Cervical Spine Flashcards
Cervical strain/sprain injuries are usually combined injuries involving…
Ligamentous structures
Cervical musculature
What are some causes of cervical strain/sprain?
Forced mvmt past end range
Sudden contraction
Violent high velocity mvmt
Presentation of cervical strain/sprain?
Non-radicular, non-focal neck pain, \anywhere from the base of the skull to the cervicothoracic junction
c/o neck stiffness/limited ROM
+/- cervicogenic HA pattern
PE findings in cervical strain/sprain?
TTP over involved muscle, facet joint, &/or transverse process
ROM limitations
What are some non-trauma reasons to order x-rays in a pt presenting with neck pain?
> 50 with new sxs
constitutional sxs
mod-severe neck pain >6wks
progressive neuro findings
infectious risk
hx of malignancy
What can you use to determine if you should order cervical x-rays in a pt with hx of recent trauma?
Canadian C-spine rules**
Nexus low risk criteria
-no X-rays if all 5 criteria met
What are some high risk factors that mandate x-ray in Canadian c-spine rules?
> 65
dangerous mechanism of injury
paresthesias in extremities
According to the Canadian c-spine rules, if a pt presents with any low risk factors, what should be checked prior to ordering x-rays?
if pt is able to actively rotate neck 45deg to right and left
(if able= no x-ray)
If pt c/o of sharp pain with ROM, indicates?
muscle strain/ligament sprain
If pt c/o tightness followed by pain, indicates?
muscle spasm
In a pt presenting with cervical strain/sprain, will they have pain with axial loading? Neuro exam?
NO
Usually norm :
C5-T1 (myotomes, dermatomes and reflexes)
check spurling’s test
Why would you perform a spurling’s test?
How is this performed?
help dx cervical disc herniation’s or cervical spondylosis
Pt rotates and laterally flexes to the affected side, light downward (axial) compression is applied
(+) if pain
How do whiplash injuries occur?
sudden movement of the neck
MC stopped vehicle that is rear-ended
classic presentation of whiplash injury?
Delayed onset of cervical pain and stiffness (12-24 hrs)
Pain peaks at 3-5 days post injury
Pain/stiffness with flexion and extension
-ROM loss can be dramatic
PE findings in pt presenting with whiplash?
TTP over involved muscle, facet joint and/or ligaments
ROM limitations
(-) no pain with axial loading, neuro exam usually norm