exercise
4. trauma
5. pregnancy
6. or being born with an extra rib.
34
TOS symptoms can be caused by the compression of _____ and _____ or both.
nerves and blood vessels
35
Symptoms of TOS?
1. tingling or numbness in the fingers, hands, arm.
2. weakness of hand or arm
3. swelling of hand or arm.
4. aching shoulder or neck
36
When may symptoms of TOS be worse?
when the arm is lifted above shoulder height.
37
Who is more likely to get TOS?
people who stand for long periods of time, drooping shoulders, leaning head forwards, those who carry heavy loads on their shoulders
38
______ or those in occupations with repetitive overhead arm movements may develop TOS
Athletes
39
Thyroid gland lies anterior to ____/____ vertebrae
C4/C5
40
if parotid gland is swollen, may indicate?
mumps
41
which region of the spine has more more nerve roots than vertebral levels?
cervical spine
42
First cervical disc is between ___ & ____ and is named ____ disc?
C2 & C3, C2 disc
43
First nerve root exits between ____ & ____ and is names _____ nerve root.
C0 & C1, C1 nerve root
44
Last nerve exits between ___ & ___ and is named ___ nerve root
C7 & T1, C8 nerve root
45
In general, structures supplied by the upper 3 cervical nerves can cause?
neck and head pain
46
Mid to lower cervical nerves can refer symptoms to the ??
shoulder, anterior chest, upper limb and scapular area
47
nerves from the roots, trunks, divisions, cords and branches innervate _____
upper extremity
48
The upper extremity can be affected via the _______ _____ by a disc pathology or a _____
Brachial plexus, SOL
49
Neurological exam (3)
1. muscle testing
2. reflex testing
3. sensation testing
50
Muscle testing will indicate the presence of any ____ ____. which could affect the motion of the ____ and will demonstrate the ______ of the nerve supply
motor weakness. neck. integrity
51
C5 Muscle tests
1. deltoid
| 2. Biceps
52
C5 deltoid tests?
Axillary nerve, shoulder abduction
53
C5 Biceps tests?
Musculocutateous nerve, forearm flextion
54
Muscle testing, which scale is used?
Oxford or Van Allen scale
55
Biceps reflex indicates neurological integrity of ____ and slight ____
C5, C6
56
C5 dermatome, neurological level supplies sensation to the _________
lateral arm
57
The purest patch of axillary nerve sensation is located on the lateral arm in the skin covering the _____ portion of the ____ muscle
lateral, deltoid.
58
C6 muscle testing. Wrist ______. which muscles? and which nerve?
Wrist Extension.
Extensor carpi radialis longus and brevis
extensory carpi ulnaris.
Radial Nerve
59
Brachioradialis reflex, tested proximal to ________ where the muscle becomes _____?
radial styloid process.
| Tendinous
60
Brachioradialis reflex, uses which side of hammer?
Either!
61
C6 dermatome. Sensation to?
Lateral forearm.
thumb.
2nd digit.
62
C7 muscle testing.
Elbow extension.
muscles and nerve?
Triceps
| RAdial Nerve
63
C7 - wrist flexion
| muscles and nerve?
flexor carpi radials -median nerve.
| Flexor carpi ulnaris - ulnar nerve
64
C7 - finger extension
| muscles and nerve?
extensor digitorum communis.
extensor indicis profundus
extensor digiti minimi
all radial nerve
65
C7. Triceps reflex- tap where?
where it crosses the olecranon fossa proximal to the elbow joint.
66
C7 dermatome supplies ?
middle 3rd finger and middle of palm of the hand up to the flexor wrist creases
67
C8 Muscle testing.
| Finger flexion? Muscle and nerve?
Flexor digitorum superficials, and flexor digitorum profundus, lumbricals.
median and ulnar nerves
68
C8 reflex?
there is NO reflex for the nerve root. (must verbalize)
69
C8 dermatome supplies?
4th and 5th digit, the ulnar side of the hand and the distal portion of the ulna.
70
T1 Muscle testing:
| Finger abduction
Dorsal interossei
| Ulnar nerve
71
T1. Finger Adduction
Palmer interossei
| ulnar neve
72
T1 reflex?
There is NO reflex for this nerve root
73
T1 dermatome supplies?
sensation to T1 is the medial side of forearm - 2" above and below the elbow joint.
74
T2 dermatome supplies?
medial upper arm and axillary region - 2" above the elbow upwards to the axilla.
75
segmental side bending is?
extesion of the ipsilateral joint and flextion of the contralateral joint.
76
Rotation, coupled with ipsilateral side bending involves ______ of the ipsilateral joint and ____ of the contralateral
extension
| flexion
77
Examination:
| where possible, the patient should be first be examined for _______ & _______
Fractures, craniovertebral ligamentous instability
78
The examination must be _____ & _____ so that the testing can be discontinued at the first signs of ________
Graduated & progressive.
| Serious pathology
79
Jeffersons fracture aka?
burst fx
80
Jerffersons fx, highly ______. occurs in patients with ?
unstable.
| down syndrome, RA
81
increased?
ADI
82
Jefferson FX mechanism of fx?
falling onto head from a height. may occur from MVA. diving into a pool
83
Hangmans Fx
Fracture of the pars interarticularis of C12 & And disruption of C2-C3 junction.
84
Hangmans Fx MOI?
Hyperextension
85
Lordotic curve is secondary? T/F?
true
86
lordotic curve begins formation at what age?
3-4 months
87
in forward head translation, if head is 3" in from of center of gravity, how much weight is produced in structures of the c-spine?
30lbs
88
hyoid bone is opposite from?
C3
89
Thyroid cartilage is at level of _____ vertebral body?
C4/C5
90
Carotid tubercle is located at ____ and used as a landmark for _____
C6
| Anterior surgery
91
How many z joints in cervical spine?
14 (from C0 to T1)
92
angle of Z joints ?
45 degrees
93
Uncovertebral joints extend from ___ to ___
C3 - T1
94
How many Uncovertebral joints?
10
95
Uncovertebral joints are described as?
saddle-shaped, diarthrodial articulations
96
most common area for pathology in C-spine?
C5/C6
97
Cervicothoracic junction (CTJ) is from ____ to ___
C7- T1
98
CTJ forms the _____ _____, through which the neurovascular structures of the upper extremities pass
thoracic outlet
99
which ligament is narrower in the upper c- spine but wider in lower C-spine thatn thoracic?
ALL
100
Which ligament is broader and thicker in the c-spine?
PLL
101
There are 7 clinical signs and symptoms of serious pathology. Know them.
1. unexplained weight loss
2. night pain
3. involvement of more than 1 nerve root
4. expanding pain
5. weak and painful resisted testing (4 findings and their interpretations)
6. spasm with PROM
7. T1 palsy
102
Upper Quarter Scan of an examination involves?
AROM & PROM
C5, C6, C7, C8 and T1
DTR
Sensation
103
A major contributor to cervicogenic pain is a lack of _____ ______ due to poor _____ _____.
postural control, neuromuscular function
104
Klippel - Feil deformity?
The bodies of 2 or more vertebrae are fused.
105
During resisted tests (muscle testing), the clinician looks for relative ____ and ____
strength & fatigability
