Cervical Disc Disease Flashcards
What nerves innervate the outer 1/3 of the annulus?
Sinuvertebral nerve (from somatic root) Vertebral nerve (from autonomic root)
What traps and holds water, which is what gives the nucleus pulposus its strength and resiliency?
Proteoglycan aggrecan
How much water can proteoglycan aggrecan hold?
500x its weight
Where is the referred pain for C3-C4 disc?
C7 spinous process and posterior border of trapezius
Where is the referred pain for C4-C5 disc?
Superior angle and spine of scapula
Where is the referred pain for C5-C6 disc?
Center of the medial border of scapula
Where is the referred pain for C6-C7 disc?
Inferior angle of scapula
What root does a HNP of the C4-C5 disc hit?
C5 nerve root
What is the most common cause of cervical radiculopathy?
Foraminal Encroachment (70-75%)
How much is a cervical HNP responsible for radiculopathies?
20-25%
What are the most common sites for a Cervical disc herniation?
C5 and C6
What nerve root is the most common incidence for cervical radiculopathies?
C7
What describes pathological annular fissuring within the disc without external disc deformation due to trauma/whiplash?
Internal Disc Derangement
What is the major pain generator for IDD?
Outer 1/3 of annulus
What is an area where pain is experienced with root pathology?
Dynatomes
What is an area of sensory disturbance with root pathology?
Dermatomes
Is cervical pain better or worse with extension and rotation?
Worse
Is cervical pain better or worse with flexion and arm abduction (Bakody’s sign)
Better
What is an indication of cervical myelopathy?
Increased upper and lower limb reflexes/Upper motor neuron signs
What is the motor/reflex/dermatome of the C5 nerve root?
Motor: Deltoid
Reflex: Biceps Brachii
Dermatome: lateral brachium
What is the motor/reflex/dermatome of the C6 nerve root?
Motor: Wrist extension
Reflex: Brachioradialis
Dermatome: Lateral forearm, 1st and 2nd digit
What is the motor/reflex/dermatome of the C7 nerve root?
Motor: wrist flexion
Reflex: triceps
Dermatome: 3rd finger
What is the motor/reflex/dermatome of the C8 nerve root?
Motor: finger flexion
Reflex: none
Dermatome: 4th and 5th digit and medial forearm
What is the motor/reflex/dermatome of the T1 nerve root?
Motor: interossei
Reflex: none
Dermatome: Medial brachium
