Cercival Flashcards
1
Q
What do the cruciate ligament, in the neck, attached to? (2)
A
- Transverse ligament covers the dens and attaches horizontally to C1.
- Longitudinal band attaches superiorly to occiput and inferiorly to C2.
2
Q
What are common exam findings for neck pain with headache?(cervicogenic)(4)
A
- Positive cervical flexion rotation test
- Headaches reproduce with provocation of the involved upper cervical segments
- Limited cervical range of motion
- Strength endurance and coordination deficits of the neck muscles
3
Q
What does the atlas lack?(2)
A
Vertebral body and spine process
4
Q
Patients with cervical ridiculopathy, what four variables will help the therapist achieve a favorable outcome?
A
- Age <54y.o
- Dominant arm not affected
- Symptoms did not worsen looking down
- Multi mode treatment include manual therapy, cervical traction, and DNF strengthening for at least 50% of visits
- 4 of 4 90.4% success rate
- 3 of 3 85.4% success rate
5
Q
When a patient with neck pain reports a history of trauma what should be included in the differential diagnosis? (3)
A
- Presence of cervical instability
- Spinal fracture
- Presence of or potential for spinal cord or brain stem injury
6
Q
What are the key muscles for manual muscle testing for upper extremity?(5)
A
- C5-deltoid
- C6-biceps brachiosaurus and extensor carpi radialis longus/brevis
- C7-triceps and flexor carpi radialis
- C8-abductor pollicis brevis
- T1-first interossei
7
Q
What are common findings for neck pain with radiating pain?(radicular) (3)
A
- Neck and neck related radiating pain reproduce or relieved with ridiculopathy testing.
- Positive test cluster-upper limb nerve mobility, Spurling test, cervical distraction test, cervical range of motion
- May have upper extremity sensory, strength, or reflex deficits associated with involved nerve roots
8
Q
What are valid self reported questionnaires used for the neck?(2)
A
- Neck Disability index (NDI)-Minimal clinical importance difference was 7(14% points)
- Patient specific functional scale (PSFS)-Minimal detectable change 2.1
9
Q
What are common symptoms for neck pain w/ movement coordination impairments(WAD)? (5)
A
1. Mechanism of onset linked to trauma or whiplash 2.Associated (referred) shoulder girdle or upper extremity pain 3 Associated varied nonspecific concussive signs and symptoms 4.Dizziness/nausea 5.Headache, concentration, or memory difficulties; confusion; hypersensitivity to mechanical, thermal, acoustic, odor, or light stimuli; heightened distress
10
Q
What does the axis have?
A
Dens, A enlongated projection
11
Q
What are common exam findings for neck pain with movement coordination impairment?(6)
A
- Positive cranial cervical flexion test
- Positive neck flexor muscle endurance test
- Positive pressure algometry
- Neck pain with mid range motion that worsen within range position
- Point tenderness may include myofascial trigger points
- Sensorimotor impairment may include altered muscle activation patterns, proprioception deficit, postural balance or control
- Neck and referred pain reproduce by provocation of involved cervical segments
12
Q
What are common symptoms for neck pain w/ mobility deficits? (3)
A
- Central and/or unilateral neck pain
- Limitation in neck ROM that consistently reproduces symptoms
- Associated (referred) shoulder girdle or upper extremity pain may be present
13
Q
What five variables will determine who would benefit from intermittent cervical traction?(5)
A
- Patient reports peripheralization with lower cervical spine (C4-7) mobility testing
- Positive shoulder abduction sign
- Age >55y.o.
- Positive upper limb tension test (median nerve by us using shoulder abduction to 90°)
- Relief of symptoms with the manual distraction test
14
Q
What are common symptoms for neck pain w/ headaches? (2)
A
- Noncontinuous, unilateral neck pain and associated (referred) headache
- Headache is precipitated or aggravated by neck movements or sustained positions/postures
15
Q
What artery passes through the transverse processes of C1-C7?
A
Vertebral artery that becomes the basilar artery.
16
Q
What do the alar ligaments attached to? (2)
A
Dens and occipital condyles of cranial
17
Q
What are the common exam findings for neck pain with mobility deficits?(5)
A
- Limited cervical ROM
- Neck pain reproduced at end range of AROM and PROM
- Restricted cervical and thoracic segmental mobility
- Neck and referred pain reproduce with provocation of involve cervical or upper thoracic segment or cervical musculature
- Deficits of cervicascapulothoracic strengrh and motor control(chronic and acute PT)
18
Q
What are common symptoms for neck pain w/ radiating pain(radicular)? (2)
A
- Neck pain with radiating (narrow band of lancinating) pain in the involved extremity
- Upper extremity dermatomal, paresthesia or numbness, and myotomal muscle weakness
19
Q
What are common find associated with lower motor neuron?(3)
A
- Hypo reflexa or absent of DTR
- Decrease sensation to lite touch following a dermatomal pattern
- muscle weakness that follows a myotomal pattern
20
Q
What are common signs of upper motor neuron pathology?(6)
A
- Hyperreflexia of the upper and lower extremities
- More diffused sensory changes(non dermatomal pattern)
- Clonus of the ankle
- positive Hoffman and/or Babinski
- clumsiness of gait
- Generalized weakness blow the level of compression
21
Q
What are signs and symptoms of Vertebral artery insufficiency?(5)
A
- Drops attacks
- Dizziness or light headiness related to neck movements
- Dysphasia
- Dysarthria
- Positive cranial nerve signs-Anosmia, Diplopia, Ptosis
22
Q
Dermatomal level C5?
A
Lateral forearm
23
Q
Dermatomal level C6?
A
Distal thumb
24
Q
Dermatomal level C7?
A
Middle digit
25
Dermatomal level C8?
Fifth digit
26
Dermatomal level T1?
Medial forearm
27
Key muscle for UE neurological testing, C5?
Deltiod
28
Key muscle for UE neurological testing, C6?
Biceps Brachii
29
Key muscle for UE neurological testing, C7?(2)
Triceps and Flexor Carpi Radials
30
Key muscle for UE neurological testing, C8?
Abductor Pollicis Brevis
31
Key muscle for UE neurological testing, T1?
Frist dorsal Interossei
32
Interventions for neck pain w/ mobility defects? (4)
1. Cervical mobs/manipulation
2. Thracic mobs/manipulation
3. Stretching exercises
4. Coordination, strengthening, and endurance exercises
33
How do cervical nerves exit? (2)
Cervical nerve roots exit the spinal canal above their number vertebrate.
C8 nerve root a typical does not have corresponding vertebral element exits below C7 pedicle
34
What are red flags, to rule out, for headaches? (5)
1. HA are getting worse over time
2. Sudden onset of HA
3. HA associated with high fever, stiff neck, or rash
4. Onset of HA after head injury
5. Problems with vision or profound dizziness
35
How do rule in cervicogenic headaches? (symptoms)(2)
1. Pattern of symptoms that start in the neck and progress to the fronto-ocular area
2. unilateral headache
36
Signs and symptoms of cervicogenic headaches?(5)
1. Mechanical origin
2. Female to male- 4:1 middle aged
3. Pain area– posterior head &neck
4. Primarily unilateral – ipslateral neck shoulder, or arm
5. Provoked by sustained or awkward positions
37
What does the Sharp-Purser test assess?
1. Integrity of the transverse and cruciform ligament of C1-C2
2. Identifies excessive movement between or a subluxation of the atlas on the axis
38
What history and clinical features suggestive of vertebral artery dissection?(4)
1. Most common pain in the head and neck,unilateral & occipital
2. Occipital headache
3. Never experienced a similar pain before
4. Onset may be acute may be related to trauma or spontaneous
39
What five factors would lead one to believe that somebody is having a migraine?
1.Pulsating pounding headache
2.Duration of 4 to 72 hours
3Unilateral
4.Nausea
5.Disabling
4 of 5 positive likelihood 24
40
Where are the joints of Luschka?
1. Cervical spine-between C3-C7
| 2. Commonly associated with degenerative spine conditions and cervical radiculopathy
41
What does the posterior arterial system profuse?
What does the anterior arterial system profuse?
1. Hind brain(vertebrobasilar)
| 2. Cerebral hemispheres and eye(internal carotid arteries)
42
What motions stress the posterior and anterior arteries?
Posterior arteries stressed w/ contralateral rotation
Anterior arteries stressed w/ extension
43
What positively correlated to disease and dysfunction of the cervical arteries?
Hypertension
44
What Cranial nerves are not within the territory of the vertebrobasilar system? (2)
Cranial nerves I and II
45
What is typical pain pattern for dissection of internal carotid artery?(4)
1. Frontal temporal HA
2. Upper cervical or anterior lateral neck pain
3. Facial pain
4. Facial sensitivity
46
In order what cranial nerves affected by internal carotid artery pathology?(5)
1. Hypoglossal XII
2. Glossopharangeal IX
3. Vagus X
4. Accessory N. XI
5. All cranial N. can be affected expect OLFACTORY
47
What are clinical features of internal carotid artery dissection? (3)
1. Horner’s syndrome
2. Pulsatile tinnitus
3. CN palsies-CN IX-XII
48
In what plane are the thoracic facet oriented?
Frontal plane
49
What dermtomes are associated with T5, T10-T11, and T12?
T5-Nipples
T10-T11-Umbilical
T12-Groin
