Anatomy and PE of the Spine Lecture Powerpoint Flashcards
Majority of rotation of the head occurs at the ___ junction
Atlanto-Axial joint (C1-C2) held in place by the transvere ligament but can be loose or lax in individuals with trisomy 21 (not the cervical vertebrae)
Sneeze, laugh, cough causing pain in cervical spine assessment indicates….
….disc problem
__side shoulder level tends to be lower
Dominant
Acute torticollis
Facet dysfunction, inability to move head from one side to another, limitation in rotation and side bending
Neurologic reflex exams and what myotomes do they assess?
C5 and 6 - biceps c6 and 7 - Brachioradiais C7 - triceps L3-4 - patellar L4-5 - posterjior tibial L5-S1 - medial hamdstrings S1-2 - lateral hamstrings and achillles
Assessment of posture
Ear hole should be in line with acromion process
Cervical flexion corresponding myotomes
C1 and C2
Lateral cervical flexion corresponding myotome
C3
Scapular elevation corresponding myotome
C4
Shoulder abduction corresponding myotome
C5
Elbow flexion and wrist extension corresponding myotome
C6
Elbow extension and wrist flexion corresponding myotome
C7
Thumb extension corresponding myotome
C8
Abduction/adduction of fingers corresponding myotome
T1
Top of head corresponding dermatome
C1 and C2
Neck corresponding dermatome
C3
Top of shoulder corresponding dermatome
C4
Deltoid region corresponding derrmatome
C5
Lateral wrist corresponding dermatome
C6
Posterior digit 2-4 corresponding dermatome
C7
Medial hand corresponding dermatome
C8
Medial forearm corresponding dermatome
T1
Vertebral artery test
Lay supsect patient (dizzy, nystagmus, etc) supine, extend cervical spine, laterally flexing and rotate spine to close off vertebral artery on corresponding side looking for nystagmus or nausea
Spurlings (foraminal compression test)
Gently compress C spine from top of head and try to elicit radiation of pain in suspected disc herniation patient, follow up with lifting mastoid process to see symptoms alleviate (distraction)
3 most common lumbar spine spondylopathies
Spondylosis - disc degeneration
Spondylolysis - stress fracture in defect in pars interarticularis
Spondylolisthesis - forward displacemenet of one vertebrae on another
Disc prolapse vs extrusion
Prolapse sees nucleus pulposis herniating into annulus fibrosis, extrusion is full rupture into the external space of the nucleus pulposis (more severe, see foot drop and muscle atrophy)
Hip flexion corresponding myotome
L2
Kknee extension correpsonding myotome
L3
Anlke dorsiflexion corresponding motome
L4
Great toe extension corresponding myotome
L5
Ankle plantar flexion and eversion corresponding myotome
S1
Knee flexion corresponding myotome
S2
Proximal anterior thigh corresponding dermatome
L2
Distal anterior thigh corresponding dermatome
L3
Medial ankle/foot corresponding dermatome
L4
Lateral leg/mid anterior foot corresponding dermatome
L5
Lateral plantar foot corresponding dermatome
S1
Posterior thigh corresponding dermatome
S2
Straight leg raise (lasegue’s) test
Supine with hip medially rotated and knee extended, flex hip, positive is reproduction of symptoms indicating nerve compression/tension, can modify by stretching spine further by having them put chin to chest
Slump test
A way to test for fake back pain that is same as straight leg raise but sitting upright, should cause symptoms same as straight leg raise
Stork test
A way to test for spondylolysis, have take a single leg stance extend lumbar spine, positive test is reproduction of symptoms (sharp localized L spine pain)
Hoover test
A way to test for fake or “conversion” disorder that asks patient to do a straight leg raise in supine while feeling for downward pressure under opposite heel if genuinely trying to raise leg but cannot vs if exaggerating symptoms
