Approach to Cervical Complaint Final Exam Flashcards

1
Q

Causes of neck pain Atraumatic?

A
  • MSK
  • Neurologic
    • Radiculopathy
    • Myelopathy
  • Non spinal
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2
Q

Traumatic neck pain?

A
  • Myofascial injury (muscle strain, whiplash…)
  • Cervical fracture
  • lig injury
  • disc injury
  • cord or nerve root injury
  • SCIWORA
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3
Q

Myofascial neck pain symptoms?

A

Very common!

  • May/may not be traumatic
  • symptoms are pain, spasm, loss of ROM, occipital headache
  • pain can be persistent with little abnormalities seen on MRI CT or X ray
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4
Q

Cervical Fractures?

A
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5
Q

Spinal cord injury without r adiographic abonormality (SCIWORA)?

A
  • Common in eldery and kids
  • Patient presents with nonrmal films and CT but continues to have symptoms
  • Must keep the spine immobilized until MRI and eval with a neurosurgeon
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6
Q

What is cervical spondylosis?

A
  • Degenerative changes in the cervical spine
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7
Q

Nonspinal causes of atruaumatic neck pain?

A
  • Systemic disease or referred pain
    • Thoracic outlet syndrome
    • CAD
    • Malignancy
    • RA
    • Infection
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8
Q

What are the three types of torticollis?

A
  1. Congenital: muscular fibrosis of SCM
  2. Adult: acquired typically from SCM or traps muscle injury or inflammation
  3. Life threatening: retropharyngeal abscess, C spine injury, CNS tumor or spinal epidural hematoma
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9
Q

What is the most common cause of acute and chronic neck pain in adults?

A
  • Cervical spondylosis
    • osteophytes are seen on the vertebral bodies and disc spaces become more narrow
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10
Q

What is cervical myelopathy?

A
  • Any neurologic deficit related to the spinal cord
  • Signs: bilateral or distal weakness/numbeess, clumsy hands, gait disturbances, sex dysfunction, bowel/bladder dysfunction
  • Needs emergent MRI
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11
Q

What is radiculopathy of cervical spine?

A
  • Any neurologic deficit at or near nerve root
  • Signs: sharp burning pain radiating to traps down arm or periscapular area. Weakness or paresthesias may develop
  • C5-6 followed by C6-7 are most common
  • Urgent work up, non emergent, MRI NSAIDS OMM PT
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12
Q

Meningitis symptoms diagnosis?

A
  • Fever, malaise, headache, photophobia, neck pain stiffness rash
    • Petechiae rash is near death
  • Caused by:
    • Bacterial: Hemophilus, Strep Pneumonia
    • Nisseria Menigitidis: less prevalent since vaccine, gram - dipplococci
  • Diagnosed by lumbar puncture

Gram - diplocci are meningicoccus important for Boards exam!

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13
Q

Thoracic outlet syndrome

A

Confined space between rib and clavicle

  • Symptoms: arm pain, numbness, weakness
  • Roo’s/EAST test
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14
Q

What portions of OLDCARTS are important for neck pain?

A
  • Location, is it bilateral unilateral or diffuse
  • Character, is is shtarp radicular
  • Associated symptoms, weakness bowl or bladder dysfunction headache neck stiff
  • ROS: Fever chills CP SOA history or recent trauma
    • focused ROS: neurologic signs that suggest cord issues
    • shock like paresthesia
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15
Q

What re the palpable structures in the neck?

A
  • LN
  • Thyroid
  • Muscles and bones soft tissues
  • Spinous processes
  • disc space
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16
Q

ROM for the neck

A
  • flexion
  • ext
  • rotation
  • lateral bending
  • passive and active
  • Do NOT go through ROM with traumatic pain unless cleared by radiograph or clinically by Nexus criteria
17
Q

C6 T4 and T10 are sensory dermatomes where?

A
  • C6: lateral forearm and thumb
  • T4: Nipples
  • T10: umbilicus
18
Q

What are the specialty tests for cervical radiculopathy?

A
  • Spurlings test
  • Manual distraction
19
Q

Specialty test for meningeal irritation?

A
  • Kernigs sign
  • Brudzinski sign bring legs up and head flexed to relieve meninge stress
20
Q

Neck stiffness is concerning due to possible …..

A
  • C spine fracture
  • cord injuries
  • ligament injuries
  • muscle strains and spasm
  • SAH
  • Meningitis
21
Q

HVLA contraindication?

A
  • RA
  • Down syndrome
  • Carotid disease
  • OA
  • Local metastases
  • Anticoagulant
  • Osseous or ligamentous disruption
22
Q
A