C-spine disorders Flashcards
What special tests can be done to test for cervical herniated discs
Spurlings
compression
distraction
Lhermitte sign
What is the spurling test
push down on the crown of the head with head tilted toward the effected side
indicates nerve root compression
How can you test for cervical radiculopathy
Compression
distraction
valsalva
Lhermitte
What is cervical myelopathy
Severe compression of the cervical spinal cord which is secondary to cervical spine stenosis
What are the upper motor neuron symptoms seen with cervical myelopathy
Hyperreflexia
Sustained clonus
+hoffmans test
+babinski test
What is the Hoffman test
Extend the MCP and stabilize the PIP of the middle finger and force the DIP into flexion… look for spontaneous flexion of other fingers
What is the treatment for cervical myelopathy
Surgical decompression to preserve remaining function
At what degree of curvature is kyphosis diagnosed
> 50%
What is sheuermanns kyphosis
Juvenile structural deformity
M>F
What is the treatment for postural kyphosis
PT
Observation
NSAIDs
What is the treatment for congenital kyphosis
Early surgical treatment-> generally a spinal fusion
What is osteoporosis related kyphosis due to
A compression fx in the T-spine
What makes sheuermanns kyphosis stand out
They have a sharp, angular curvature thats a rigid deformity that won’t correct with laying down
Who is most likely to have TOS
Thin females with long necks
What tests can you use to check for TOS
Addisons
Supraclavicular pressure test
What is Addisons test
Extend and externally rotate the arm
Have patient turn their head to the ipsilateral side
Slightly abduct the arm
+= loss of pulse
What is the supraclavicular pressure test
Apply pressure to the trapezius and scalene for 30secs
What is the cause of torticollis
Contracture of the sternocleidomastoid muscle
When is C-spine imaging NOT needed
Alert and stable
No focal neuro deficit
No altered level of consciousness
Not intoxicated
No midline spinal tenderness
No distracting injuries
What is the MOI for occipital condyle fractures
Compression into C1 or extreme rotation
What is the treatment for occipital condyle fractures
Treatment almost always rigid cervical collar
What is a Jeffersons fracture
Burst fracture of C1 (usually unstable)
What is a hangman’s fracture
C2 fracture
Traumatic spondylolisthesis
Can be type 1, 2, or 3
What type of fractures can be seen in the vertebral body
burst
teardrop
facet
