Approach to Cervical Spine Complaint

Question 1

what is the most common cause of traumatic neck pain?

Answer 1

myofascial injury

Question 2

what are two examples of myofascial neck pain injuries?

Answer 2

whiplash or muscle strain

Question 3

you must keep a patient with SCIWORA immobilized until when?

Answer 3

MRI and evaluation/consultation with a neurosurgeon

Question 4

what demographic is a SCIWORA more common?

Answer 4

kids and elderly

Question 5

what is the vast majority of atraumatic neck pain caused from?

Answer 5

musculoskeletal

Question 6

what are the neurologic causes of atraumatic neck pain?

Answer 6

radiculopathy and myelopathy

Question 7

what are some (4) life threatening causes of torticollis?

Answer 7

retropharyngeal abscess, C-spine injury, CNS tumor, spinal epidural hematoma

Question 8

what is spondylosis?

Answer 8

degenerative changes in the spine

Question 9

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

Answer 9

spondylosis

Question 10

what is cervical myelopathy?

Answer 10

any neurologic deficit related to the spinal cord

Question 11

what are the signs and symptoms of a cervical myelopathy?

Answer 11

bilateral or distal symptoms (weakness/numbness)

Question 12

what is cervical radiculopathy?

Answer 12

any neurologic deficit occurring at or near the nerve root

Question 13

what are the signs and symptoms of cervical radiculopathy?

Answer 13

sharp, burning, pain radiating to the trapezius and down the arm

Question 14

what are the signs and symptoms of meningitis?

Answer 14

fever, malaise, headache, rash

Question 15

what are the specialty tests positive for meningitis?

Answer 15

nuchal rigidity, Kernig’s and Brudzinski’s

Question 16

what are the causes of meningitis?

Answer 16

Bacterial: hemophilus, strep, pneumonia, neiserria menigitidis (gram negative dipplococci)

Question 17

how is meningitis diagnosed?

Answer 17

lumbar puncture

Question 18

what is the thoracic outlet?

Answer 18

it is a confined space between the clavicle and first rib

Question 19

what structures pass through the thoracic outlet?

Answer 19

nerves of the brachial plexus, the subclavian artery, and the subclavian vein

Question 20

what is thoracic outlet syndrome?

Answer 20

compression of the neurovascular bundle just above the first rib and behind the clavicle

Question 21

what are the symptoms of the thoracic outlet?

Answer 21

arm pain, numbness, and weakness

Question 22

when does a patient with neck pain not require imaging?

Answer 22

if the neck pain is atraumatic and there are no red flags

Question 23

what is the clinical significance of anterior neck pain?

Answer 23

it is suggestive of a non-spinal cause (angina pectoris)

Question 24

when is it acceptable to check ROM on patients with traumatic neck pain?

Answer 24

if they have been cleared radiographically or by clinically by the Nexus criteria

Question 25

what tests are used to test for cervical radiculopathy?

Answer 25

spurling’s test and manual distraction test

Question 26

what tests are used for meningeal irritation?

Answer 26

kernig’s sign and brudzinski’s sign

Question 27

what test is used for thoracic outlet syndrome?

Answer 27

roo’s or east test

Question 28

what are the contraindications of HVLA in the cervical region?

Answer 28

if the patient has RA, down’s syndrome

Question 29

what is weak in patients with RA or down’s syndrome?

Answer 29

the odontoid ligament