Flashcards in Ch. 14 - Cervical disc disease and cervical spondylosis Deck (19)
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1
predominant sx of cervical spine disorders
neck pain and arm symptoms
2
cause of cervical spine disorders
degenerative changes in vertebral column = cervical disc disease and cervical spondylosis
3
most common level of cervical disc herniation
C6/7 > C5/6 (fulcrum of head/spine), otherwise uncommon
4
direction of disc herniation in cervical spine and implication
posterolaterally because PLL prevents direct posterior herniation ==> nerve root entrapment at the level of the spinal nerve (ie C5/6 prolapse = C6 nerve entrapment)
5
presentation of cervical disc herniation
"deep achy" neck and arm pain and neurologic manifestations of cervical nerve root compression (radiculopathy)
6
upper extremity dermatome
C5 - upper arm and forearm
C6 - shooter
C7 - middle finger
C8 - 4th/5th digits
7
upper extremity myotomes
shoulder: abduction C5, adduction: C6-8
elbow: flexion C5/6, extension: C7/8
Forearm: supinate C6, pronate C7/8
Wrist: flexion C6-8, extension C7/8
Intrinsic hands: C8/T1
8
Characteristic C6/7 disc prolapse
C7 nerve root compression = weakness with elbow extension, absent triceps jerk, numbness/tingling middle finger
9
UE reflexes
biceps - C5, brachioradialis - C6, triceps - C7
10
Characteristics of C5/6 disc prolapse
C6 nerve root compression = absent brachioradialis reflex, numbness/tingling of C6 shooter
11
Characteristics of C7/T1 disc prolapse
C8 nerve root compression = weakness in long flexors, triceps, finger extensors, intrinsic hand muscles, decreased sensation in 4th/5th digits
12
ddx disc prolapse
spinal tumor, thoracic outlet syndrome, pancoast's tumor, peripheral nerve entrapment
13
disc prolapse management
conservative - bed rest, cervical collar, NSAIDs, muscle relaxants
14
indications for surgical intervention of disc prolapse
pain > 10 days w/o relief, significant weakness, e/o myelopathy
15
Dx cervical disc prolapse with...
MRI
16
surgical interventions for disc prolapse
cervical foraminotomy with excision of prolapsed disc vs anterior cervical discectomy with fusion
17
disadvantage to anterior cervical discectomy with fusion
adjacent joint disease
18
cervical spondylosis
degenerative arthritic process of cervical spine
19