Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GMOCSE > Cervical > Flashcards

Cervical Flashcards

1
Q

Cervical myelopathy

A

LMN lesion at level of lesion and UMN lesion below the lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Signs and sx’s cervical myelopathy UMN lesion

A

Wide base or unsteady gait, hyperreflexia, sensory disturbances, pathological reflexes (Hoffman’s and Babinski), instrinsic muscle wasting of hands, loss of dexterity, nonspecific weakness of extremities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Highest sensitive tests for cervical myelopathy

A

Hoffman’s and hyperreflexia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

C spine high risk for radiographs

A

Age at least 65 years
OR
Paresthesias in the extremities
OR
Dangerous mechanism of injury - Fall from height of at least 1 m
or 5 stairs
Axial load to head
- High-speed motor vehicle
accident (>100 km/h), rollover,
or ejection
- Bicycle collision
- Motorized recreational vehicle
accident

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

C spine low risk for radiographs

A
  • Able to assume a normal sitting posture in the emergency department - Ambulatory at any time since time of injury
  • Onset of neck pain not immediate - Absence of midline tenderness in the cervical spine
  • Motor vehicle accident that does not include any of the following: Pushed into oncoming traffic
  • Hit by bus/large truck- Rollover- Hit by high-speed vehicle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

C spine radiographs ROM

A

Does have > 45 degrees of rotation? If no, refer for plain films.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Levator scapulae

A

Traverse processes of C1-4 to superior angle of scapula.

Extends, side bends ipsi, rotate ipsi

Dorsal scapular nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Neck pain with mobility deficits exam findings

A
  • Younger individual (age less than 50 years)
  • Acute neck pain
  • Symptoms isolated to the neck
  • Restricted cervical range of motion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Neck pain with mobility deficits interventions

A 
• Cervical mobilization/manipulation
• Thoracic mobilization/manipulation
• Stretching exercises
• Coordination, strengthening, and
endurance exercises
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Neck pain with headaches exam findings

A

• Unilateral headache associated with neck/suboccipital
area symptoms that are aggravated by neck movements or
positions
• Headaches produced or aggravated with provocation of the
ipsilateral posterior cervical myofascia and joints
• Restricted cervical range of motion
• Restricted cervical segmental mobility
• Abnormal/substandard performance on the cranial cervical
flexion test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Neck pain with headaches interventions

A

• Cervical mobilization/manipulation
• Stretching exercises
• Coordination, strengthening, and
endurance exercises

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Neck pain with movement

coordination impairments - exam findings

A

• Long standing neck pain (duration > 12 weeks)
• Abnormal/substandard performance on the cranial cervical
flexion test
• Abnormal/substandard performance on the deep neck
flexor test
• Coordination, strength, and endurance deficits of neck and
upper quarter muscles (longus colli, middle trapezius, lower
trapezius, serratus anterior)
• Flexibility deficits of upper quarter muscles (anterior/
middle/posterior scalene, upper trapezius, levator scapulae,
pectoralis minor, pectoralis major)
• Ergonomic inefficiencies with performing repetitive
activities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Neck pain with movement coordination impairments - interventions

A

• Coordination, strengthening, and
endurance exercises
• Patient education and counseling
• Stretching exercises

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Neck pain with radiating pain - exam findings

A

• Upper extremity symptoms, usually radicular or referred
pain, that are produced or aggravated with Spurling maneuver and upper limb tension tests, and reduced with
the neck distraction test
• Decreased cervical rotation ( less than 60°) toward the involved side
• Signs of nerve root compression
• Success with reducing upper extremity symptoms with
initial examination and intervention procedures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Neck pain with radiating pain - interventions

A

• Upper quarter and nerve mobilization
procedures
• Traction
• Thoracic mobilization/manipulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Red flags - Subarachnoid
hemorrhage–ischemic
stroke

A
  • Sudden onset of a severe headache

* History of hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Physical exam findings for red flags Subarachnoid
hemorrhage–ischemic
stroke

A
  • Concurrent elevated blood pressure
  • Trunk and extremity weakness, aphasia
  • Altered mental status
  • Vertigo, vomiting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Physical exam findings - VBI

A
  • Vertigo that lasts for minutes (not seconds)
  • Visual disturbances
  • Apprehension with end range neck movements
  • Unilateral hearing loss
  • Vestibular function abnormalities
19
Q

Red flags - meningitis

A
  • Headache
  • Fever
  • Gastrointestinal signs of vomiting and symptoms of nausea
20
Q

Physical exam findings for red flags of meningitis

A
  • Positive slump sign
  • Photophobia
  • Confusion
  • Seizures
  • Sleepiness
21
Q

Red flags - Primary brain tumor

A

• Headache
• Gastrointestinal signs of vomiting and symptoms of
nausea

22
Q

Physical exam findings for red flags with primary brain tumor

A
  • Ataxia
  • Speech deficits
  • Sensory abnormalities
  • Visual changes
  • Altered mental status
  • Seizures
23
Q 
Red flags - Mild traumatic brain
injury
Post concussion
syndrome
Subdural hematomal,
A
  • Dangerous injury mechanism
  • Headache
  • Nausea/vomiting
  • Sensitivity to light and sounds
24
Q

Physical exam findings mild TBI , post concussion syndrome, subdural hematoma

A
  • Loss of consciousness/dazed–an initial Glaslow Coma Scale of 13 to 15
  • Deficits in short-term memory
  • Physical evidence of trauma above the clavicles
  • Drug or alcohol intoxication
  • Seizures
25
Q

Red flags cervical fracture of ligamentous instability

A

• Major trauma such as a motor vehicle
accident or a fall from a height with
associated immediate onset of neck pain
• Rheumatoid arthritis or Down syndrome

26
Q

Red flags data during physical exam for cervical fracture of ligamentous instability

A 
• Midline cervical spine tenderness
• Positive ligamentous integrity tests:
o Sharp-Purser test
o Alar ligament integrity test
• Apprehension with or inability to actively rotate head
27
Q

red flags Cervical central cord lesion

A

• Older age
• History of a trauma (especially motor vehicle
accident or fall)
• Incontinence

28
Q

Cervical central cord red flags physical exam findings

A

• Gait disturbances due to hyperreflexic lower extremities
• Upper extremity (especially hand) sensory and motor
deficits, and atrophy

29
Q

Red flags pancoast tumor

A

• Men over 50 with a history of cigarette
smoking
• “Nagging” type pain in the shoulder and
along the vertebral border of the scapula–
often progressing to burning pain down the
arm into the ulnar nerve distribution

30
Q

Pancoast tumor red flags exam findings

A 
• Wheezing with auscultation when tumor obstructs
bronchus
• May have Horner syndrome
o Ptosis (drooping eyelid)
o Constricted pupil
o Sweating disturbances
31
Q

Septic arthritis (A-C joint) red flags

A

• Insidious onset of chest pain localized in the
sternoclavicular joint
• History of intravenous drug use, diabetes,
trauma, infection (especially of central
venous access)

32
Q

Septic arthritis red flags exam findings

A
  • Tender sternoclavicular joint
  • Limited shoulder movement
  • Swelling over sternoclavicular joint
  • Fever
33
Q

Thoracic spine manipulation CPR

A

• Symptoms duration less than 30 days.
• No symptoms distal to the shoulder.
• Subject reports that looking up does not aggravate
symptoms.
• Fear-Avoidance Beliefs Questionnaire-Physical Activity
Scale less than 12.
• Diminished upper thoracic kyphosis (T3-T5).
• Cervical extension less than 30°.

34
Q

Cervical spine manipulation CPR

A

• Initial scores on the NDI less than 11.5.
• Having bilateral involvement pattern.
• Not performing sedentary work more than 5 hours
per day.
• Feeling better while moving the neck.
• Did not feel worse while extending the neck.
• The diagnosis of spondylosis without radiculopathy.

35
Q

Muscle length pec minor

A
  • supine w/ arms at side
  • negative test align symmetrically in frontal plane.
  • positive: one side more anterior than the other
  • differentiate between GH capsular mobilty
36
Q

muscle length pec major

A
  • supine with both knees flexed
  • PT stabilizes proximal portion of pec major
  • horizontal abduction for upper fibers and horizontal abduction + 135 deg flexion for lower fibers.
  • normal if arm is able t
37
Q

Levator scap and posterior scalenes muscle length

A
  • supine
  • depress scapula
  • cradle occiput
  • flex c-spine and side bend contra and rotate contra.
38
Q

Upper trap muscle length

A
  • supine
  • grab superior proximal scapula
  • depress scapula
  • flex c-spine
  • side bend contra
  • rotate ispi
39
Q

Cranial cervical flexion test normal

A

A normal response
is for the pressure to increase between 26 mmHg to 30
mmHg and be maintained for 10 seconds without using
superficial cervical muscle substitution patterns.

40
Q

Cranial cervical flexion abnormal response

A

• Is unable to generate an increase in pressure of at
least 6 mmHg.
• Is unable to hold the generated pressure for 10 seconds.
• Uses superficial neck muscles to accomplish the cervical
spine flexion motion.
• Uses a sudden movement of the chin or pushing (extending)
the neck forcefully against the pressure device.

41
Q

Neck flexor endurance test

A

the patient is instructed to maximally
retract his chin and maintain that position isometrically
as he lifts his head and neck approximately one inch off of the plinth. At this time, the examiner will place
his hand under the patient’s head (at the occipital bone)
and focus his attention on the skin folds created by the
patient in his anterior neck. The patient is told to “tuck
your chin” and “keep your head up” when the skin folds
on the anterior neck begin to separate or the patient’s
occiput begins to touch the clinician’s hand. Losing the
skin fold or touching the therapist’s hand for greater than
one second will terminate the test

42
Q

Interventions with neck pain with radiating pain - 4 variable model for identifying patients who will be successful

A 
• Age less than 54 years.
• Dominant arm is not affected.
• Looking down does not worsen symptoms.
• Multimodal treatment including manual therapy, cervical traction, and deep neck flexor muscle strengthening for at
least 50% of the visits.
43
Q

Valsava manuever

A

elicit UQ symptoms while pt bears down to increase intrathecal pressure. (+) test reproduces pt sx’s.

44
Q

CPR intermittent traction

A

• Patient reported peripheralization with lower cervical
spine (C4-C7) mobility testing.
• Positive shoulder abduction sign.
• Age ≥ 55 years.
• Positive upper limb tension test (median nerve bias utilizing
shoulder abduction to 90°).
• Relief of symptoms with manual distraction test.

GMOCSE (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions