Cervical Lab Flashcards
Presence of pain in neck while coughing indicates what
Possible disc pathology
If a patient has had trauma in the past ____, we need to know about it as it can be the cause of their problem even if onset is delayed
6 weeks
What age is spondylosis most common
60+
What are the 3 mandatory questions for cervical screen
any dizziness or have you found yourself on the floor recently and don’t know why?
Do you have any history of RA? Or any other inflammatory arthritis, or have you taken into systemic steroids?
Any neurological symptoms in leg?
The Canadian c spine rule says anybody over ____ gets imaging if there’s a traumatic injury
65
The Canadian c spine rule says anybody experiencing what symptom gets imaging if there’s been a traumatic injury?
Paresthesia in extremities
The Canadian C spine rule says that what mechanisms will automatically have someone get imaging?
dangerous mechanism:
Fall from over 3 feet
Axial load to head
high speed MVC crash
Motorized recreational vehicle collision
Bicycle collision
What low risk factors mechanisms will allow someone to have their ROM screened under the Canadian c spine rule?
Simple rear end MVC
Sitting up in ED
ambulatory at any time
Delayed onset of neck pain
Absence of midline c spine tenderness
If someone has a low risk factor under the Canadian c spine rule, what should you assess next to determine if they need imaging
If they can actively rotate neck 45 degrees each direction
When is the Canadian c spine rule not applicable
Non trauma
Under 15 Glasgow coma
Unstable vitals
Under 16
Acute paralysis
Known vertebral disease
Previous c spine injury
Pregnant
To clear the cervical spine, what 3 structures should you test?
Transverse ligament
Alar ligament
Vertebral basilar arteries
The modified sharp purser test is for what ligament at what joint?
Transverse ligament at AA (c1 and c2)
What is considered a positive sharp purser test?
A clunk felt, or symptoms reproduced (symptoms should resolve when you apply pressure to forehead in a positive test )
If the first cervical spine clearing test comes back positive what should you do
Complete the other 2 tests so you know what to tell the doctors
The person have someone drive them to ED
Is a positive C spine clearing test urgent or emergent
Urgent
The supine lift off test is for what ligament at what joint
Transverse ligament at AA (c1 and c2)
What does a positive supine liftoff test feel like?
Boggy and squishy with excessive mobility of that joint
Where do you put your pincer grip for a sharp purser test?
C2 SP
To test the alar ligament, what movement of the head are you testing
Rotation and side bending
Testing the alar ligament is testing what joint?
OA joint (C0 and C1)
Where should you palpate for testing the alar ligament?
SP of C2
What is considered a positive alar ligament test
If you can rotate and side end a persons head without feeling movement at the SP of C2
What should a patient do with their eyes while resting VBI
Pick a spot on the wall and stare, keeping eyes open
How long do you hold the position of extension and rotation for the VBI test
Until the person is done counting back from the 10, unless they start showing any symptoms of the 5Ds or 3Ns
What movement and Which way do you glide the OA joint in order to open on the R
Flexion and gliding to R
What movement and which way do you glide the OA joint to open on the L
Flexion w glide to the left
What movement and which way do you glide the OA joint to close on the R
Extension and to the left
What movement and which way do you glide the OA joint to close on the L
Extension and to right
How do you perform joint mobility of the AA joint?
Flex neck to take up slack first
Then rotate L and R
To perform side glides on C2 to T1, what angle do you push at
45 degrees to target facets
To perform side glides in flexion for C2-T1, which way do you go to open on the R?
To the R
When sidegliding in ext for C2 to T1, which way do you go to close on the L?
To the R
How long do you maintain compression/distraction pressure for the compression test
5-8 seconds
Pain reproduced with distraction could indicate what pathologies
Spinal ligament tear
Tear or inflammation of annulus fibrosis
Muscle spasm
Large disc herniation
Dural irritability
