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Ortho Second Exam Material > Cervical > Flashcards

Cervical Flashcards

1
Q

Head arcs posterior and the flexor muscles contract. ?

A

Hyperextension

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2
Q

Head rebounds anterior, anterior structures compress and extensor muscles stretch. ?

A

Hyperflexion

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3
Q

Most superficial back muscles _________ and extends from _____ to _____?

A

Trapezius, EOP, T12

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4
Q

Innervation for trapezius comes from _____ Nerve

A

Spinal Accessory (CN XI)

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5
Q

Spinal N fibers from _____ rami of ___&____ cervical spinal nerves

A

Ventral, C2 and C3

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6
Q

Largest muscle in the anterior neck?

A

SCM

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7
Q

SCM is attached ______ by 2 heads from the _____ aspect of the medial 1/3 of the ____ and the manubrium of the sternum

A

inferiorly, posterior , clavicle

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8
Q

SCM attaches?

A

mastoid process

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9
Q

enlarged lymph nodes may indicate infection from respiratory tract and can cause ______

A

Torticollis

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10
Q

In lymph are infected, should feel like?

A

tender, big, soft, mobile and Symmetrical

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11
Q

Torticollis aka?

A

Wry neck

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12
Q

torticollis etiology?

A

unknown

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13
Q

torticollis is often associated with injury to ______ on same side at time of birth

A

SCM

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14
Q

Muscles transformation into a fibrous cord that cannot lengthen with the growing neck?

A

torticollis

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15
Q

Both sexes are affected _____ in torticollis

A

equally

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16
Q

Torticollis occurs most frequently in _____ between ___&____ decades

A

Adults, 5th and 6th.

Aquired

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17
Q

Considered a problem with the child - torticollis

A

Congenital torticollis

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18
Q

SCM muscle contraction causes _____ of the head to the _______ side and flexion of the neck to the same side.

A

rotation , opposite

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19
Q

Major stabilizer and elevator of the superior angle of the scapula

A

levator scapulae

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20
Q

with scapula stabilized, the levator produces _____&_____ of the neck to the ____ side;; while acting _____, cervical extension is produced

A

rotation & side bending, same side, bilaterally

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21
Q

Rhomboid _____ attaches to SP of C7 and T1

A

Minor

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22
Q

Rhomboid Major attaches from SP of ___ through ____.

A

T1, T5

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23
Q

Rhomboid _____ is inactive during ___ head and neck movements

A

major, isolated

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24
Q

Clay shovelers fx is a type of ______ avulsion injury

A

hyperflexion

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25
Q

Clay shovelers fx is most common at __ & __ & __

A

C7, C6 & T1

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26
Q

If avulsion fx not limited to SP but extends into ______, there is greater potential for ________ injury

A

lamina, spinal cord

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27
Q

Scalenes extend obliquely and share a relationship with _____ artery?

A

subclavian

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28
Q

Scala = ______ in latin?

A

ladder

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29
Q

Adaptive shortening of the scalenes will affect the ______ of the upper _______. Due to?

A

mobility , their distal attachments.

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30
Q

Scalenes attach into?

A

1st and 2nd ribs.

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31
Q

If in spasm, scalenes elevate the _____ and can be implicated in __________________.

A

Ribs, thoracic outlet syndrome.

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32
Q

TOS occurs when the _____&_____ of the outlet is _____&______.

A

size & shape, compressed & narrowed.

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33
Q

TOS can happen because of ?

A
  1. posture
  2. muscle tightness
  3. exercise
  4. trauma
  5. pregnancy
  6. or being born with an extra rib.
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34
Q

TOS symptoms can be caused by the compression of _____ and _____ or both.

A

nerves and blood vessels

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35
Q

Symptoms of TOS?

A
  1. tingling or numbness in the fingers, hands, arm.
  2. weakness of hand or arm
  3. swelling of hand or arm.
  4. aching shoulder or neck
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36
Q

When may symptoms of TOS be worse?

A

when the arm is lifted above shoulder height.

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37
Q

Who is more likely to get TOS?

A

people who stand for long periods of time, drooping shoulders, leaning head forwards, those who carry heavy loads on their shoulders

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38
Q

______ or those in occupations with repetitive overhead arm movements may develop TOS

A

Athletes

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39
Q

Thyroid gland lies anterior to ____/____ vertebrae

A

C4/C5

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40
Q

if parotid gland is swollen, may indicate?

A

mumps

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41
Q

which region of the spine has more more nerve roots than vertebral levels?

A

cervical spine

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42
Q

First cervical disc is between ___ & ____ and is named ____ disc?

A

C2 & C3, C2 disc

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43
Q

First nerve root exits between ____ & ____ and is names _____ nerve root.

A

C0 & C1, C1 nerve root

44
Q

Last nerve exits between ___ & ___ and is named ___ nerve root

A

C7 & T1, C8 nerve root

45
Q

In general, structures supplied by the upper 3 cervical nerves can cause?

A

neck and head pain

46
Q

Mid to lower cervical nerves can refer symptoms to the ??

A

shoulder, anterior chest, upper limb and scapular area

47
Q

nerves from the roots, trunks, divisions, cords and branches innervate _____

A

upper extremity

48
Q

The upper extremity can be affected via the _______ _____ by a disc pathology or a _____

A

Brachial plexus, SOL

49
Q

Neurological exam (3)

A
  1. muscle testing
  2. reflex testing
  3. sensation testing
50
Q

Muscle testing will indicate the presence of any ____ ____. which could affect the motion of the ____ and will demonstrate the ______ of the nerve supply

A

motor weakness. neck. integrity

51
Q

C5 Muscle tests

A
  1. deltoid

2. Biceps

52
Q

C5 deltoid tests?

A

Axillary nerve, shoulder abduction

53
Q

C5 Biceps tests?

A

Musculocutateous nerve, forearm flextion

54
Q

Muscle testing, which scale is used?

A

Oxford or Van Allen scale

55
Q

Biceps reflex indicates neurological integrity of ____ and slight ____

A

C5, C6

56
Q

C5 dermatome, neurological level supplies sensation to the _________

A

lateral arm

57
Q

The purest patch of axillary nerve sensation is located on the lateral arm in the skin covering the _____ portion of the ____ muscle

A

lateral, deltoid.

58
Q

C6 muscle testing. Wrist ______. which muscles? and which nerve?

A

Wrist Extension.
Extensor carpi radialis longus and brevis
extensory carpi ulnaris.
Radial Nerve

59
Q

Brachioradialis reflex, tested proximal to ________ where the muscle becomes _____?

A

radial styloid process.

Tendinous

60
Q

Brachioradialis reflex, uses which side of hammer?

A

Either!

61
Q

C6 dermatome. Sensation to?

A

Lateral forearm.
thumb.
2nd digit.

62
Q

C7 muscle testing.
Elbow extension.
muscles and nerve?

A

Triceps

RAdial Nerve

63
Q

C7 - wrist flexion

muscles and nerve?

A

flexor carpi radials -median nerve.

Flexor carpi ulnaris - ulnar nerve

64
Q

C7 - finger extension

muscles and nerve?

A

extensor digitorum communis.
extensor indicis profundus
extensor digiti minimi
all radial nerve

65
Q

C7. Triceps reflex- tap where?

A

where it crosses the olecranon fossa proximal to the elbow joint.

66
Q

C7 dermatome supplies ?

A

middle 3rd finger and middle of palm of the hand up to the flexor wrist creases

67
Q

C8 Muscle testing.

Finger flexion? Muscle and nerve?

A

Flexor digitorum superficials, and flexor digitorum profundus, lumbricals.
median and ulnar nerves

68
Q

C8 reflex?

A

there is NO reflex for the nerve root. (must verbalize)

69
Q

C8 dermatome supplies?

A

4th and 5th digit, the ulnar side of the hand and the distal portion of the ulna.

70
Q

T1 Muscle testing:

Finger abduction

A

Dorsal interossei

Ulnar nerve

71
Q

T1. Finger Adduction

A

Palmer interossei

ulnar neve

72
Q

T1 reflex?

A

There is NO reflex for this nerve root

73
Q

T1 dermatome supplies?

A

sensation to T1 is the medial side of forearm - 2” above and below the elbow joint.

74
Q

T2 dermatome supplies?

A

medial upper arm and axillary region - 2” above the elbow upwards to the axilla.

75
Q

segmental side bending is?

A

extesion of the ipsilateral joint and flextion of the contralateral joint.

76
Q

Rotation, coupled with ipsilateral side bending involves ______ of the ipsilateral joint and ____ of the contralateral

A

extension

flexion

77
Q

Examination:

where possible, the patient should be first be examined for _______ & _______

A

Fractures, craniovertebral ligamentous instability

78
Q

The examination must be _____ & _____ so that the testing can be discontinued at the first signs of ________

A

Graduated & progressive.

Serious pathology

79
Q

Jeffersons fracture aka?

A

burst fx

80
Q

Jerffersons fx, highly ______. occurs in patients with ?

A

unstable.

down syndrome, RA

81
Q

increased?

A

ADI

82
Q

Jefferson FX mechanism of fx?

A

falling onto head from a height. may occur from MVA. diving into a pool

83
Q

Hangmans Fx

A

Fracture of the pars interarticularis of C12 & And disruption of C2-C3 junction.

84
Q

Hangmans Fx MOI?

A

Hyperextension

85
Q

Lordotic curve is secondary? T/F?

A

true

86
Q

lordotic curve begins formation at what age?

A

3-4 months

87
Q

in forward head translation, if head is 3” in from of center of gravity, how much weight is produced in structures of the c-spine?

A

30lbs

88
Q

hyoid bone is opposite from?

A

C3

89
Q

Thyroid cartilage is at level of _____ vertebral body?

A

C4/C5

90
Q

Carotid tubercle is located at ____ and used as a landmark for _____

A

C6

Anterior surgery

91
Q

How many z joints in cervical spine?

A

14 (from C0 to T1)

92
Q

angle of Z joints ?

A

45 degrees

93
Q

Uncovertebral joints extend from ___ to ___

A

C3 - T1

94
Q

How many Uncovertebral joints?

A

10

95
Q

Uncovertebral joints are described as?

A

saddle-shaped, diarthrodial articulations

96
Q

most common area for pathology in C-spine?

A

C5/C6

97
Q

Cervicothoracic junction (CTJ) is from ____ to ___

A

C7- T1

98
Q

CTJ forms the _____ _____, through which the neurovascular structures of the upper extremities pass

A

thoracic outlet

99
Q

which ligament is narrower in the upper c- spine but wider in lower C-spine thatn thoracic?

A

ALL

100
Q

Which ligament is broader and thicker in the c-spine?

A

PLL

101
Q

There are 7 clinical signs and symptoms of serious pathology. Know them.

A
  1. unexplained weight loss
  2. night pain
  3. involvement of more than 1 nerve root
  4. expanding pain
  5. weak and painful resisted testing (4 findings and their interpretations)
  6. spasm with PROM
  7. T1 palsy
102
Q

Upper Quarter Scan of an examination involves?

A

AROM & PROM
C5, C6, C7, C8 and T1
DTR
Sensation

103
Q

A major contributor to cervicogenic pain is a lack of _____ ______ due to poor _____ _____.

A

postural control, neuromuscular function

104
Q

Klippel - Feil deformity?

A

The bodies of 2 or more vertebrae are fused.

105
Q

During resisted tests (muscle testing), the clinician looks for relative ____ and ____

A

strength & fatigability

Ortho Second Exam Material (3 decks)

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