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MSK 3 > C-Spine Common Presentations > Flashcards

C-Spine Common Presentations Flashcards

1
Q

what is a positive Kernig’s sign?

A

hip flexion to 90deg and unable to straighten knee (positive for meningitis)

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2
Q

what types of cancer commonly metastasize to the vertebrae? (Hint: PB KTL)

A

Prostate
Breast
Kidney
Thyroid
Lung

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3
Q

40% of kidney neoplasms metastasize where? (Hint: PVP)

A

Pelvis
Vertebrae
Proximal femur

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4
Q

metastases of the ____ affect women 3x > men

A

thyroid

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5
Q

what age is someone likely to develop RA?

A

prior to 50

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6
Q

20-80% of pts with RA develop instability where in the c-spine?

A

AA instability (C1-C2)

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7
Q

what is basilar invagination?

A

when the dens drifts superior d/t ligamentous laxity and it can contact brain structures

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8
Q

ankylosing spondylitis = ossification of ligaments of what 3 structures?

A

Spine
IV discs/endplates
Facet structures

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9
Q

risk of SCI is how many times greater in pts with ankylosing spondylitis?

A

11.4x

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10
Q

pts with ankylosing spondylitis have a greater risk of ____ hematoma

A

epidural

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11
Q

low-impact trauma is most common at what c-spine vertebrae in pts with ankylosing spondylitis?

A

C5-C7

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12
Q

what gender and age is at greater risk of developing ankylosing spondylitis?

A

Men (10x > women)
20s - 30s

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13
Q

fusion of what c-spine vertebrae is most common in Klippel Feil syndrome?

A

C2 and C3 (vertebrae never separated during development)

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14
Q

what are the consequences of VBI/CAD?

A

Retinal or brain ischemia
Compression or stretching = local symptoms (see CN S/S)
SAH or ICH

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15
Q

what is the mean age for VBI/CAD?

A

39 - 45

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16
Q

what is one of the biggest risk factors for VBI/CAD?

A

HTN

17
Q

what are 5 other big risk factors for VBI/CAD?

A

Hx of migraine-type HA
DM
Blood clotting disorders/alterations in blood properties
Hx of smoking
Immediately postpartum

18
Q

what are the 5 D’s and 3 N’s?

A

Dizziness
Dysarthria (poor muscle coordination when talking)
Dysphagia
Diplopia
Drop attacks (beginning of LOC, legs give out, suddenly feel like you’re going to fall)
Nystagmus
Nausea
Numbness (dysesthesia of face / lips / extremities)

19
Q

ossification of what ligament is common with c-spine myelopathy? (reason unknown)

A

PLL

20
Q

what 5 things are included in the CPR for c-spine myelopathy?

A
  1. Gait deviation
  2. Hoffman’s
  3. Inverted Supinator
  4. Babinski
  5. Patient age > 45
21
Q

what is the pars interarticularis?

A

stretch of vertebra btw sup/inf articular processes, like the “neck” of the spinous process

22
Q

what is a Jefferson fx and how does it happen?

A

4-part burst fx of C1 that happens from compression (ex: diving, something falling on the head)

23
Q

spondylolisthesis = vertebral body displaces in what direction?

A

anteriorly

24
Q

degenerative spondylolisthesis is most common at what parts of the c-spine?

A

C3-C5

25
Q

describe the 4 grades of spondylolisthesis

A

Graded by % vertebral body slips
I → 0-25%
II → 25-50%
III → 50-75%
IV → > 75%

26
Q

does z-joint arthropathy typically have UL or BL symptoms?

A

UL (remember this differs from disc pain referral patterns!)

27
Q

what 4 things are included in Wainner’s Cluster for cervical radiculopathy?

A

Ipsi c-spine rotation AROM < 60deg
Positive Spurling’s Test
Positive Cervical Distraction
Positive ULTT (median n. bias)

28
Q

what can be fractured with Whiplash Associated Disorders (WAD)? (Hint: LOAD)

A

Laminae of C2
Occipital condyles (upper c-spine)
Articular pillars/subchondral plates
Dens

29
Q

where do the referred and radicular pain come from in WAD?

A

Referred pain = from z-joints and other structures
Radicular pain = from inflammation or injury to spinal n.

30
Q

are symptoms usually UL or BL with WAD?

A

BL

31
Q

cervicogenic HA: where does trigeminal nerve refer pain to?

A

frontal, orbital, parietal

32
Q

cervicogenic HA: where does C1-C3 refer pain to?

A

occipital and auricular

MSK 3 (4 decks)

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