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OMM Lab M1 > Cervical I > Flashcards

Cervical I Flashcards

1
Q

Neck pain epidemiology

A

. More females than males
. Lifetime prevalence: 70%
. Incidence peaks 20-40 y/o
. Incidence higher in patients w/ multiple medical problems, high job stress, and occupational factors

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2
Q

Neck pain complaint causes

A 
. Poor posture 
. Repetitive use and strain 
. Degenerative spine/disc 
. Trauma 
. Rheumatic conditions 
. Head and neck infections 
. Psychological stress 
. Respiratory problems 
. Compensatory
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3
Q

Atlas

A

. No vertebral body
. Rotates around dens of C2
. Heavy lat. mass palpable just inf./post to mastoid processes
. Small post. Tubercle instead of spinous process

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4
Q

Axis

A

. Dens (odontoid process)

. Larger palpable, bifid spinous process

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5
Q

What contributes to stability of cervical spine

A

. Unique uncinate (uncovertebral) joints of Luschka on lat. vertebral body

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6
Q

Uncinate joints

A

. Allow fl/extension but limit segmental sidebending
. Potentially reduce disc herniation
. Shearing stresses can cause degenerative spurs as early as teen yrs

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7
Q

Degenerative arthritis in uncinate and facet joints are causes of what?

A

.cervical nerve root compression

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8
Q

Z joints of cervical spine

A

. 45 degree angle toward the eye

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9
Q

Cervical transverse processes

A

. Ant. Part is modified rib
. Post. Part is true transverse process
. Ant. And post. Parts are fused but maintain a foramen for vertebral a. Starting at C6

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10
Q

Vertebral aa.

A

. Provide circulation to post. Brain

. Extension and sidebending/rotation of c spine can put vertebral aa. At risk for occlusion in some patients

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11
Q

Lateral masses/articular pillars of c spine

A

. Facet joints form bony column on lat. aspect of cervical column (lat. mass)
. Key landmark
. Palpable masses are not transverse processes

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12
Q

Cervical landmarks for palpation

A 
. Occiput
. Lat. mass of atlas 
. Spinous process of axis 
. Hyoid bone
. Thyroid
. Cricoid
. Vertebra prominens, large spinous process
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13
Q

Neuro testing C5, 6, 7

A

. C5: motor: deltoid, biceps, bicep reflex, lat. arm dermatome
. C6: motor: bicep, wrist extensors, extensor reflex, lat. forearm dermatome
. C7: motor: tricep, wrist flexors, finger extensors, flexor reflex, middle finger dermatome

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14
Q

Neuro testing C8 and T1

A

. C8: motor: interossei, finger flexors, no reflex, 4-5 fingers and forearm dermatome
. T1: motor: interossei, no reflex, med. elbow dermatome

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15
Q

Fascia of neck

A

. Superficial, intermediate, deep
. Follows tube w/in tube structure
. Continues into mediastinum to blend into pericardium and great vessels
. Superficial fascia splits to invest the t rap and SCM mm.
. Superficial lymph penetrates investing fascia to gain access to deep lymph

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16
Q

Cervical lymphatic

A

. Divided into superficial and deep chains

. Stretching neck mm. And fascia helps lymph drain

17
Q

Paravertebral mm.

A

. Longus colli (C1-T3)
. Longus capitus (occiput to C3-6)
. Traps: primary connection btw head, neck, and upper extremity

18
Q

Ant. Neck mm.

A

. Strap mm. Attach to sternum to hyoid and hyoid to skull
. Scalenes and deep paravertebrals stabilize head and neck
. Provide proprioceptive feedback

19
Q

Sternocleidomastoid m.

A

. Divides neck into ant. And post. Triangles
. Attaches to clavicle and sternum
. Innervated by CN XI
. Unilaterally sidebends beck to ipsilateral side, rotates away
. Bilaterally: flexor of neck, extender at OA joints
. Elevates amnubrium and med. ends of clavicle to assist in pump-handle motion in deep respiration

20
Q

Congenital torticollis

A

. Infants present w/ neck sidebent and rotated in opposite directions

21
Q

;evaporated scapula

A

. From transverse processes of C1-4
. Insert: upper med. scapula
. Elevates scapula and rotates med.

22
Q

Suboccipital mm.

A

. Stabilize head and act as proprioceptive sensors

. Irritability leads to headache that penetrates deep in skull

23
Q

Post. Spinal mm.

A

. Semispinalis, cervicis, and longissimus

. Can cause extension dysfunctions

24
Q

Ant. Spinal mm.

A

. Longus colli/rectus capitus

. Can cause flexion dysfunctions

25
Q

Deep layer post. Mm.

A 
. Multifidae and rotators cervicis 
. Receive segmental innervation 
. Palpation of tart is best indication of segmental somatic dysfunction 
. Short mm. 
. Essential mm. Of proprioception
26
Q

Accessory mm. Of respiration

A

. SCM

. Scalenes

27
Q

Scalene mm.

A

. Connect cervical transverse processes to ribs 1 and 2
. Bilaterally flex neck
. Unilaterally sidebend neck ipsilaterally, rotate away
. Brachial plexus and subclavian a. Lie btw not. And middle scalene mm.
. Scalene dysfunction can cause dysfunction of cervical spine and affect neurovascular components of upper extremity

28
Q

Thoracic outlet syndrome

A

. Neurovascular compression btw ant. And middle scalenes, clavicle and 1st rib OR bite pec minor and upper ribs
. Result of trauma, repetitive movements, tumors, pregnancy, or cervical rib
. N. Compression causes pain, weakness,
. Arterial compression causes pallor and coldness in arm
. Venous compression causes swelling and pain in arm

29
Q

Adson’s maneuver

A

. Tests for subclavian a. Compression
. Compression: loss of radial pulse w/. Ipsilateral sidebending of neck, abducting and externally rotating arm, extending neck and holding breath
. Test position tenses ant. And middle scalenes to narrow interscalene space
. Pos test: radial pulse obliterated and symptoms reproduced

30
Q

Standing exam for neck pain

A

. Standing structural for posture, symmetry, relationship of head to weight, amt of lordosis

31
Q

Seated exam for neck pain

A

. AROM/PROM for cervical and thoracic regions,
. Neurovascular exam
. Exam of thoracic spine and ribs

32
Q

Active ROm of neck

A 
. Flexion: 90 degrees
. Extension 70
. Sidebending 35-45
. Rotation 90 
. 50% of rotation occurs at atlantoaxial joint
33
Q

Wallenberg test

A

. Tests for vertebral insufficiency
. Cervical spine is extended and then gently rotated side to side
. If nystagmus develops or patient is nauseous or dizzy then cervical articulatory techniques contraindicated

34
Q

OA in c spine

A

. Hypertrophic changes of z joints and vertebral bodies
. Treat w./ specific mobilization of restricted areas
. Strengthen cervical musculature and facilitate stability

35
Q

RA and down’s in c spine

A

. Ligamentous laxity of C2 causing C1 and C2 instability

. Contraindication of thirst techniques

OMM Lab M1 (18 decks)

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