7- Cervical Spine 2 (AK) Flashcards
The most common disk herniation is at what vertebrae level?
C6-7 level
Which is not a common etiology of radiculopathy?
a) disk herniation
b) degenerative disease with spurring
c) spinal stenosis
d) tumor
e) infection/Inflammation
f) systemic disease
none; ALL are common etiologies of disk herniations
A 36yo male comes in with neck pain that he describes as “shooting” or “electrical” like. When he coughs (or tries a valsalva maneuver) the pain gets worse. He also complains about parasthesias, decreased motor function, muscle atrophy and tendon reflex changes. What do you think he has?
radiculopathy
A 65 yo f walks into your office. You notice that she has a broad and unsteady gait. She shows hyporeflexia at an involved level with hyperreflexia at levels below. Suspecting you know the answer, you try the Babinski test and note that it is positive. What correct diagnosis did you have?
Myelopathy at a certain level
What is a myelopathy?
cord compression or vascular insufficiency
Cervical spondylolytic myelopathy is the most common spinal cord dysfunction in the…..?
Elderly!
100% will have it by the age of 70.
If you suspect a myelopathy, what tests would you do?
Spurling Test (push down on head) and Distraction test (lift up on head)
A patient has bicep and deltoid weakness, radiating down from the anterior arm into the elbow. If he has neurologic damage, what disc level is the damage likely to have occurred?
C5
Biceps and wrist extensors. Decrease in brachioradialis, decreased sensation from thumb to mid forearm. If he has neurologic damage, what disc level is the damage likely to have occurred?
C6
Decreased in finger extensors and wrist flexors. Decreased triceps reflex. If he has neurologic damage, what disc level is the damage likely to have occurred?
C7
A patient presents with decreased finger flexors. Decreased sensation on ulnar side of the forearm into the 4th and 5th fingers. If he has neurologic damage, what disc level is the damage likely to have occurred?
C8
A patient presents with mild decrease in sensation on the upper half of his forearm. If he has neurologic damage, what disc level is the damage likely to have occurred?
T1
Bobby complains of pretty significant neurological sysmptoms. You suspect possible radiculopathy or myelopathy. What test is the only diagnostic tool capable of assessing the physiological status or integrity of nerve roots with a reasonably high sensitivity. (It should include paraspinal and limb muscles.)
a) Xray
b) MRI
c) Needle Electromyography
d) Myelography
e) CT
c) Needle Electromyography
Which of the following pharmacotherapy is not indicated for acute pain (chronic pain only)?
a) Analgesics/narcotics
b) NSAIDS
c) Muscle relaxants
d) Antidepressants
e) Injections
d) Antidepressants
What is a relative OMT contraindication for someone with a myelopathy?
a) ST
b) MFR
c) FP
d) HVLA
d) HVLA
Is Epidural Injection a conservative treatment?
No; you definitely need to try other conservative treatments first. There is a 40% chance of epidural injections failing.
T or F: It is unclear if the surgical risk is outweighed by any long-term benefit
True
Which of the following is not true about OA mechanics
a) Sidebending and rotation occur to opposite sides regardless of AP curves
b) Primary rotation is Flexion and Extension only
c) Occipital motion is on the axis
c) Occipital motion is on the axis
Occipital motion is on the ATLAS (not axis)
T or F: The primary motion for the upper portion of C2-C7 is sidebending
FALSE: The primary motion for the upper portion of C2-C7 is ROTATION (not sidebending)
