cervical pathology Flashcards
what are the treatment considerations and RA
- know contraidications and precuations
- NEVER MANIPULATE
- encourage gentle movement and active ROM exercises during periods of remission
- be aware of various treatment meds
what are headaches of vascular origin
PT may have transient effect but if truly a migraine minimal long term effect
what are organic headaches
- does not change with activity, motion, physical exam
- not appropriate for our clinic
what are mechanical/cervicogenic headaches
-our lane
what does a pt present with when a suspicion of a fracture of atlas or axis
- painful neck splinting (turn shoulders, not neck)
- neck and occipital numbness
- pain or stiffness in neck and reluctance to move the neck
- neurological signs and symptoms
- unrelenting headache
describe OA in the C/S
natural history of DJD and DDD in C/s:
- gradual onset of sypmtoms in spine and/or arm which increase in frequency and severity with time
- decreased side bend
- morning stiffness improves throughout day
- 90% over 60 y/d have radiographic changes
describe spondylosis in the C/S
- synonymous with OA
- age related degenerative changes that be gin in the IVD and then progress to the facet and uncovertebral joints
- cervical spondylitic myelopathy is the most serious consequence
what are the 4 groups of cervical spondylosis
- neck pain
- neck pain w prox referral
- radicular pain
- myelopahty
what are the symptoms of advanced cervical spondylosis
-cause by narrowing of:
vertebral canal giving cord signs
intervertebral foramen giving nerve root signs
what are the pt reported feelings with cervical spondylsosis
- pain locally or radiating
- may have radiculopathy or myelopathy
- stiffness
- movement and posture=aggravating
where do cervical disc protrusions usually occur
laterally bc of width and strength of posterior longitudinal ligament and uncovertebral joint
what are cloward areas
-pain in the thoracic region but pathology occruing in cervical
what is a radiculopathie
-radicular pain caused by mechanical or chemical irritation to the nerve root complex creating an inflammatory process
caused by :
- facet hyperrophu
- IVD degeneration
- osteophyte formation
- lamina hypertrophy
- acutely, seen in young patients
what are signs and symptoms of radiculopathy
- unilateral motor and/or sensory symptoms in the UE with neck pain before arm pain
- msucle weakness in a myotomal pattern
- snesory changes in dermatome
- hypoactive reflex
- arm position can change symptoms (smell my armpit sign)
describe cervical radiculopathy
- often preceded by episodic neck pain
- symptoms may develop slowly or suddenly
- posture: slight flexion, lateral flex away froma ffected side
- generally involved C5-7 segmnets
