cervical spine

Question 1

C3 to C7

Answer 1

cervical spine

Question 2

serves as attachment site for neck muscles

MOI: MVA, posture, poor breathing pattern

Answer 2

first rib

Question 3

joints of the CS

Answer 3

IVJ
Z jt
U jt

Question 4

saddle shaped, diarthrodial jts
extend from c3 to t1
formed between uncinate processes
thought to prevent disc herniation

Answer 4

unconvertebral joints/joints of von luschka (u joints)

Question 5

neck pain origins

Answer 5

whiplash/MVA
Collisions
Spondylosis
infection, tumor or disease processes

Question 6

a restriction of cervical extension, side bending and rotation to the same side as the pain is

Answer 6

closing restriction

Question 7

a restriction of cervical flexion, sidebending and rotation to the opposite side of the pain is

Answer 7

opening restriction

Question 8

patients with mechanical neck pain benefit from

Answer 8

thoracic spine manipulation

Question 9

referred pain areas of discs into the scapular region from the CS

Answer 9

Cloward signs

Question 10

deep, dull ache
focal pain areasin the middle of back and scapular boarder from timulation of anterior/anterolat disc
spread out over the scapula and into the upper arm with post/postlat disc
induced by local pressure
associated with muscle spasms

Answer 10

cloward sign

Question 11

CS disc herniation patient presentation

Answer 11

20-30 years of age
less common than lumbar
C6-7 and C5-6 most common
can result in localized pain, referred pain, radiculopathy or myelopaty

Question 12

disc herniation, subjective

Answer 12

ache/stiffness
cloward signs
may or may not have distal symptoms

Question 13

UCS DH pain pattern

Answer 13

base of the neck, head and face

Question 14

C4-5 DH pain pattern

Answer 14

base of the neck and top of the shoulder

Question 15

C5-6, C6-7 DH pain pattern

Answer 15

scapula, across the shoulder jt, and post/lat aspect of upper arm

Question 16

CS DH agg

Answer 16

looking down, turning head
ADLs may be limited
speed of movement may be altered
driving, sitting, work

Question 17

DH history

Answer 17

not associated with incident
may be related to sustained posture
slow onset or wake with pain
may have history of MVA

Question 18

DH objective

Answer 18

ROM: limited flexion/extension
Painful ipsilateral ROM: SB and rot
Painful CPA’s
Positive spurling

Question 19

DH intervention

Answer 19

traction
posture
modalities
ergonomics
body mechanics
mckenzie's repeated motion

Question 20

spondylosis of discs

Answer 20

30-55 y/o

Question 21

spondylosis of facet jts

Answer 21

> 55 yrs of age

Question 22

spondylosis of u jts

Answer 22

> 55 yrs of age

Question 23

common levels of disc degeneration

Answer 23

C4-5
C5-6
C6-7

Question 24

Disappearance of NP by age of

Answer 24

40-45

Question 25

loss of disc height loss of normal lordosis results in intersegmental hypermobility and instability/subluxation

Answer 25

Disc degeneration

Question 26

spondylosis subjective

Answer 26

``` cloward sign diffuse symptoms, unilat or bilat presence of radiculopathy long history of neck pain may have history or MVA ```

Question 27

Spondylosis agg

Answer 27

sustained flexion quick movements end of range movements

Question 28

Spondylosis objective

Answer 28

``` Posture ROM may be limited with pain Palpation: central and unilat segmental exam: sensory loss, motor loss, hyporeflexia upper limb neural tension ```

Question 29

spondylosis intervention

Answer 29

``` joint mobs traction posture education ergonomics exercise: scapular stabiliation, thoracic extension ```

Question 30

MOI acute cervical facet syndrome

Answer 30

sudden neck movement result of synovial capsule impingement within a facet localized pain with or without muscle spasms acute torticollis

Question 31

MOI chronic cervical facet syndrome

Answer 31

caused by chronic inflammation due to arthritis/injury

Question 32

cervical facet syndrome objective

Answer 32

``` limited ROM w/wo muscle guarding side flexion is limited to both sides PPIVM: segmental motion limited PAIVM: limited, painful Lack of neurological signs palpable point tenderness and muscle spasm ```

Question 33

cervical facet syndrome intervention

Answer 33

think of specific techniques rather than global approaches manual therapy: unilat PA, contract-relax, joint specific traction HEP posture

Question 34

ANR subjective

Answer 34

pain worse distally in dermatomal pattern possible cloward sign can be constant and/or latent

Question 35

ANR objective

Answer 35

``` posture looks uncomfortable attempt to correct deformity increases symptoms ROM: only able to test 1-2 motions Palpation may not be able to do this neuro + ```

Question 36

ANR intervention

Answer 36

education ice/modalities manual traction joint mobilization:only when decreased severity and irritability

Question 37

CNR subjective

Answer 37

patchy distribution usually intermittent can be nagging, able to sleep at night

Question 38

CNR agg

Answer 38

sustained flexion | movements that narrow foramen

Question 39

CNR objective

Answer 39

``` postural changes +/- neuro signs ROM: limited in closing movments possible GH limitations Central PA +spurling + neurodynamic findings ```

Question 40

CNR intervention

Answer 40

``` joint mob traction neurodynamic treatment ergonomic modification of activities joint protection ```

Question 41

stenosis objective

Answer 41

``` neck pain my be absent initially neck and arm pain painful and restricted ROM presence of sensory and motor deficits wasting of intrinsic muscles of hands resulting in loss of hand dexterity segmental and central neuro exam ```

Question 42

stenosis intervention

Answer 42

``` patient education Ther-ex manual therapy: specific level traction, unilat pa cervical collar surgery ```