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MSK III > 1 Cervical Spine Syndromes > Flashcards

1 Cervical Spine Syndromes Flashcards

1
Q

What are the Mobility examination findings in a patient?

A
  • Recent onset of symptoms
  • No radicular signs and symptoms
  • Restricted ROM with side to side roation and/or discrepancy in lateral flexion ROM
  • no signs of nerve root compression/peripheralization
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2
Q

What intervention is proposed with Mobility classifed patients?

A
  • Cervical and thoracic spine mobilization/manipulation
  • Active ROM exercises
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3
Q

What are the Centralization findings?

A
  • Radicular signs/symptoms
  • Peripheralize or centralize with ROM
  • Signs of nerve root compression
  • Symptoms distal to elblow
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4
Q

What intervention is proposed for Centralization patients?

A
  • Mechanical and cervical traction
  • Repeated movements/activites to promote centralization symptoms
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5
Q

What are the Conditioning and Exercises Increase findings in a patient?

A
  • No radicular signs/symptoms
  • Chronic Symptoms
  • Low pain and disability scores
  • No nerve root compression signs or perhipheral/centralization
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6
Q

What interventions are propsed with exercise and conditioning classification patients?

A
  • Aerobic conditioning
  • Strengthening and endurance for upper neck
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7
Q

What are the findings for Pain Control patients?

A
  • Acute onset of symptoms
  • Traumatic mechanism
  • High pain and disability scores
  • recent onset of symptoms
  • Reffered or radiating symptoms to Upper Quarter
  • Poor Tolerance for exam
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8
Q

What are the intervention strategies for Pain Control patients?

A
  • Gental ROM + activity
  • ROM for adjacent regions
  • Physical modalities as needed
  • Activity modification
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9
Q

What are the examination findings for Headache patients?

A
  • Primary complaint headache
  • Cervicogenic headache
  • Unilateral headache with onset by neck pain
  • triggered by neck movement/positions
  • Pressure on posterior neck brings symptoms
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10
Q

What interventions are proposed for Headache patients?

A
  • Manual Therapy
  • Neck Flexor/scapular strengthening
  • C spine manipulation/mobilization
  • Postural education
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11
Q

What is the formular for evaluating neck and upper extrimity pain?

A
  • Know normal and recognize deviation
  • Reproduce pain by reproducing abnormal movement/position
  • Understand mechanism pain is caused
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12
Q

Describe pain originating from soft tissues

A

Soft tissues can cause majority of symptom s

upper C spine

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13
Q

Describe muscular pain from tension

A
  • May occur at periosteal site of attachment
  • Common site is base of skull
    • attachment of upper trapezii and subocciptals
  • May occur within belly of a muscle from either acute or sustained contractions
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14
Q

Muscular Pain from Tension (ACUTE)

A
  • Isometric contractions produce greater intramuscular pressure than isotonic
  • Increasd internal pressure leads to inflammation and “myositis”
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15
Q

Muscular Pain from Tension (Sustained Contraction)

A

Leads to Ischemic pain

  • lack of O2
  • Accumulated irritating metabolites (Factor P, potassium, Lactic Acid)
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16
Q

Describe Joint Pain of the NEck

A
  • OA pain due to capsule thickening = limited ROM
  • Stretching thicked and contracted periarticular tissues on attempted neck motions causes pain felt in neck
  • Limits motion
17
Q

Describe pain from IVD

A
  • Distributed in broad areas, ill defined margins
  • (cloward areas around scap dont apply to C3)
  • Discogenic pain may be central, unilateralm bilateral or bilateral asymmetrical
18
Q

Describe Pain from Vertebral canal

A
  • Nerve roots at Upper C Spine (C123)
  • Suboccipital muscles C1 C2
  • Greater AUricular and lesser occiptal nerves C2 C3
  • Upper trap CN XI C2 C3
  • Vertebral artery within transverse foramen
19
Q

What are the 3 parts of the Trigeminal nerve (Spinal Nucleus)

A
  • Pars Oralis
  • Pars Interpolaris
  • PArs Caudalis

POPIPC

20
Q

What is invovled in the nociceptive transmission information?

A
  • Trigeminocervical nuclues
  • seen as pain center for the entire head and upper neck
21
Q

What are 2 upper C spine conditions that can give rise to cervical headaches?

A
  • RA
    • erosive synovitis of the media and lateral atlantoaxial joints (joints and ligaments supplied by C1 - C3 nerves)
  • AO Osteoarthritis
    • Joint innervated by C1 and C2 sinuvertebral nerves
22
Q

Explain Trigger Points with cervical headaches

A
  • Trigger points in splenius capitus, trapezius, SCM, and subocciptal muscles can refer pain to the head
  • Only muscles inntervated by C1 C2 C3 are capable of producting headache
23
Q

What is C3 Dorsal Raums Syndrome?

A

C2 3 apophyseal joint innervated by C3 dorsal ramus and many studies implicate this joint as a causation of headache

  • Vulnerable to trauma
24
Q

What is Cervical Spondylosis?

A

Occiptal headaches arise b/c spasm of the posterior neck muscles which attach to occiput

Also possible cervical spondylosis with arthosis of cervical joints

25
Q

What is occipital neuralgia?

A
  • Compression of greater occiptal nerve = headache
  • Studies show could be more likely to arthritis of upper C joints
26
Q

What are post traumatic headaches?

A

Sign of upper C injur concominant with any more obvious lower C lesion

27
Q

What is RA?

A
  • Systemic Disease
  • More common in females
  • Mid life 40-50
  • Synovitis = major feature of TA
28
Q

What is Synovitis?

A
  • Synovial membrane becomes inflammed
  • Joints become swollen, painful and feels puffy/boggy
  • Persistant inflammation leads to cartilage erosion and subchondral bony proliferation
29
Q

How does RA affect the C spine?

A
  • Loosening effect on ligaments of AA joint
  • Synovitis of Facet joints
  • muscular aches
  • fatigue
30
Q

What are treatment considerations for RA?

A
  • gengle movement and active ROM exercises during remission
  • Provide support (soft collar), heat, pain relieving modalities during acute inflammatory epsidoes
  • Be aware of meds ( NSAIDS, Steriods, Gold injections )

NEVER MANIPULATE

31
Q

What is Acute Wry Neck?

A
  • “Torticollis”
  • Static Protective deformity
  • between C2 - C7 (Usually at C2/3)
  • Manifest in morning
  • Atalgic posture
    • Slight flexion and side bending AWAY from painful side
32
Q

What is the presentation of Acute Wry Neck?

A
  • younger adults/children
  • Gradual onset 1-2 hours without cause
  • Difficult to elevate painful side arm
  • Movements towards side of pain hurt or restricted
  • Flexion full range and painfree (movement AWAY from painful side)
33
Q

What are 3 mechanisms of Acute Wry Neck?

A
  • Meniscoid villus - impacted synovial inclusion (prolonged stretch > Slight edema > Meniscoid villus)
  • Periarticular Congestion/localized irritability without inclusion
  • Slow shift of cervical disc substance
    • Strained posutre during sleep (lower c spine)
34
Q

What is Type I Wry Neck?

A
  • Facet
  • Sudden onset (particular movement), on waking, during night or any time
  • pain unilateral locallized pillar of neck
    • Does no spread
  • Easily relieved with MANIPULATIONS OR MOBILIZATIONS
35
Q

What is Type II Wry Neck?

A
  • Waking in the morning onset
  • Pain one side base of neck and spreads unilaterally to yoke area and mid scap (Cloward), possible spread down outer/posterior arm or elbow
  • Takes longer to relieve
  • Can be provoked by manipulation or mobs
    • u_se sustained traction in flex/rotational distraction or sustained_
36
Q

What is the presentation of Cervical Joint Locking?

A
  • Facet Joint is cause of pain
  • IMpaction of synovial fold (meniscoid synovial villus) or joint capsule iteself between joint surfaces
  • Patient is young/athletic wit no previous neck injury or symptoms
  • Sudden onset with sudden movement
  • Sidebend and rotation away from painful side
37
Q

What is the treatment for cervical joint locking?

A

Treatment intially for gaping or opening of the facet joint for realse of synovium

Soft tissue healing

MSK III (13 decks)

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