Cervical Spine Flashcards

1
Q

What is cervical spondylosis?

A

Degeneration of the cervical intervertebral discs

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2
Q

Spondylosis of the cervical spine predisposed to which condition?

A

OA of the cervical spine

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3
Q

How do patients with spondylosis of the cervical spine present?

A
  1. Slow onset stiffness
  2. Pain in the neck
  3. Radiation of pain to the occiput and shoulder
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4
Q

What is the mainstay of treatment for cervical spine spondylosis?

A

Physio and analgesia

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5
Q

Osteophytes may impinge on nerve roots in the cervical spine which may result in what?

A

Radiculopathy involving the upper limb dermatomes and myotomes

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6
Q

Impinging osteophytes in the cervical spine may require what treatment?

A

Decompression (for severe symptoms)

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7
Q

If patients have nerve root compression secondary to cervical disc prolapse, what do they complain of?

A

Shooting neuralgic pain down a dermatomal distribution

(there may be weakness and loss of reflexes)

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8
Q

Typically, in cervical disc prolapse, the ________ nerve root is involved

A

Lower

(C7/C8)

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9
Q

A large central disc prolapse in the cervical spine may lead to what?

A

Myelopathy with upper motor neurone symptoms and signs

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10
Q

What are signs and symptoms of upper motor neurone disruption?

A
  1. Wide based gait
  2. Weakness
  3. Increased tone
  4. Upgoing plantar response
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11
Q

Atraumatic cervical spine instability can occur in which two conditions mainly?

A
  1. Down syndrome
  2. RA
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12
Q

Children with down syndrome are at risk of developing which type of cervical instability and subluxation?

A

Atlanto-axial (C1/C2)

(this may also lead to spinal cord compression)

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13
Q

How can children with down syndrome be screened to check for abnormal motion in the cervical region?

A

Flexion/extension X-rays

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14
Q

What is the recommendation for children with

a) Minor degrees of cervical instability
b) Severe degrees of cervical instability

A

a) Avoidance of high impact sport
b) Surgical stabilisation (especially if there is abnormal neurology)

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15
Q

Why does atlanto-axial subluxation occur in patients with RA?

A

There is destruction of the connecting synovial joint

(and potentially also rupture of the transverse ligament)

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16
Q

Spinal cord compression due to atalnto-axial subluxation in RA can be _______

A

Fatal

17
Q

How are patients with atlanto-axial subluxation treated?

A
  1. Wearing a collar (to prevent flexion)
  2. More severe cases mandate surgical fusion
18
Q

Lower cervical subluxation are due to what?

A
  1. Destruction of the synovial facet joints
  2. Destruction of the synovial uncovertebral joints
19
Q

Lower cervical subluxations can also present with _______ _________ __________ signs

A

Upper motor neurone