Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PTY1022 PT THEORY > Week 2 Cervicothoracic spine > Flashcards

Week 2 Cervicothoracic spine Flashcards

1
Q

Cervical spine

A

LoG passes posteriorly creating an extension moment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Thoracic spine

A

LoG passes anteriorly creating a flexion moment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Forward deviations of the head and neck result in

A

increased demand on the levator scapula and upper trapezius

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Ruptured transverse ligament
破裂

A
  • C1 can slide forward on C2, risking compression of the brainstem
  • Common causes of rupture: Trauma, Rheumatoid arthritis, Down syndrome
  • Halo-Thoracic brace
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Costovertebral movements

A
  • The ribs move in a ‘bucket handle’ motion during respiration
  • Flexion, extension and coupled rotation/ lateral flexion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Neutral zone

A
  • translational (accessory) movement is greatest
  • relatively less tension in spinal ligaments
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

flexion - limit to movement (O/C1)

A

ligamentum nuchae
posterior atlantoaxial ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

flexion - limit to movement (C1/C2)

A

ligamentum nuchae
ligamentum flavum
facet joint capsules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

flexion - limit to movement (C2-C7)

A

ligamentum nuchae
ligamentum flavum
PLL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

flexion - limit to movement (thoracic spine)

A

ligamentum flavum
PLL
facet joint capsules
rib cage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

flexion - limit to movement (lumbar spine)

A

ligamentum flavum
facet joint capsules
posterior annulus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

extension - limit to movement (O/C1, C1/C2)

A

passive tension in the anterior atlantoaxial ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

extension - limit to movement (C2-C7)

A

contact of spinous process
ALL
anterior neck muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

extension - limit to movement (thoracic spine)

A

contact of spinous process
ALL
anterior trunk muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

extension - limit to movement (lumbar spine)

A

contact of spinous process
ALL
anterior trunk muscles
anterior annulus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

rotation & lateral flexion - limit to movement (O/C1, C1/2)

A

alar ligaments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

rotation & lateral flexion - limit to movement (C2-C7)

A

annulus fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

rotation & lateral flexion - limit to movement (thoracic spine)

A

annulus fibrosis
facet joint capsules
intertransverse ligaments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

rotation & lateral flexion - limit to movement (lumbar spine)

A

annulus fibrosis
facet joint capsules
intertransverse ligaments
iliolumbar ligaments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

coupled movements

A

rotation and lateral flexion occurring simultaneously

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

muscle action

A

Using the cervicothoracic spine as a stable base, the musculature of this region supports and moves the upper quadrant and thoracic cage

Muscle attachments from the upper limb extend the length of the cervical and thoracic spines to allow a broad dispersal of forces, e.g. trapezius, latissimus dorsi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is vertebral arteries

A
  • branches of the subclavian arteries
  • enter deep to the transverse process of C6
  • pass upwards through the transverse process of each cervical vertebra until C1 and enter the skull via the foramen magnum
  • the vertebral artery is vulnerable to stretch and trauma
  • as it passes through the transverse foramen and passes posteriorly around the lateral mass of C1
  • result in damage to the lining of the artery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

risk factors for neck pain

A

female
previous episode of neck pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

characteristics of inflammatory BP - age at symptom onset, onset, activity, morning stiffness, inflammatory markers

A

age at symptom onset - <40 yo
onset - persists for >3 months
activity - improves with exercise
morning stiffness - moderate, persists for >45 minutes
inflammatory markers - elevated in 50-70%

25
Q

characteristics of mechanical BP - age at symptom onset, onset, activity, morning stiffness, inflammatory markers

A

age at symptom onset - any age
onset - variable
activity - improves with rest
morning stiffness - mild, short-lived
inflammatory markers - normal

26
Q

red flags questions need to ask in an interview

A
  • UWL
  • medications are using
  • any x-rays
  • any difficulty using bladder
  • any pins and needles/ numbness in both legs and arms
  • any fever or night sweats
27
Q

cancer (cervical spine)

A
  • unremitting pain
  • PHx of cancer
  • UWL
  • age > 50yo
28
Q

general health of red flags

A
  • temp > 37 degrees
  • BP > 160/95mmHg
  • resting pulse > 100bpm
  • resting resp rate > 25pm
  • fatigue
29
Q

*spinal cord involvement of red flag *- cervical myelopathy 頸椎頸脊髓病變

A
  • unsteady gait
  • Hoffman’s sign
  • bladder disturbances
  • sensory changes
  • wasting of hand intrinsic muscles

頸椎頸脊髓病變(Cervical Myelopathy) 脊髓病變是臨床上常見疾病，極容易被病人所忽視疾病。 頸椎神經根病變會 帶給病人疼痛感覺，脊髓病變症狀進展情況緩慢，不會有很特殊的症狀。 初期雙 手麻而已，慢慢地出現上身有緊縛感、下肢無力等。 當意識到情況不對時，往往 在臨床上已經相當嚴重了。

30
Q

vertebral artery of red flags

A
  • dizziness
  • double vision
  • difficult to talk
  • difficult to swallow
  • drop attacks (fainting) 晕倒
31
Q

upper Cx ligamentous

A
  • instability
  • occipital headache and numbness
32
Q

cervical myelopathy (central stenosis)

A
  • narrowing of spinal canal causing compression of spinal cord
  • most commonly the result of degenerative changes in cervial vertebra, discs, PLL, ossicifation of ligamentum flavum
  • can be result in cancer and trauma
  • requires a surgical opinion
33
Q

symptoms of cervical myelopathy

A
  • sensory changes to hands/ arm
  • loss of motor control
  • bladder signs
  • loss of balance
  • heaviness in legs
34
Q

whiplash injury

A

acceleration-deceleration injury

35
Q

symptoms of whiplash injury

A
  • activity limitation
  • cervicothoracic pain
  • dizziness
  • muscle spasm
  • tenderness
  • pain or numbness in the arm and/or hand
  • poor concentration
  • stiffness reduced ROM
  • +/- arm pain
36
Q

WAD need imaging? (high risk factors)

A

any high risk factors?
age > 65
dangerous mechanism
numbness in extremities

–> if yes, radiography

37
Q

WAD need imaging? (low risk factors)

A

low risk factors:
- not immediate onset of neck pain
- ambulatory at any time (can walk anytime)
- sitting position in ED (able to sit in ED)
- absence of midline C-spine tenderness
—-> if the patient do not have any low risk factors, must go to radiography

if there is one of the above:
then, is the patient able to rotate neck (45 degrees left and right) actively?
—-> No, go to radiography

if yes, no radiography

38
Q

WAD grading systems

A

grade 0 - no complaints or physical signs
grade 1 - neck complaints but no physical signs
grade 2 - neck complaints and musculoskeletal signs
grade 3 - neck complaints and neurological signs
grade 4 - fracture/ dislocation

39
Q

grade 0 of WAD

A

no complaints or physical signs

40
Q

grade 1 of WAD

A

neck complaints but no physical signs

41
Q

grade 2 of WAD

A

neck complaints and musculoskeletal signs

42
Q

grade 3 of WAD

A

neck complaints and neurological signs

43
Q

grade 4 of WAD

A

fracture/ dislocation

44
Q

psychosocial and pain factors associated with chronicity/ disability (yellow flags) for WAD

A
  • anxiety
  • high pain intensity
  • high NDI (neck disability index) score
  • post traumatic stress symptoms
  • poor expectations of recovery
45
Q

outcome measures for predictors of pooer recovery of WAD

A

Visual analog scale (VAS) > 5.5/10
Neck disability index (NDI) >29

46
Q

not a predictor for WAD

A
  • accident features
  • imaging findings
  • motor dysfunction 功能障碍
47
Q

prognosis of WAD

A
  • 50% will continue to report pain and disability 1 year after injury
  • take place within the first 2-3 months after recovery occurs
48
Q

management of WAD

A
  • education:
    return to normal activity ASAP
    avoid use of cervical collar
  • exercises:
    ROM, strengthening, postural, functional retraining
  • pain education and management
49
Q

cervicogenic headache

A
  • pain in head but referred from a primary source in the cervical spine
  • arise from C1-C3
50
Q

presentations of cervicogenic headache

A
  • slow onset
  • unilateral headache, generally starting in the neck and ‘spreading’ forwards
  • muscle tightness
  • decreased strength endurance
  • reduced neck flexion/ extension ROM
51
Q

management of cervicogenic headache

A

exercise to improve endurance strengthen and stretch cervical spine, thoracic spine regions and shoulder girdle

52
Q

cervical spondylosis

A

affects the lower cervical spine, C5/6 is the most mobile region of the neck

53
Q

symptoms of cervical spondylosis

A
  • neck pain with radiating UL pain
  • increased pain with Cx ROM
  • neuro signs (nerve root distribution)
54
Q

management of cervical spondylosis

A
  • strengthening/ posture exercise
  • pain management education
55
Q

cervical fractures

A

high risk activities - diving, horse riding, football, skiing

56
Q

thoracic compression fracture

A

occur in people with reduced bone density or with trauma (such as falls)

  • effect on cervical posture
57
Q

wry neck (torticollis)

A

idiopathic/ nerve or muscle damage

在自然情況下，當一個人的臉部總是轉向固定的一側，而頭頸部傾向另一側，這種情形即稱為斜頸症

58
Q

presentation of wry neck

A
  • reduce neck ROM, difficulty to look to one side
  • pain
  • palpable facet joint tenderness/ stiffness
59
Q

management of non specific neck pain

A
  • Acute/ Sub acute:
    – Exercise: Cx/ Thoracic ROM, scapulothoracic strengthening, endurance
    – Cervical mobilisation
  • Chronic:
    – As above
    – Pain education
    – Postural, coordination, proprioception, kinaesthetic
    and cognitive awareness retraining, aerobic exercise
    – Dry needling, traction (grade B)

PTY1022 PT THEORY (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions