4. Cervical Spine

Question 1

Vertebral body

Answer 1

Weight-bearing portion of vertebra

Question 2

Vertebral arch

Answer 2

Composed of pedicles and lamina; surrounds SC

Question 3

Vertebral foramen

Answer 3

Space within vertebral arch

Question 4

Intervertebral foramen

Answer 4

Opening between vertebrae on each side of column, allowing passage of spinal nerves

Question 5

Intervertebral discs

Answer 5

Make up 20-30% of spinal column length; Increase in size from cervical to lumbar; > disc height = > mobility

Question 6

Cervical disc thickness

Answer 6

3mm

Question 7

Lumbar disc thickness

Answer 7

9 mm

Question 8

Cervical Vertebrae - Defining Characteristics

Answer 8

Small body; Spinous processes are short & extend horizontally

Question 9

C1

Answer 9

Atlas; no body or spinous process; articulates with occipital condyles superiorly; Facet on internal surface of anterior arch for articulation with dens

Question 10

C2

Answer 10

Axis; Anterior facet for articulation on dens

Question 11

Anterior atlantoaxial lig.

Answer 11

Runs along anterior of body; limits extension of C1-C2

Question 12

Anterior longitudinal lig.

Answer 12

runs along anterior of body; limits extension

Question 13

Posterior longitudinal lig.

Answer 13

Runs along posterior of body; limits flexion

Question 14

Ligamentum flavum

Answer 14

Connects lamina to lamina; limits flexion

Question 15

Ligamentum nuchae

Answer 15

Connects tips of spinous processes; limits flexion

Question 16

Alar

Answer 16

CONNECTS ODONTOID TO OCCIPUT; LIMITS ROTATION

Question 17

Atlanto-occipital joint

Answer 17

(Occiput-C1); Nodding; NO DISC; flex, lat flex; NO ROTATION

Question 18

Atlanto-axial joint

Answer 18

MOST MOBILE JOINT OF SPINE; no disc; flex, lat flex, rotation

Question 19

C4-C6

Answer 19

Greatest amount of flexion

Question 20

C2-C4

Answer 20

Greatest amount of lateral flexion

Question 21

Cervical discs

Answer 21

More fibrous; less likely to herniate

Question 22

Rectus capitus action

Answer 22

cervical flexion

Question 23

Scalenes

Answer 23

cervical flexion

Question 24

Trapezius action

Answer 24

elevation, lat flexion, extension

Question 25

Levator scapulae

Answer 25

elevation, lat flexion, rotation, flex

Question 26

Splenius

Answer 26

Lateral flexion

Question 27

Sternocleidomastoid

Answer 27

Opposite lateral rotation

Question 28

Cervical plexus

Answer 28

Gives rise to phrenic n.

Question 29

Important Cervical Spine HX Questions

Answer 29

Neck stiffness; headache; vision changes

Question 30

Important TMJ Hx Questions

Answer 30

Jaw pain/click/lock; malocclusion; bruxism

Question 31

Torticollis

Answer 31

Permanent spasm; slight lat rot and looking up

Question 32

Mandibular RoM

Answer 32

Should be able to place 3 fingers in mouth

Question 33

Occiput/jaw angle dermatome

Answer 33

C2/3

Question 34

Supraclavicular/lateral shoulder dermatome

Answer 34

C4

Question 35

Lateral upper arm dermatome

Answer 35

C5

Question 36

Thumb, lat forearm dermatome

Answer 36

C6

Question 37

3rd digit dermatome

Answer 37

C7

Question 38

5th digit; ulnar forearm dermatome

Answer 38

C8

Question 39

Medial arm & elbow dermatome

Answer 39

T1

Question 40

Adson Maneuver

Answer 40

Assesses Thoracic Outlet Syndrome; palpate radial pulse while patient abduct, extends, and ER shoulder; pt holds breath; (+) = pulse disappears

Question 41

Thoracic Outlet Syndrome

Answer 41

Involves subclavian a. compression;

Question 42

Compression Test

Answer 42

Push down on head to apply pressure to cervical spine; (+) = radiating arm pain from nerve root lesion or disc herniation; OR (+) = local cervical pain from facet joint, transverse process, spinous process

Question 43

Valsalva Test

Answer 43

Increases venous pressure and CSF pressure; (+) = pain; herniated disc will most likely radiate

Question 44

Brudzinski's Sign

Answer 44

Tests for meningitis; Passive neck flexion; (+) = Involuntary hip/knee flexion when neck is raised

Question 45

Kernig's Sign

Answer 45

Test for meningitis; Passive flexion of hip/knee, then extension; (+) = Hip/knee resistance with passive flexion; causing neck pain

Question 46

Chvostek Test

Answer 46

Test of facial nerve; Tap parotid gland over masseter; (+) = tetany; twitch if Ca++ levels low

Question 47

Jaw Reflex Test

Answer 47

Test of trigeminal nerve; Pt mouth slightly open, provider's finger on chin, tap with hammer; (+) = Mouth clenches tightly or opens dramatically

Question 48

Cervical Disc Herniation

Answer 48

Pain in dermatomal distribution of the arm; numbness & tingling; decrease/alteration in sensation

Question 49

Cervical Stenosis

Answer 49

Narrowing of intervertebral foramen placing pressure on SPINAL NERVE ONLY

Question 50

Hyperextension injury

Answer 50

Whiplash; Injury to sternocleidomastoid strain; Anterior longitudinal ligament strain; possible fx of spinous process; possible disc herniation; due to anterior neck muscles are physiologically weaker than posterior

Question 51

Cervical Strain

Answer 51

Muscle/tendon stretch or tear; Caused by forceful movement; Strain occurs IN MUSCLE THAT DOES OPPOSITE ACTION

Question 52

Cervical Sprain

Answer 52

Ligament or capsule stretch or tear