Cervical Spine Flashcards Preview

Musculoskeletal > Cervical Spine > Flashcards

Flashcards in Cervical Spine Deck (15):
1

Emergency vs Outpatient protocol for Whiplash

•Emergency Room – get CT if in pain. Immobilize.
•Outpatient – get x rays. Must see T1. C6/7 fractures are commonly missed,

2

Treating whiplash

Rest, ice, NSAIDs, reassurance, PT for high risk, CBT. NOT surgical.

3

Spurling sign

Tests for radiculopathy.
Tilt head to compress nerve on side head is moving toward.

4

3 environmental risk factors for disc herniation

Smoking, vibrating equipment, and repetitive lifting.

5

When should you get an MRI for radiculopathy?

Only if pain last >6 weeks

6

Treating radiculopathy
Less than 2 weeks?
More than 6 weeks?

•Less than 2 weeks: reduce activity, try to keep working, gabapentin for nerve pain, NSAIDs, analgesics (short-term opioids), steroids, PT
• 75% of pxs recover w/o surgery. Disc resorbs over time.
•> 6 weeks: get MRI to confirm diagnosis.
• Indications for surgery: failure to improve, disabling pain, progressive neuro problems, severe weakness / quadriparesis.
• Do discectomy + fusion or replacement

7

C5
Motor weakness
Sensory loss
Decreased reflex

Motor weakness: deltoid, biceps
Sensory loss: shoulder
Decreased reflex: biceps

8

C6
Motor weakness
Sensory loss
Decreased reflex

Motor weakness: biceps, wrist extension, pronation
Sensory loss: thumb, index finger
Decreased reflex: biceps

9

C7
Motor weakness
Sensory loss
Decreased reflex

Motor weakness: triceps
Sensory loss: index, middle finger
Decreased reflex, tripeps

10

C8
Motor weakness
Sensory loss
Decreased reflex

Motor weakness: intrinsics
Sensory loss: ulnar digits
Decreased reflex: none

11

Hoffman's sign

Tests for cervical myelopathy
Flick index finger and see thumb flex (UMN sign)

12

What diameter is considered spinal stenosis?

Less than 10 mm

13

Treating spinal stenosis: mild vs moderate / severe

•Mild – observe. Surgery is more risky. Do PT, steroid injections.
•Moderate / severe – need surgical decompression. Poor prognosis. Only 80% of pxs improve w/ surgery.

14

When should a C spine be immobilized? (4)

Trauma to head / neck, neuro signs, intoxicated, or distracting injuries such as a fractured pelvis.

15

Who needs neck imaging after trauma? (6)

•Pxs who exibit neuro deficits
•Pxs w/ altered sensorium, head injury, or intoxication
•Pxs w/ neck pain or tenderness
•Pxs w/o neck pain, but w/ significant distracting injury (polytrauma, such as femur fracture)