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CERVICAL CONDITIONS & TMJ DISORDERS > CERVICAL CONDITIONS > Flashcards

CERVICAL CONDITIONS Flashcards

1
Q

enumerate the 7 conditions involving the cervical region:

A
  1. cervical strain and sprain
  2. cervical internal disk disruption
  3. cervical spondylosis & stenosis
  4. cervical joint pain
  5. torticollis
  6. cervical radiculopathy & radicular pain
  7. whiplash injury
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2
Q

classification of cervical strain and sprain

A

axial pain - is confined to one spot or region. It may be described a number of ways, such as sharp or dull, comes and goes, constant, or throbbing.

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3
Q

definition of cervical strain and sprain

A

A cervical strain is a musculotendinous injury
produced by an overload injury resulting from
excessive forces imposed on the cervical
spine.

Cervical sprains are overstretching or tearing
of spinal ligaments.

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4
Q

epidemiology of cervical strain and sprain

A

85% of neck pain results from acute, repetitive, or chronic neck injuries.

women are more affected; in the age range of 30-50 yo

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5
Q

etiology of cervical strain and sprain

A

most common in motor vehicle accidents

most common cause of pain after non-catastrophic sports injuries

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6
Q

pathophysiology of cervical strain and sprain

A

acceleration - deceleration injuries : a form of head injury caused by the head suddenly being placed into motion or abruptly stopped, as, for example, when the individual is in a car accident.

increased thoracic kyphosis and consequential cervical lordosis and extension, strain occurs in the Levator Scapulae, Superior Trapezius, SCM, Scalene and Suboccipital muscles.

increased thoracic kyphosis and consequential cervical lordosis and extension, strain occurs in the Levator Scapulae, Superior Trapezius, SCM, Scalene and Suboccipital muscles.

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7
Q

clinical manifestations of cervical strain or sprain

A

Dull, sharp localized neck pain

Headache that is typically sharp/ dull localized to the cervical or shoulder girdle musculature

Neck fatigue

Muscle stiffness/ guarding

↓ Cervical ROM

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8
Q

definition of cervical internal disk disruption

A

Indicates that an IV disk has lost its normal internal architecture but maintains a preserved external contour in the absence of nerve root compression

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9
Q

classification of cervical internal disk disruption

A

axial pain - is confined to one spot or region. It may be described a number of ways, such as sharp or dull, comes and goes, constant, or throbbing.

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10
Q

epidemiology of cervical internal disk disruption

A

20% - traumatically-induced CIDD

41% - suffering from CIDD & concomitant joint injury

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11
Q

etiology of CIDD

A

End plate fractures due to excessive loads;
disc dislocation; loss of disk height; annular
fissue; ostephytosis; reactive end-plate
changes are markers of disk degeneration

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12
Q

pathophysiology of CIDD

A

Stimulation of local mechanoreceptors and nociceptors and annular defect -> migration of nuclear material or inflammation mediators -> stimulate the outer annulus, dura mater, posterior longitudinal ligament, dorsal root ganglion or spinal nerve

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13
Q

clinical manifestations of CIDD

A

Posterior neck pain, occipital and suboccipital pain, upper trapezius pain, inter- and periscapular pain, nonradicular arm pain, vertigo, tinnitus, ocular dysfunction, dysphagia, facial pain, and anterior chest pain

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14
Q

clinical manifestation of CIDD

A

Posterior neck pain, occipital and suboccipital pain, upper trapezius pain, inter- and periscapular pain, nonradicular arm pain, vertigo, tinnitus, ocular dysfunction, dysphagia, facial pain, and anterior chest pain

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15
Q

definition of cervical spondylosis & stenosis

A

Degenerative changes in the cervical spine are common with advancing age.

IV discs lose hydration and elasticity, leading to cracks and fissures.

Surrounding ligaments also lose their elastic properties.

spondylosis refers to degeneration of the spine, whereas stenosis specifically refers to the narrowing of the spinal canal that can happen as a part of spondylosis.

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16
Q

classification of cervical spondylosis and stenosis

A

no classification for this condition

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17
Q

epidemiology of cervical spodylosis and stenosis

A

prevalence of cervical spondylosis was 13.76%

female > males

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18
Q

etiology of cervical sponylosis and stenosis

A

spondylosis - caused by the normal wear-and-tear of aging

stenosis - Wear and tear damage from osteoarthritis on your spinal bones can prompt the formation of bone spurs, which can grow into the spinal canal.

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19
Q

pathophysiology of cervical spondylosis and stenosis

A

Intervertebral disks lose hydration and elasticity with age, and these losses lead to cracks and fissures. The surrounding ligaments also lose their elastic properties and develop traction spurs. The disk subsequently collapses as a result of biomechanical incompetence, causing the annulus to bulge outward. As the disk space narrows, the annulus bulges, and the facets override. This change, in turn, increases motion at that spinal segment and further hastens the damage to the disk.

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20
Q

clinical manifestation of cervical spondylosis and stenosis

A 
Neck pain 
LOM 
Tenderness at posterior aspect of neck 
(+) neurological signs 
(+) Spurling’s/Foraminal Compression Tests 
(+) Lhermitt’s sign
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21
Q

definition for cervical joint pain

A

Most commonly occurs in association with a symptomatic intervertebral disk at the same level

22
Q

classification for cervical joint pain

A

no classifications

23
Q

epidemiology for cervical joint pain

A

58-88% complain of headaches

50-53% c/o posterior headaches after whiplash injury

24
Q

etiology of cervical joint pain

A

Traumatic, non-traumatic

cervical zygapophyseal joint pain affects usually one joint and can be due to spondylosis or improper biomechanics

25
Q

pathophysiology of cervical joint pain

A

Zygapophyseal join fractures, intra-articular hemorrhage and capsular tears

26
Q

clinical manifestation for cervical joint pain

A

Unilateral paramidline neck pain is more painful than any associated headaches

Pain from the cervical zygapophyseal joints
c1-2 AND c2-3 = Occiput
c3-4 AND c4-5 = Posterior neck
c5-c6 = Supraspinatus fossa of the scapula
c6-7 = Scapula
c1-2, C2-3, C3-4 AND c4-5 = FACE
c3-4, c4-5. AND c5-6 = HEAD

27
Q

definition of torticollis

A

Wry neck or cervical scoliosis

Persistent involuntary contractions of the muscles in one side of the body

28
Q

classification for torticollis

A

none

29
Q

epidemiology of torticollis

A

4/1000 births

75% involving on the right side

30
Q

etiology of torticollis

A

Congenital

a. faulty fetal position
b. direct trauma on the muscle
c. nerve injury

Muscle imbalance due to existing conditions

31
Q

pathophysiology of torticollis

A

congenital - caused by local trauma to the soft tissues of the neck just before or during delivery.

acquired - can be the result of blunt trauma to head and neck, or from simply sleeping in an awkward position.

32
Q

clinical manifestations of torticollis

A

Head is slightly flexed and drawn towards the
contracted side with the face rotated over the
shoulder

33
Q

definition of cervical radiculopathy & radicular pain

A

cervical radicular pain defined as pain
involving the shoulder girdle and distally,
manifested as pain in the upper limb

34
Q

classification of cervical radiculopathy and radicular pain

A

none

35
Q

epidemiology of cervical radiculopathy and radicular pain

A

Peak incidence at ages 50-54

55yo< due to acute disc herniation

55yo> due to degenerative changes

36
Q

etiology of cervical radiculopathy and radicular pain

A

due to disc herniation, stenosis,osteophytes,

swelling with trauma, spondylosis

37
Q

pathophysiology of cervical radiculopathy and radicular pain

A

Cervical IV disc herniation inflammatory response and pressure gradient-> radicular pain

degenerative changes-> ligamentous hypertrophy, hyperostosis, disk degeneration, facet joint arthropathy, ostephytes, cysts-> stenosis and Impingement radiculopathy

38
Q

clinical manifestations of cervical radiculopathy and radicular pain

A

Muscle weakness in the Unilat UE (myotome)

Paresthesia in the Unilat UE ( dermatome)

Hyporeflexia

aggravated by side flexion, rotation, extension and relieved by distraction

39
Q

definition of whiplash injury

A

Whiplash is a neck injury due to forceful, rapid back-and-forth movement of the neck, like the cracking of a whip. Whiplash is commonly caused by rear-end car accidents. But whiplash can also result from sports accidents, physical abuse and other types of traumas, such as a fall.

40
Q

classification for whiplash injury

A

none

41
Q

epidemiology of whiplash injury

A

The prevalence of whiplash injuries was 7.7% and 9.6% in men and women, respectively.

42
Q

etiology of whiplash injury

A

commonly caused by rear-end car accidents

43
Q

pathophysiology of whiplash injury

A

Passive movement of the neck, muscular control and stabilize the cervical spine does not react quickly enough to prevent injurious forces from occurring across the cervical functional spinal units

44
Q

clinical manifestations of whiplash injury

A 
neck pain
headaches
shoulder girdle pain 
upper limb paresthesia
weakness
dizziness
visual disturbances 
tinnitus
45
Q

GENERAL complications for CERVICAL CONDITIONS

A

Long-term complications that may develop from cervical injuries include chronic pain, headaches, depression, permanent loss of cervical ROM, and disability.

46
Q

GENERAL diagnosis for CERVICAL CONDITIONS

A

CT scan: for bony conditions

Myelography: disc conditions

Discography: for the disc

Electrodiagnostic evaluation: NCV (Nerve conduction velocity, EMG) for cervical neve root and peripheral function

47
Q

general DDX

A

cervical radiculopathy vs brachial plexus lesion

cervical myelopathy vs cervical radiculopathy

48
Q

general prognosis for cervical conditions

A

cervical conditions worsen with age, due to aging, there are anatomical and physiological changes in the body which may lead to worsening of the condition.

prognosis also differs if the pt is involving him or herself in engaging in interventions or exercises that help alleviate or perhaps slow down disease progression.

49
Q

gen healthcare management for CERVICAL CONDITIONS

A

medical - not much medical intervention if condition can be controlled through medication.

pharmacological - use of nsaids, oral steroids, muscle relaxants, opioids, and antidepressants may be observed so as to control or alleviate symptoms of these conditions.

surgical - as for surgical management, cervical implants may be placed in these patients. Cervical implants are devices surgeons use to decompress and stabilize the neck. These devices are implanted either from the front (anterior) of the spine, or from the back (posterior).

50
Q

GENERAL other healthcare management for CERVICAL CONDITIONS

A

physiatrist - helps give an individual the power to make major changes in their life, and to help target the exact issues relating to their mental or behavioral health challenges.

speech pathology - needed in patients with speech impairments due to cervical conditions

51
Q

special tests

A

Spurling test-test for foraminal encroachment on an inflamed cervical nerve root

Lhermittes- indicative of spinal cord pathology as well as herniated cervical disc

Adson’s maneuver- with neurovascular compromise secondary to TOS

CERVICAL CONDITIONS & TMJ DISORDERS (2 decks)

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