Cervical Spine TBC 2

Question 1

Cervical radiculopathy: DDx

Answer 1

• RTC
• peripheral n. entrapment
• TOS
• brachial plexus
• herpes zoster
• CRPS
• tumor/abscess
• cardiac dysfunction

Question 2

Cervical radiculopathy: typically presumed to involve narrowing of (structure) due to inflammation and/or degenerative changes

Answer 2

intervertebral foramen

Question 3

Cervical radiculpathy: Common diagnosis based clinically on presence of

Answer 3

• neck pain extending into the arm
• s/s of nerve root compression during PE

Question 4

Cervical radiculopathy: dysfunction of the nerve root in the cervical spine via

Answer 4

• compression
• traction
• irritation
• lesion

Question 5

Cervical radiculopathy: causes for nerve root dysfunction in younger patients

Answer 5

herniated disc

Question 6

Cervical radiculopathy: Causes for dysfunction of nerve root in cervical spine in older patients

Answer 6

• foramina narrowing
• osteophytes

Question 7

Cervical radiculopathy: People of any age affected, but most frequently seen in this age range

Answer 7

40-50

Question 8

Cervical radiculopathy: prevalence

Answer 8

83 in 100,000

Question 9

Cervical radiculopathy: typically (bilateral/unilateral) symptoms

Answer 9

unilateral

Question 10

Cervical radiculopathy: associated s/s

Answer 10

• radiating arm pain in a dermatomal pattern
• neck pain
• myotomal weakness
• paresthesia/numbness
• HA
• scapular pain
• reflexes

Question 11

Cervical radiculopathy: symptoms increased with these motions

Answer 11

• rotation
• extension

Question 12

Cervical radiculopathy: This is the single best neuro screening test for cervical radiculopathy

Answer 12

biceps reflex

Question 13

Cervical radiculopathy: If the biceps reflex is diminished or absent, the chance of having a cervical radiculopathy increases from 23% to (%)

Answer 13

59%

Question 14

Cervical radiculopathy: Of the cervical radiculopathy cluster, this test has the highest sensitivity

Answer 14

ULTT

Question 15

Cervical radiculopathy: cluster

Answer 15

• ULTT median
• (+) Spurling
• (+) distraction
• Ipsilateral rotation < 60˚

Question 16

Disc lesions: these types of disc prolapses are relatively rare in the cervical spine

Answer 16

posterolateral

Question 17

Disc lesions: posterolateral disc prolapse relatively rare in cx spine. Why?

Answer 17

Nucleus take up only 15% of disc

Question 18

Disc lesions: prolapses causing neuro signs are more common in the (upper/lower) cervical spine

Answer 18

lower

Question 19

Disc lesions: prolapses causing neuro signs more common in the lower cervical spine due to

Answer 19

larger uncinate processes in upper cervical spine

Question 20

Disc lesions: pain is intense and may be (location)

Answer 20

• scapular
• radiating into arm

Question 21

Disc lesions: disc prolapses in lower cervical spine

This movement is usually limited and the pt may also present with what (positioning)?

Answer 21

flexion

torticollis

Question 22

Disc lesions: This treatment modality relieves symptoms

Answer 22

traction

Question 23

Disc lesions: XR findings?

Answer 23

negative

Question 24

Disc lesions: Central herniation is most common in this age group

Answer 24

< 45 yo

Question 25

**Disc lesions:** central herniation causes these symptoms

Answer 25

* BUE pain * multisegmental paresthesias, especially in the hands and later in the feet

Question 26

**Disc lesions:** central herniation This movement reproduces symptoms and may also cause these signs

Answer 26

neck flexion UMN signs

Question 27

**Disc lesions:** central herniation (%) of pts after MVA who have central posterior prolapse

Answer 27

25-40%

Question 28

**Disc lesions:** Shoulder abduction test Decrease in symptoms is indicative of

Answer 28

C5-6 nerve root compression

Question 29

**Radiculopathy treatment cluster:** age

Answer 29

\< 54

Question 30

**Radiculopathy treatment cluster:** dominant arm (is/is not) affected

Answer 30

is not

Question 31

**Radiculopathy treatment cluster:** looking down (does/does not) worsen symptoms

Answer 31

does not

Question 32

**Radiculopathy treatment cluster:** treatment involves

Answer 32

* manual therapy * cervical traction * DNF strengthening *_at least 50% of visits_*

Question 33

**Level of evidence:** Clinicians ***should*** consider the use of mechanical intermittent cervical traction, combined with other interventions such as manual therapy and strengthening exercises, for reducing pain and disability in patients with neck and neck-related arm pain

Answer 33

B: moderate evidence

Question 34

**Cervical radiculopathy treatment:** these are useful for increasing function, AROM, and decreasing pain and disability

Answer 34

manual therapy + therapeutic exercise

Question 35

**Cervical radiculopathy treatment:** manual therapy techniques found to be successful in systematic review

Answer 35

* thrust mobs to cervical and thoracic spine * cervical mobs * METs * neurodynamics

Question 36

**Cervical radiculopathy treatment:** PT is (more/less/at least as) effective as surgery for treatment

Answer 36

at least as effective