25: Approach To Cervical Complaint Flashcards
Neck pain is highly litigious - what’s that mean
Lots of people sue about neck pain due to disability and MVCs
Neck pain is the ___ cause of disability in the US
4
Why is SCIWORA most common in children and elderly?
Children: spine is flexible and head is large
Elderly: restriction of motion secondary to DJD
Adult torticollis
Acquired, typically from SCM or trapezius muscle injury or inflammation, or from cervical muscle spasms or cervical nerve irritation
Life threatening causes of torticollis
Retropharyngeal abscess, C-spine injury, CNS tumor, spinal epidural hematoma
The most common cause of Acute and chronic neck pain in adults
Cervical spondylosis
Which type of meningitis do we vaccinate against?
Neisseria meningitidis
Thoracic outlet
Confined space between clavicle and first rib
Which structures pass through the thoracic outlet?
Nerves of brachial plexus, subclavian A, subclavian V
Which is more common, vasculogenic or neurogenic Thoracic Outlet Syndrome?
Neurogenic (95%)
When to image a patient with atraumatic neck pain
Progressive neurological findings or pts with moderate/severe neck pain that doesn’t respond to conservative management over six weeks
Some red flags for neck pain
Recent major trauma, neurologic sx, shock-like paresthesia, fever, IVDU, immunosuppression, chronic glucocorticoid use, unexplained weight loss, Hx CA, HA, visual sx, anterior Neck pain
Two things to look for during a vascular exam of the neck
Carotid pulse, jugular vein distention (sign of CHF)
Checking ROM in traumatic neck pt
Never check ROM unless pt has been cleared of cervical fracture or spinal cord injury radiographically or clinically
Why is c spine HVLA contraindicated in pts with RA and Down Syndrome?
Weak alar (odontoid) ligament
