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Musculoskeletal II > 3- Craniovertebral > Flashcards

3- Craniovertebral Flashcards

1
Q

What is the function of the upper cervical spine? Lower cervical spine?

A

UCS positions the head on the neck

LCS positions in the head in space

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2
Q

What is the expected ROM for cervical rotation?

A

80-90 degrees

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3
Q

What is the expected ROM for cervical sidebending?

A

45 degrees

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4
Q

What is the expected ROM for cervical flexion?

A

40 degrees

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5
Q

What is the expected ROM for cervical extension?

A

70-80 degrees

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6
Q

How is cervical ROM affected as we age?

A

Decreases 4-5 degrees over every 10 year period

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7
Q

Where do the alar ligaments attach?

A

to a pair of anterior tubercles on the foramen magnum

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8
Q

Where are the brain-stem-spinal cord junction housed?

A

Posterior of the foramen magnum

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9
Q

Which cervical vertebrae are typical?

A

C3-6

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10
Q

How are C3-6 oriented superiorly? Inferiorly?

A

Superiorly: concave transversely, convex A-P

Inferiorly: Convex transversely, concave A-P

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11
Q

Where do the transverse processes of C3-6 face?

A

Lateral, anterior, Inferior

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12
Q

What houses the vertebral artery C3-6?

A

Transverse foramen

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13
Q

Which directions for the superior and inferior facets face C3-6?

A

Superior: posterior and cranial

Inferior: anterior and caudal

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14
Q

What is different about C7?

A

Transitional vertebra that connects the mobile C-spine to the stable T-spine. It has a long spinous process with a single tuberacle at the end

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15
Q

What is different about cervical discs?

A

They have less soft nuclear material because they bear less weight

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16
Q

Where does the alar ligament run? What does it do?

A
  • dorsolateral dens to medial occipital condyles
  • limits rotation and SB of the occiput on the axis
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17
Q

The UCS is responsible for approximately _____% of the motion throughout the entire C-spine

A

50%

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18
Q

SB and rotation are couple to the ______ side in O-A joint, UCS

A

Opposite

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19
Q

SB and rotation are couple to the ______ side in the LCS

A

Same

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20
Q

During right sidebending, the right occiput moves _____. The left?

A

R= medial, inferior,anterior

L= LPS

21
Q

Which directions to the superior articular facets of C1 face?

A

superior and medial

22
Q

How many degrees of freedom does the O-A joint have?

A

2 (flex/ext, SB)

23
Q

What is special about C2-3?

A

It is a transitional vertebra. The superior articulat facets behave like UCS. The inferior articular facets behave like LCS

24
Q

How are the superior articular facets of C2-C7 oriented?

A

slightly convex, face cranial and posterior

25
Q

How are the inferior articular facets oriented?

A

Slightly concave, face caudal and anterior

26
Q

What is the facet orientation in the LCS?

A

approximately 45 degrees to horizontal

27
Q

What are some indicators of neoplastic conditions?

A
  • Age >50 yrs
  • Previous history of cancer
  • Unexplained weight loss
  • Constant pain
  • Night pain
  • Unexplained capsular patterns
28
Q

What temperature can be an indicator of inflammatory or systemic disease?

A

>100 F

29
Q

What BP can be an indicator of inflammatory or systemic disease?

A

> 160/95 mmHg

30
Q

What resting pulse can be an indicator of inflammatory or systemic disease?

A

>100

31
Q

What resting respiration can be an indicator of inflammatory or systemic disease?

A

>25 bpm

32
Q

What else can be an indictor of systemic or inflammatory disease?

A

Fatigue

33
Q

What are some high risk factors that indicate X-Ray?

A

> 65 y.o.

Dangerous MOI

Limb paresthesias

34
Q

What are some low risk factors that may indicate X-Ray?

A

Rear-end MVA

Delayed onset neck pain

Absence of midline tenderness

35
Q

What is the neck step in indication for Xray?

A

Check if the patient is able to rotate 45 degrees to both sides

36
Q

What are some indicators of cervical cord compression?

A
  • Bilateral or quadrilateral limb paresthesias with cervical motion
  • Hyper-reflexia
  • Clonus
    • Babinski’s or + Hoffman’s
37
Q

What are some indicators of cervical myelopathy

A

B or Q limb paresthesias and/or weaknesses

+ Hoffman’s and/or + Babinski’s

Hyperreflexia

Sensory disturbance of the hands

Muscle wasting of the hand intrinsics

Unsteady gait

Bowel and bladder disturbances

38
Q

How is cervical myelopathy graded?

A

1-5 based on gait disturbances

1= normal gait, mild

39
Q

How long must you wait after a whiplash injury to test vertebral artery?

A

4-6 weeks

40
Q

What are some outcome predictors for whiplash?

A

Post-traumatic stress

High NDI score

Cold hyperalgesia

Age

41
Q

What are the most commonly involved root levels of cervical radiculopathy?

A

C6 and 7

42
Q

When is peak incidence for cervical radiculopathy?

A

4th and 5th decades

43
Q

What is a medical emergency?

A

Acute torticollis caused by a facet joint dislocation

44
Q

What should you ask regarding VBI?

A

Hx or neck trauma

5Ds And 3 Ns

Hx or RA, HTN, Stroke

Steroid use

Increasing symptoms with specific movements

45
Q

What does the alar ligament test test?

A

Frontal plane stability (alar ligament integrity)

46
Q

What does the Transverse ligament test test for?

A

Saggital plane stability (transverse ligament integrity)

47
Q

What does the Jefferson Fracture Test test for?

A

Transverse plane stability

48
Q

What does the distraction test test for?

A

Longitudinal stability

49
Q

What does the Sharp-Purser Test test for?

A

integrity of the transverse ligament, UCS translational stability

Musculoskeletal II (11 decks)

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