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MSK > CERVICAL > Flashcards

CERVICAL Flashcards

1
Q

Cervicocephalic

A

C0-C2
upper cervical spine

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2
Q

Cervicobrachial

A

C3-C7
lower cervical spine

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3
Q

Where greatest flexion-extension occurs

A

C5-C6

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4
Q

OPP

A

midway between flexion and extension

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5
Q

CPP

A

full extension

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6
Q

CP

A

side flexion and rotation> extension

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7
Q

Joints of Luschka or Uncinate Process

A

limits extension

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8
Q

IV discs

A

makes 25% of height
none in C1-C2
gives lordotic shape

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9
Q

Nucleus Pulposus

A

inner layer
compressive forces

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10
Q

Annulus Fibrosus

A

outer layer
tension

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11
Q

Atlanto-occipital Joint

A

yes joint
C0-C2 (occipital condyles and atlas)

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12
Q

Atlanto-Occipital Joint Actions

A

side flexion: 10
flexion-extension: 15-20
negligible rotation
ellipsoid

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13
Q

Alar Ligaments

A

limits flexion and rotation
major stabilizing ligament of C1-C2

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14
Q

Atlanto-axial Joint

A

no joint
C1-C2

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15
Q

Atlanto-axial Actions

A

flexion-extension: 10 deg
side flexion: 5 deg
rotation: 50 deg
pivot joint

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16
Q

Vertebral Artery

A

passes transverse process, starting at C6, entering as high as C4
20% of blood along with ICA (80%)

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17
Q

Movements stressing the Vertebral Artery

A

rotation and extension: 20
significant decrease in blood flow

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18
Q

4 areas where vertebral artery is greatly stressed

A
  1. transverse process of C1
  2. bony canals of vertebral transverse processes
  3. between C1-C2
  4. C1 going to the skull
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19
Q

Cervical Spondylosis

A

> 25 y/o
inc to 60%= 45 y/o
inc to 85%= >65 y/o

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20
Q

Cervical Disc Herniation

A

17-60

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21
Q

Cervical Spinal Stenosis

A

11-60 (30-60)

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22
Q

Hypertension

A

vertebrobasilar insufficiency
big red flag

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23
Q

Diabetes affecting blood

A

thickened blood causes nerve ischemia

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24
Q

Asthma (muscles)

A

tightness of scalenes
hypertrophy of SCM

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25
Q

Headaches

A

cervicogenic, unilateral; C1-C3
muscle tightness in the occiput

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26
Q

Bilateral Headache

A

systemic

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27
Q

What to ask when headache is present?

A

how long does it last
what triggers
relieving factors in postural change
check for temporal pattern, behavior, medications

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28
Q

Headache + Vomiting

A

vertigo
vestibular system
fluids are not balanced

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29
Q

Dizziness

A

vertebrobasilar affectation

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30
Q

Headache secondary to trauma

A

positional change won’t cause relief= normal

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31
Q

Atraumatic headache

A

positional change won’t relief= systemic/ malignancy

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32
Q

Assumed position in cervical spondylosis

A

flexion (to increase disc space since it is narrowed)

33
Q

Assumed position in cervical disc herniation

A

extension (bring disc back to its place)

34
Q

Assumed position in radiculating pain

A

lowered head

35
Q

Cervical Radiculopathy

A

unilateral affectation (myotomal, dermatomal, hyporeflexia)
acute: disc herniation
chronic: spondylosis

36
Q

Cervical Neuropathy

A

ipsilateral
secondary to disc herniations

37
Q

Myofascial Pain Syndrome

A

diffused, generalized, aching pain
atleast 3 trigger points for atleast 3 months

38
Q

Persistent pain not resolved in supination

A

space occupying lesions= tumors

39
Q

Referred pain for thoracic spine

A

medial scapular border

40
Q

Referred pain for C3-C4

A

cervicothoracic spine and ipsilateral upper trapezius

41
Q

Referred pain for C4-C5

A

superomedial border of scapula

42
Q

Referred pain for C5-C6

A

medial border of scapula

43
Q

Referred pain for C6-C7

A

lower scapular area and midscapular boder

44
Q

5Ds of Vertebrobasilar Insufficiency

A

dizziness
diplopia: double vision
drop attack: falls without provocation
dysarthia: difficulty speaking
dysphagia: difficulty swallowing

45
Q

Cancer and Weight loss

A

sudden weight loss, no stress, and neck pain

46
Q

Psychosocial Environment

A

stress factors can produce symptoms of upper back pain

47
Q

Rust’s Sign

A

protective posturing of the head and neck (holding and supporting due to apprehension/ instability)

48
Q

Klippel Feil Syndrome

A

congenital fusion of the cervical vertebra; C3-C5

49
Q

Torticollis

A

SCM
constant full aching/ congenital/ acquired
ipsilateral flexion and contralateral rotation

50
Q

Shoulder Asymmetry

A

atrophy of upper trapz (spinal accessory palsy) and deltoids (axillary nerve palsy)

51
Q

Position where maximum relaxation of the neck is achieved

A

supination

52
Q

Position when cervical spine is injured

A

head is tilted away from the pain and face tilted upwards
also seen in wry neck

53
Q

Position when the pt is hysterical

A

head is tilted and rotated toward the pain
face is tilted downward

54
Q

Protraction of the cranium

A

upper craniocervical: extended
lower cervical: flexed

55
Q

Retraction

A

upper craniocervical: flexed
lower to mid cervical: extended

56
Q

Upper Crossed Syndrome

A

tight: pectoralis major and minor; levator scapulae and upper trapezius
weak: deep neck flexors, rhomboids, serratus anterior, and lower trapezius

57
Q

Habitual Chin Poking

A

adaptive shortening of occipital muscles
increased stress of facet joints and posterior discs
weakness of the deep neck flexors
rounded shoulders

58
Q

Rounded Posture

A

protracted scapula, IR humerus, tight anterior structures, lengthened posterior structures

59
Q

Habitual Posture

A

postural compensation, weak muscles, hearing loss, temporomandibular problems, wearing bifocals or trifocals

60
Q

End feel

A

tissue stretch

61
Q

Passive Physiological Intervertebral Movements

A

between each pair of vertebrae
check for segmental ranges
stabilizing the movement of the distal vertebrae and passively moving the head

62
Q

Pain in flexion

A

meningitis, tumor, fracture of dens

63
Q

Forward Bending

A

lower cervical spine (80-90 deg)

64
Q

Pain in extension

A

vertebral vascular dysfunction, spinal cord compression

65
Q

ROM of side flexion

A

20-45

66
Q

ROM of rotation

A

70-90

67
Q

Movement restriction in extension and right side bending

A

right extension hypomobility
left flexor muscle tightness
anterior capsular adhesions
right subluxation
right small disc protrusion

68
Q

Movement restriction of flexion and right side bending

A

left extensor muscle tightness
left flexion hypomobility

69
Q

Movement restriction of extension and right side bending restriction greater than extension and left side bending

A

left posterior capsular adhesions
left subluxations
left capsular pattern

70
Q

flexion and right side bending restriction equal to extension and left side bending

A

left arthrofibrosis

71
Q

side bending in neutral, flexion, and extension

A

uncovertebral hypomobility or anomaly

72
Q

Myotomal Distribution

A

C1-C2: cervical flexion
C3 and C11: side flexion
C4 and C11: shoulder shrug
C5: shoulder abduction and er
C6: elbow flexion and wrist extension
C7: elbow extension and wrist flexion
C8: ulnar deviation and thumb extension
T1: abduction/ adduction

73
Q

Hoffmann Sign

A

involuntary flexion movement of the thumb and or index finger when the examiner flicks the fingernail of the middle finger down

74
Q

ULTT 1

A

median nerve, anterior interosseous nerve, C5-C7

75
Q

ULTT 2

A

median nerve, musculocutaneous nerve, axillary nerve

76
Q

ULTT 3

A

radial nerve

77
Q

ULTT 4

A

ulnar nerve, C8-T1

78
Q

Functional ROM Neck flexion

A

60-70

79
Q

Functional ROM of Neck Extension

A

40-50

MSK (7 decks)

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