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Active Care Exam Two > Cervical and Thoracic Spine > Flashcards

Cervical and Thoracic Spine Flashcards

1
Q

How prevalent is DDD in the cervical spine in those over 60 years old?

A

80% (asymptomatic)

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2
Q

At what level of the cervical spine do we see the greatest degree of axial rotation?

A

C1/C2 (45 degrees of the total 90)

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3
Q

At what level of the cervical spine do we see the greatest degree of lateral flexion?

A

Lower cervicals (35 degrees of total 40)

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4
Q

Why does the amount of axial rotation gradually decrease as we descend the cervical spine and transition into more lateral flexion?

A

Increased incline of cervical facets

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5
Q

Which is responsible for contributing more of the non-neural stability to the cervical spine: osseoligamentous system or musculature?

A

Musculature

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6
Q

Which general grow of muscles that impact the cervical spine are tightened in upper cross syndrome? Weakened?

A 
Tightened = global/extrinsic, superficial muscles that produce movement
Weakened = local/intrinsic, deep muscles that control segments
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7
Q

What is the normal flexion to extension strength ratio seen in the cervical spine?

A

60%

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8
Q

Which muscles are the deep neck flexors and are responsible for posture more so than providing actual movement?

A

Longus capitis, longus colli, rectus capitis anterior

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9
Q

What kind of presentation do we see with patients with reduced neck strength?

A

Neck pain (research showed resolution when muscles are strengthened)

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10
Q

Which intrinsic muscles aid in upper cervical flexion?

A

Rectus capitis anterior, rectus capitis lateralis

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11
Q

Which intrinsic muscles aid in lower cervical flexion?

A

Longus capitis, longus colli

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12
Q

Which intrinsic muscles aid in upper cervical extension?

A

Rectus capitis posterior major and minor, obliquus wapitis inferior and superior, semispinalis capitis, splenius capitis, longissimus capitis

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13
Q

Which intrinsic muscles aid in lower cervical extension?

A

Semispinalis cervicis, splenius cervicis, longissimus cervicis

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14
Q

What are the functions of the longus colli muscle?

A

Stiffens and stabilizes, supports curve against weight of head, counteracts buckling forces on cervical lordosis

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15
Q

Which muscles make up the global (extrinsic) cervical spine musculature?

A

SCM, anterior/medial scalene, upper trap, levator scap

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16
Q

What muscles are tightened in the upper cross syndrome?

A

Upper trap, levator snap, pectorals

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17
Q

What muscles are weakened in the upper cross syndrome?

A

Deep neck flexors, lower trap, serratus anterior

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18
Q

What is the presentation of cervical extension syndrome?

A

Rounded shoulders, anterior head carriage, head extension, elevation of shoulders, winging scapulae

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19
Q

What muscle causes the rounded shoulders seen with cervical extension syndrome?

A

Facilitated pecs

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20
Q

What muscle causes the anterior head carriage seen with cervical extension syndrome?

A

Facilitated SCM

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21
Q

What muscle causes the head extension seen with cervical extension syndrome?

A

Facilitated suboccipitals

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22
Q

What muscle causes the elevation of the shoulders seen with cervical extensions syndrome?

A

Facilitated upper trap and levator scap

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23
Q

What muscle causes the winging scapulae sometimes seen with cervical extensions syndrome?

A

Inhibited serratus anterior

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24
Q

Where would a patient with cervical extension syndrome experience a headache?

A

Suboccipital region (tight musculature)

25
Q

What signs are indicative of a failed cervical spine flexion motor pattern when performing the test?

A

1 chin protrusion occurring first 2 overactive SCM 3 shaking

26
Q

Which has more overall motion: upper or lower cervical spine?

A

Upper

27
Q

The quadruped rockback involves what musculature?

A

Levator scap, upper trap

28
Q

What is the purpose of the quadruped rockback?

A

Assess for extension

29
Q

What is the “George Constanza Method” of spinal rehab?

A

Do the opposite of what you find

30
Q

To correct for cervical extension syndrome, which general group of muscles must be engaged?

A

Intrinsic stabilizers

31
Q

How can a patient improve during supine cervical flexion when known to have cervical extension syndrome?

A

Work on tucking in the chin and holding

32
Q

How can a patient improve during the quadruped rockback when known to have cervical extension syndrome?

A

Keep spine neutral (“chin to adams apple”)

33
Q

What is the primary goal in the rehab of muscle dysfunction?

A

Retrain control (NOT INCREASE STRENGTH)

34
Q

Which is more common: cervical flexion or extension syndrome?

A

Extension

35
Q

Which tends to occur to a younger spine: cervical flexion or extension syndrome?

A

Flexion

36
Q

What is the overall appearance of the spine with cervical flexion syndrome?

A

Decreased cervical lordosis AND thoracic kyphosis, loss of flexion in thoracic spine (“straight neck/military neck”)

37
Q

What is the appearance of the shoulders with cervical flexion syndrome?

A

Depressed (insufficient recruitment of extensors)

38
Q

Why are patients with cervical flexion syndrome encouraged to “slump” during exercises?

A

Encourages flexion in the thoracic spine that is lost, helps activate extensors in cervical spine to revert back to neutral position

39
Q

Which major joints of the body are prone to a loss of mobility rather than stability?

A

Ankle, hip, thoracic, glenohumeral, upper cervical spine

40
Q

What major joints of the body are prone to a loss of stability rather than mobility?

A

Knee, lumbar, scapula, lower cervical spine

41
Q

What has the research found linking the importance of thoracic spine treatment with cervical neck pain?

A

Better results following adjustments if thoracics exercises were also administered; thoracic adjustments aided neck pain

42
Q

Thoracic spine manipulation has been shown in research to aid with what other ailments besides general pain?

A

Rotator cuff tear, adhesive capsulitis, overall ROM

43
Q

What are the negative effects of hyperkyphosis of the thoracic spine?

A

1 scapular instability
2 impaired cervical motion
3 respiration issues

44
Q

How can hyperkyphosis of the thoracic spine affect the scapulae?

A

Scapular protraction leading to rounded shoulders with scaps in forward position

45
Q

Why is scapular protraction an issue for the patient?

A

1 shoulder pain
2 narrows joint space for movement
3 strains shoulder ligaments
4 decreases shoulder strength

46
Q

What is paradoxical breathing as seen with hyperkyphosis of the thoracic spine?

A

Shoulders elevating and relying on accessory muscles for inspiration

47
Q

What is diaphragm breathing?

A

Allowing the expansion of the ribs laterally

48
Q

Which breathing style is considered the proper technique and therefore allows for greater space?

A

Diaphragm breathing

49
Q

What is the test where the patient stands against the wall with arms abducted to 90 degrees with the elbows bent at 90?

A

Wall angel

50
Q

How does a patient fail the wall angel exercise?

A

If thoracolumbar junction does not flatten

51
Q

Which exercises involves the patient squatting down while raising the arms against a wall?

A

Wall slide

52
Q

What is the purpose of the wall slide exercise?

A

Focus mobility to the thoracic spine to stretch lat and pec

53
Q

What muscles are involved with the wall slide exercise?

A

Lat and pec

54
Q

What is the purpose of the arm elevation test?

A

Screen for thoracic mobility

55
Q

When a patient struggles with the arm elevation test, what muscles are potentially involved?

A

Lats and pecs (hypertonic)

56
Q

How does a patient fail the arm elevation test?

A

Decreased extension mobility of thoracic spine seen when spine comes off wall

57
Q

What is the purpose of the cat-camel exercise?

A

Increase thoracic extension

58
Q

What is the name of the “cog-wheel” idea of posture breaks where the patient sits at the edge of the chair with the feet out wide, chin tucked, rotating arms outward, lifting sternum to deeply breathe with the abdomen?

A

Brugger’s posture break

59
Q

How can we add resistance to the Brugger’s posture break?

A

Add elastic band

Active Care Exam Two (4 decks)

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