Cervical Orthopedics

Question 1

Pathologic subluxation of atlas on axis compromises spinal cord and causes what? Associated with what?

Answer 1

Compressive myelopathy

RA and AS

Question 2

Traumatic mechanism of injury, non-specific symptoms exacerbated by upright position and relieved with supported head

Answer 2

Cervical instability

Question 3

Nonspecific neck pain with radiating symptoms into one arm

Answer 3

Cervical radiculopathy

Question 4

Diffuse neck pain exacerbated by movements

Answer 4

Mechanical neck pain, facet syndrome, muscle strain, ligamentous sprain

Question 5

Neck pain bilateral UE symptoms with occasional balance or coordination deficits

Answer 5

Cervical myelopathy

Question 6

Pain in certain postures alleviated by positional change

Answer 6

Upper cross syndrome

Question 7

Cervical range of motions

Answer 7

Flexion: 60
Extension: 75
Lateral flexion: 45
Rotation: 80

Question 8

Rust sign indicates?

Answer 8

Sprain
RA
Fracture
Severe pathologic cervical subluxation

Question 9

Examples of pathologic cervical conditions that may cause cervical myelopathy

Answer 9

• Spondylitis spurs/canal stenosis
  -central disc herniation MC*****
  -tumor
  Dislocation
  -syringomyelia

Question 10

MC levels affected by IVF encroachment (irriation caused by localized displacement of nucleus, cartilage, fragmented bone beyond IVD space)

Answer 10

C6/C7

Question 11

MC causes of IVF encroachment

Answer 11

Lateral canal stenosis
(Due to VB osteophytes, Z-joint or Lig Flavum hypertrophy)
Cervical disc herniation

Question 12

S/s of cervical NR compression

Answer 12

• Distal dermatomal Paresthesia
• decreased DTR
• fasciculation
• movements of neck causes increased radiation

Question 13

Determine Sign indicates what?

Answer 13

Cough/sneeze

SOL causing NR compression

• herniated/protruding disc
• tumor
• compression fx!!!!

Question 14

NR pain is produced/aggravated by things that cause what?

Answer 14

Sudden increase in intrathoracic and intraabdominal pressure

Question 15

What should patients with radicular symptoms and pronounced dejerine sign be told to do during a cough.sneeze?

Answer 15

Bend knees and lean into a wall to decrease intradiscal pressure and minimize effect

Question 16

What does student unexpected absence of dejerine sign indicate?

Answer 16

Fragmentation of the disc

Question 17

Naffziger test indicates?

Answer 17

Pressure over jugular veins and cough. Pain along nerve

= NR compression/strain/sprain

Question 18

What sign is always positive in presence of cord tumor (meningiomas)

Answer 18

Naffziger

Question 19

Naffziger is always positive in patients with what

Answer 19

Cord tumors—meningiomas

Question 20

Brachial plexus lesions due to what?

Answer 20

Traction injuries

Lateral neck flexion away from side involved

Question 21

S/s of brachial plexus lesion

Answer 21

Ipsilateral shoulder depression

Weakness of deltoid, biceps, supraspinatous, infraspinatous

Question 22

Erbs palsy

Answer 22

Upper brachial plexus injury

c5,c6,c7

Question 23

Erbs palsy seen with what

Answer 23

Difficult head first births requiring forceps/vacuum

Question 24

S/s of erbs palsy

Answer 24

Waiter’s tip deformity

Question 25

Waiter’s tip deformity seen with what

Answer 25

Erbs palsy (upper brachial plexus injury)

Question 26

Klumpke’s palsy

Answer 26

Lower brachial plexus injury

C8,T1

Question 27

Klumpkes palsy seen with what

Answer 27

Breech births for falls and attempt to grab overhead

Question 28

S/s of klumpke’s palsy

Answer 28

Claw hand

Question 29

Claw hand is seen with what

Answer 29

Klumpke’s palsy