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MSK > 2.2. Cervical Spine Subjective Examination > Flashcards

2.2. Cervical Spine Subjective Examination Flashcards

1
Q

Demographic data include? (5)

A

Name
Age
Sex
Handedness
Systemic conditions (hypertension, diabetes, asthma)

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2
Q

Spondylosis (also called spondylosis deformans) is often seen in persons ____
years of age or ____

A

25 years of age or older

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3
Q

It is a generalized disease of aging
initiated by intervertebral disc degeneration.

A

Spondylosis

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4
Q

Cervical spondylosis is present in ___% of those older than 45 years

A

60%

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5
Q

Cervical spondylosis is present in ___% of those older than 65 years

A

85%

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6
Q

Symptoms of osteoarthritis do not usually appear until a person is ___ years of age or older

A

60 years of age or older

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7
Q

T OR F: Shoulder of the dominant hand sides is always lower than the non-dominant

A

TRUE; If a patient manifests higher
dominant side shoulders, it could
indicate cervical conditions that
needs to be checked later on

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8
Q

In patients with neck conditions, asthma may cause ____ of the breathing muscles because of their difficulty in breathing

A

hypertrophy of
the breathing muscles

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9
Q

Chief complaint include? (7)

A

pain,
weakness,
heaviness,
stiffness or LOM,
numbness/paresthesia,
headache/dizziness,
functional limitations

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10
Q

Behavior of symptoms (4)

A

SAR 24

Sustained posture or movement
Aggravating & relieving factors
Referred pain
24 hour pattern

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11
Q

quantity & quality of pain (4)

A

CLIT

consistency/duration
location
intensity
type

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12
Q

T OR F: Pain is considered normal in traumatic cases and is present because of the area’s inflammation

A

TRUE

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13
Q

T OR F: Pt experiences pain but has no history of trauma & cannot be resolved by rest or positional changes is considered a red flag

A

TRUE

This might imply other problems such as systemic, carcinogenic/malignancy and now prompt further testing and observation

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14
Q

T OR F: If the pain is mechanical, such as in muscle tightness or nerve root impingement, pain will still not be relieved in certain positions

A

FALSE

Pain is relieved in certain positions for mechanical problems

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15
Q

Lumbar Spondylosis relieving position

A

flexed position (nakakuba)

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16
Q

Cervical disc herniation relieving position

A

Patient usually extend their neck to
avoid the hernia from pressing on
the spinal nerves or spinal cord

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17
Q

location of pain usually associated with musculoskeletal problems

A

localized

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18
Q

location of pain usually associated with spinal cord problems, nerve roots, or brachial plexus

A

radiating

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19
Q

Cervical radiculopathy primary symptoms (5)

A

unilateral motor and sensory symptoms into the upper limb,
with muscle weakness (myotome),
sensory alteration (dermatome),
reflex hypoactivity,
focal activity

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20
Q

T OR F: Radiculopathy usually presents bilaterally

A

FALSE

Radiculopathy are nerve root problems in the cervical spine that presents unilaterally

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21
Q

Condition brought about by other spinal
conditions (e.g. herniations, spondylosis) with any nerve impingement

A

Radiculopathy

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22
Q

acute radiculopathies are associated with?

A

disc herniations

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23
Q

chronic radiculopathies are associated with?

A

spondylosis

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24
Q

Disc herniations in the cervical spine
commonly cause severe neck pain that may radiate into the _____ (3), limit ____ (1), and an increase in pain on ____ (4)?

A

severe neck pain that may radiate into the shoulder, scapula and/or arm, limit ROM, and an increase in pain on coughing, sneezing, jarring, or straining

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25
Q

injury to the spinal cord itself

A

Cervical myelopathy

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26
Q

Cervical myelopathy primary symptoms (4)

A

Spastic weakness,
Paresthesia,
Incoordination in 1 or both lower limbs,
Proprioceptive and/or sphincter dysfunction

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27
Q

Diffused pain on the upper back may indicate?

A

Myofascial pain syndrome

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28
Q

How many trigger points in order for the
condition to be considered as Myofascial pain syndrome?

A

at least 3 trigger points

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29
Q

T OR F: if the problem is postural, pain appears after sustaining a specific posture for a long time

A

TRUE

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30
Q

T OR F: Persistent pain that does not resolve even in prone may indicate malignancy or other conditions that may have something that occupies the spaces in the cervical region

A

FALSE

Persistent pain that does not resolve even in SUPINE

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31
Q

chief complaint of weakness is associated with?

A

myotomal problem

32
Q

chief complaint of heaviness is associated with?

A

vascular problems

33
Q

T OR F: Sensory disturbances may signal nerve
root compression

A

TRUE

34
Q

chief complaint of stiffness or LOM is associated with?

A

arthritic changes

35
Q

Can be a chief complaint due to musculoskeletal dysfunction of the spine especially in the C1-C3 levels

A

Headaches & Dizziness

36
Q

Headaches & Dizziness may indicate muscle tightness usually for what muscle group?

A

muscle that inserts to occiput

37
Q

headaches that are musculoskeletal in origin
present ____

A

unilaterally

38
Q

headache is a major complaint after trauma may indicate?

A

traumatic brain injury or concussion

39
Q

Reports of dizziness can affect what function?

A

ear/vestibular function

40
Q

dizziness may indicate what problems and insufficiency?

A

vestibular/ear problems or vertebrobasilar insufficiency

41
Q

5 Ds of VBI

A

dizziness,
diplopoia,
drop attack,
dysarthria,
dysphagia

42
Q

double vision

A

diplopia

43
Q

dancing eyes

A

nystagmus

44
Q

depressed visual field

A

scotomas

45
Q

dizziness associated with certain head or body positions may indicate?

A

semicircular canal problem or vertebral artery problem

46
Q

Falling with no provocation while remaining conscious

A

drop attack

47
Q

Drop attack is a symptom of VBI that may indicate ____ oxygen levels in the brain

A

low oxygen levels/hypoxia in the brain

48
Q

indicates defects in articulation, enunciation, or rhythm of speech

A

Dysarthria

49
Q

characterized by slurring, slowness of speech, indistinct speech, and breaks in normal speech rhythm

A

Dysarthria

50
Q

difficulty swallowing

A

Dysphagia

51
Q

Pain on swallowing may indicate? (4)

A

disc protrusion into the esophagus or pharynx,
osteophyte projection,
vertebral subluxation,
soft- tissue swelling in the throat

52
Q

When a patient has dysphagia, swallowing becomes more difficult and the voice becomes weaker when the neck is flexed or extended?

A

extended

53
Q

What joint dysfunction is commonly accompanied by headaches?

A

Craniovertebral joint dysfunction

54
Q

C1 headaches occur where?

A

at the base and top of the head

55
Q

C2 headaches occur where?

A

referred to the temporal area

56
Q

pain and referred symptoms are decreased or relieved by placing the hand or arm of the affected side on top of the head

A

Bakody’s sign

57
Q

Bakody’s sign usually indicative of problems in what cervical levels?

A

C4 or C5

58
Q

lead to anxiety, pain catastrophizing (negative or heightened orientation toward pain), and other adverse psychosocial factors over time, and it can play a major role in the symptoms felt by the patient

A

Chronic post whiplash syndrome

59
Q

a report of an insidious onset in someone
older than 55 years of age may indicate?

A

cervical spondylosis

60
Q

typically occur from a blow to part of the brachial plexus or from stretching or compression of the brachial plexus

A

“Burners” or “stingers”

61
Q

may result from excessive nodding as the patient tries to focus through the correct part of the glasses

A

Upper cervical symptoms

62
Q

often painful when activities that require push-and pull motion (such as, lawn mowing, sawing, and cleaning windows) are performed

A

Cervicothoracic (lower cervical/upper thoracic spine) joint problems

63
Q

Extension or Flexion: What can aggravate
symptoms in patients with radicular signs and symptoms?

A

extension

64
Q

what pain usually occurs immediately?

A

Bone pain

65
Q

what can either come on immediately
(e.g., a tear) or occur several hours or days later (e.g., stretching caused by a motor vehicle accident).

A

muscle or ligamentous pain

66
Q

Pain affected by laughing, coughing, sneezing, or straining can mean that an increase in _____ may be contributing to the problem.

A

increase in intrathoracic or intraabdominal pressure

67
Q

T OR F: paresthesia (a “pins and needles” feeling) happens occurs if pressure is applied to the nerve root.

A

TRUE

68
Q

T OR F: Unilateral symptoms usually indicate either systemic disorders (e.g., diabetes, alcohol abuse) that are causing neuropathies or central space–occupying lesions.

A

FALSE

BILATERAL symptoms usually indicate either systemic disorders that are causing neuropathies or central space–occupying lesions.

69
Q

T OR F: If symptoms are not varied by a change in position, the problem is likely to be mechanical in origin.

A

FALSE

If symptoms are not varied by a change in position, the problem is NOT LIKELY to be mechanical in origin.

70
Q

Lesions of what cervical level may affect the diaphragm and thereby affect breathing? (3)

A

C3, 4, 5

71
Q

encourages forward head posture and increases activity of accessory respiratory muscles

A

Mouth breathing

72
Q

Type of pillow that tend to retain their shape and have more “bounce;” they do not offer as much support

A

Foam pillows

73
Q

What sleeping positions can increase the stress on the lower cervical nerve roots (2)

A

patient “hugging” the pillow
OR
abduct the arms when sleeping

74
Q

T OR F: Abnormalities in one area frequently affect another area. For example, excessive thoracic kyphosis may cause a “poking” chin (cervical spine is in extension) to compensate for the thoracic deformity and to maintain the body’s center of gravity centered beneath the base of support.

A

FALSE

Abnormalities in one area frequently affect another area. For example, excessive LUMBAR lordosis may cause a “poking” chin (cervical spine is in extension) to compensate for the LUMBAR deformity and to maintain the body’s center of gravity centered beneath the base of support.

75
Q

normal lordotic curvature of neck

A

30° to 40°

MSK (7 decks)

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