cervical spine Flashcards
What are the 4 concerning considerations?
- fracture
- ligamentous instability
- space occupying lesion
- vascular
What are the big 3 must ask questions
- Any dizziness, blackouts or drop attacks?
- Any history of RA or other inflammatory arthiritis, or treatment by a systemic steroid
- Any neurological symptoms in the arms or legs?
What are the 5 D’s
- dizziness
- drop attacks
- diplopia
- dyarthria
- dysphasia
What are the 3 N’s
- Nausea
- nystagmus
- numbness
What is a positive vertebral artery insufficiency test
dysarthria, dysphagia, diplopia, dizziness, drop attacks, numbness, nausea, nystagmus
what is the NEXUS criteria
for a fracture: S: midline posterior spinal tenderness present P: painful distracting injury present I: intoxication present N: focal neurological deficits present E: encephalophathy present
which special tests test for ligamentous instability
- sharp-purser
- alar ligament stress test
- transverse ligament stress test
what is a positive sharp-purser test
- reproudction of myelophatic symptoms during forward flexion, decrease in symptoms during anterior to post movement or excess displacement during AP movement
- if positive, refer out for imaging and stabilization
what is a positive alar ligament test
significant side bending with empty end feel, and transverse process does not come into fingers with side bending
what are some sypmtoms of cervical spondylotic myelophatrhy
- decreased hand dexterity
- gait instability
- sensory and motor dysfunction
which tests c an you use for myelopathy
use a combo including:
- hoffmans sign
- DTR; biceps, triceps, patellar
- inverted supinator sign
- hand withdrawal reflex
- babinski
- clonus
what are common symptoms for neck pain wtih mobility deficits
- pain central or unilateral
- motion limited, consistently reproduces symptoms
- may have associated/referred shoulder girdle or UE pain
what are common symptoms for neck pain wtih radiating pain
- neck pain with radiating pain in involved extremity
- UE dermatomal paresthesia, numbnbesss, or myotomal weaknesss
what are common symptoms for neck pain wtih movement coordination impairments
- mechanism of onset linked to trauma or whiplash
- may have associated/referred shoulder girdle or UE pain
- associated varied nonspecific concussive signs and symptoms
- dizziness/nausea
- headache, concenration difficulties, confusion, hypersensitivty to mechanical/thermal/acoustic/odor or light stimuli
what are common symptoms for neck pain with headache (cervogenic)
- noncontinous , unilateral neck pain and associated/referred headache
- headache is preciptated or aggravated by neck movements or sustained positions/postures
what are the recommendations for neck pain with headache?
- therapeutic environment for pt
- HA SNAG
- deep flexor strengthening
- progression of neck flexor strengthening
what are the recommendations for neck pain with mobility deficits?
- manual therapy to cervicothoracic spine
- neck and scapulothoracic strengtheining
- reinforcemnt of mobility and ROM
- address recretion and vocation needs with guidance on activity
- STM, dry needling, laser, traction
where is the C4 dermatome
posterior lower neck, clavicle
where is the C5 dermatome
mid deltoid
where is the C6 dermatome
radial aspect, 2nd finger
where is the C7 dermatome
dorsal aspect middle finger
where is the C8 dermatome
ulnar aspect 5th finger
where is the T1 dermatome
medial forearm
what is C1 and C2 myotome
neck flexion
