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Simmons NURP 502 Exam 4 > 12: Neck Pain > Flashcards

12: Neck Pain Flashcards

1
Q

What test is used to assess nerve root irritation or spinal cord compromise?

A

Electromyography

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2
Q

T/F In torticollis, spasms are usually sporadic and uncontrollable.

A

False. They are usually uncontrollable and continuous.

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3
Q

When is an x-ray useful in neck pain?

A

If there is trauma. No trauma, no x-ray.

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4
Q

With cervical disc dz, when do you order an x-ray?

A

No need, as it won’t show disc issues. It only shows bony changes. May see DJD or narrowing of foramina of vertebrae. Can be useful in trauma, if a bone injury is suspected.

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5
Q

When is a CAT scan used instead of MRI?

A

CAT scans are used more for acute injury, in ERs, or if the patient has metal in their body.

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6
Q

Is this an acute cervical strain or chronic?

Burning or aching, with or without radiation to the arm or hand.

A

Chronic

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7
Q

What can be a sign of nerve or disc involvement in cervical disc dz?

A

Pain that is relieved by lifting an arm above the head.

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8
Q

What x-ray view looks at C1-T1 (alignment and disc space)?

A

Cross table lateral

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9
Q

How do you evaluate ROM?

A
  • Evaluate degree of ROM and pain with movement
  • Some people have full ROM (forward flexing of neck) but cannot extend neck at all
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10
Q

With neck pain, the majority of pts will want an MRI. When should this be considered?

A

If neurological, or pain persists or worsens after conservative treatment (4–6 weeks), order an MRI or CAT scan.

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11
Q

How much time should pass before referring to physical therapy?

A

No improvement within 3 days

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12
Q

Usually an abrupt onset of pain. Danger signs include radiculopathy in only 1 arm. Look for pain, weakness, numbness, and tingling.

A

Cervical Disc Dz

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13
Q

What is the compression test and what does it show?

A

Compress downward on head to reproduce radicular symptoms if herniated disc is present.

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14
Q

In neurological testing, what vertebra does the triceps reflex test?

A
  • C7
  • Triceps, wrist flexors, and finger extensors
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15
Q

In neurological testing, what vertebra is associated with the interossei muscles (not assessed via a reflex)?

A

T1

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16
Q

In neurological testing, what vertebra does the biceps reflex test?

A
  • C5
  • Biceps and deltoid
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17
Q

In neurological testing, what spinal nerve does abducting and adducting fingers test (not assessed via a reflex)?

A
  • C8
  • Finger flexors, interossei muscles
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18
Q

In neurological testing, what vertebra does the radial reflex test?

A
  • C6
  • Biceps and wrist extensors
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19
Q

What is the PE for neck pain?

A
  • Palpate C-spine
  • Range of motion
  • Resisted range of motion
  • Grip strength
  • Special maneuvers
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20
Q

If a person has neck pain, evaluate for _____ problems.

A

If a person has neck pain, evaluate for neurological problems.

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21
Q

If patients with carpal tunnel are unable to resolve, look to the neck. Frequently, a _____ nerve involvement presents similarly to carpal tunnel.

A

If patients with carpal tunnel are unable to resolve, look to the neck. Frequently, a C6 nerve involvement presents similarly to carpal tunnel.

22
Q

What is the management for neck pain?

A
  • Typical, conservative treatment:
    • Anti-inflammatories
    • Ice
    • Muscle relaxants
  • PT for soft tissue mobilization and sometimes traction to release pressure on spine
    • U/S
    • Stimulation
    • Cervical exercises
  • Discuss work and sleep positions
    • Typically sleep on a pillow that does not support neck
    • Cervical pillow has valley that supports neck while keeping spine aligned
23
Q

What direction does the pain take if there is a herniated disc and you perform the compression test?

A

Pain doesn’t go down to the lower back. It will go out if there is a herniated disc.

24
Q

If distraction alleviates radicular pain, what does this indicate?

A

There is probably some nerve involvement or a herniated disc that’s compressed.

25
Q

When evaluating a pt for cervical disc dz, what might alleviate the pain?

A

Raising arm above head. This alleviates the stress and pull on the herniated disc.

26
Q

If a person has _____ pain, but didn’t injure themselves, look to the neck.

A

If a person has shoulder pain, but didn’t injure themselves, look to the neck.

27
Q

When do you refer for neck pain?

A
  • Cervical fracture
  • Intractable pain with neurological deficit (weakness, numbness, tingling, and unremitting neurological types of pain)
  • If no relief after 4-6 weeks
28
Q

What is the congenital form of torticollis called?

A

Wry Neck

29
Q

Why do you check the pulse while performing adson’s test?

A

It checks for a thoracic outlet problem.

30
Q

What is adson’s test and what does it test?

A
  • Abduct and externally rotate shoulder while turning head toward arm being tested.
  • C5-T1
31
Q

When will electromyography be useful?

A

6-8 weeks after onset of radicular pain

32
Q

What is it called when you elevate a person’s neck by lifting up the head a little bit?

A

Distraction

33
Q

What x-ray view looks at C1 and C2 (atlas and axis of spine)?

A

Odontoid view (through mouth)

34
Q

What does a muscle spasm feel like on exam?

A

Ropy type of nodule that goes along muscle fibers.

35
Q

Contraction or spasm of neck muscles causing head to be lifted and tilted to one side; usually accompanied by rotation of chin upward.

A

Torticollis

36
Q

What is the cause of torticollis?

A

Unknown, but possible infx.

37
Q

T/F If a plain x-ray suggests a fracture, CT or MRI are indicated.

A

True

38
Q

How do you palpate the C-spine?

A
  • Check alignment
  • Assess tenderness over vertebral processes
  • Feel for abnormal masses and point tenderness, especially with trauma
39
Q

Is this an acute cervical strain or chronic?

Sharp neck pain with radiation to head, shoulder, or hand.

A

Acute

40
Q

_____ stems from overuse, whiplash (usually mechanical).

A

Cervical strain stems from overuse, whiplash (usually mechanical).

41
Q

What test looks at alignment, disc space, and facets?

A

X-ray

42
Q

T/F 10% of people have degenerative joint disease (DJD), arthritis, or a herniated disc in their neck or back, with no symptoms.

A

True. Once identified, evaluate further.

43
Q

Neck pain can be either _____ or _____.

A

Neck pain can be either neurological or mechanical.

44
Q

When is neck pain chronic?

A

3+ months

45
Q

What is the treatment for cervical disc dz?

A
  • Anti-inflammatories (pain control)
  • ROM exercises
46
Q

What is the treatment for torticollis?

A
  • Physical therapy
  • Pain control (anti-inflammatories)
  • Muscle relaxants
  • Possibly neck braces (if prolonged)
47
Q

What single vertebra are these muscles associated with?

Interossei muscles

A

T1

48
Q

What single vertebra are these muscles associated with?

Triceps, wrist flexors, and finger extensors

A

C7

49
Q

What single vertebra are these muscles associated with?

Biceps and wrist extensors

A

C6

50
Q

What single vertebra are these muscles associated with?

Biceps and deltoid

A

C5

51
Q

What single spinal nerve are these muscles associated with?

Finger flexors, interossei muscles

A

C8

Simmons NURP 502 Exam 4 (21 decks)

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