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
