Cervical Spine Flashcards
Cervical Strain
Also known as ‘whiplash’
Where the tissues are taken past their physiological barrier
causes:
- hyperextension of the neck then hyeprflexion. Stretching the tissues past its physiological barrier.
- trauma like car accident, sports trauma like a football or rugby injury
age group affected:
- no specific age group
risk factors:
- people who drive
- people who play sports and are very active
CP:
- neck pain and stiffness
- trapezial pain and stiffness
- headache
- limiting range of motion
- symptoms begin acutely, if not treated can become chronic
Cervical Disc Degeneration
Over time the intervertebral discs between the vertebrae suffer from wear and tear and lose height and water.
causes:
- wear and tear over time.
- persistent activity like picking up heavy loads for a job can increase degeneration
age group:
- older population
- degeneration starts at about 20 and increases as you get older
risk factors:
- age- as you get older degeneration increases
- occupation- someones job can increase the likelihood of degeneration
CP:
- decreased range of motion
- stiffness, morning stiffness
- low grade neck pain
prognosis:
- csp degeneration less than lsp degeneration
- once degeneration occurs, there is no cure, degeneration will gradually get worse and worse
Csp disc herniation
Displacement of the intervertebral disc material into the spinal cord or nerve roots of the cervical spine.
outer layer- annulus fibrosis
inner layer- nucleus pulposus
where the annulus fibrosis is disrupted and the nucleus pulposus can press on the spinal cord or nerve root (central and lateral herniation)
causes:
- acute- trauma, specific incident like a car accident, heavy lifting and sports
- chronic cases can be more common in older patients
- degeneration can cause an increased likelihood of herniation. This is due to the discs being able to take less tensile stress, causing tears that disrupt the annulus fibrosis
age group:
- acute cases can be young adults
- most common 40
- 40+ is generally chronic cases
risk factors:
- degeneration can increase likelihood of herniation occurring
- cigarette smoking
CP:
- neck and arm pain
- cervical radiculopathy, numbness, tingling running down the upper limb
- the clinical presentation can be mistaken for forearm or shoulder pathology
- most common location C5-C6
- difficulty with gait or balance, bilateral upper extremity weakness, and upper neutron signs may be the result of more severe pathology (spinal cord compression)
prognosis:
- can cause spinal cord compression, this is much more serious and may require a more aggressive treatment plan to fix
CSP spinal stenosis
Narrowing of the spinal canal.
Meaning the spinal cord has less room to run through.
causes:
- congenital- pt can be born with small pedicles in the vertebrae. This will mean that the distance between the anterior and posterior of the vertebrae is smaller meaning more compression is placed on the spinal cord.
- degeneration- degenerative changes can lead to osteophyte formation leading to less room for the spinal cord
CP:
- neck pain, trapezial pain
- decreased range of motion and stiffness
- pain and stiffness worse in morning
- pain at night
- radicular pain- running down the upper extremity
- difficulty doing fine motor functions
Cervical Facet Syndrome
Degeneration of the cartilage in between the zygopophyseal joints.
This breakdown in cartilage can cause the joint to rub against each other causing pain and stiffness
causes:
- wear and tear over time can cause the degeneration on cartilage in the zygopophyseal joint
age group:
- older people as it is a degenerative disease
risk factors:
- people prone to arthritis
clinical presentation:
- neck pain
- unilateral pain, no radiation down the upper extremity
- rotation is usually painful and limited
prognosis:
- can become worse when competing in activities that require lots of movements, where the spine is bending.
- if facet pain has lasted longer than 2 weeks it will not go away, and will require treatment to get rid of the pain
Cervical Artery Dysfunction
Umbrella term for dysfunction cause with manual therapy applied to the cervical and cervicothoracic spine
Rare condition
CP:
- neck and head pain
- headaches
- speech or swallowing issues
- increase in blood pressure
- nystagmus
- dizziness
- blurred vision
- balance disturbance
Trigger points
Hyperirritiable spots located in a taut band of skeletal muscle. They produce pain locally and in a referred pattern and often accompany chronic musculoskeletal disorders.
causes:
- acute trauma or repetitive microtrauma may lead to development of stress in muscle fibres and formation of trigger points.
CP:
- regional and persistent pain resulting in decreased range of motion
- palpation of trigger points will elicit pain
- an active trigger point causes pain at rest
Chronic disc degeneration (cervical spondylosis)
Degeneration will occur over time in your intervertebral discs.
The discs dehydrate and lose height.
The discs can collapse and flatten and bony spurs may appear.
causes:
- degeneration and wear and tear over time.
age group:
- older patients will suffer more from degeneration
- due to degeneration starting at 20 years old
risk factors:
- discs drying out
- discs cracking
CP:
- neck pain and back pain
- comes and goes
- feels worse when you sit, bend or lift something
- gets better when you change position or lie down
prognosis:
- treatment can be completed to keep pain at bay
- no cure, will progressively get worse over time due to it being degenerative
Pyogenic infection
Infection in the spine. Usually staphylococcus aureus, and reaches the spine via the blood stream.
cause:
- can be caused by a bacterial infection, fungus or tuberculosis
CP:
- initial destructive changes occur to discs.
- access formation can occur, pus can get secreted into the spine causing severe pain
- neck pain associated with muscle spasm
- neck movements severely restricted
- may have elevated ESR
Tuberculosis
Bacterial infection that can affect any joint. Can travel to the spine via the blood stream.
causes:
- can be caught from droplets in the air caught from other people. This is the bacterial infection
risk factors:
- confined spaces with people who have contracted TB
CP:
- pain and swelling
- muscle wasting and palpable synovial thickening
- decreased ROM
- neck can become kyphotic
Rheumatoid Arthritis
Autoimmune disease. Immune system attacks body tissues mistakenly.
cause:
RA occurs in 4 stages if unchecked-
Stage 1 preclinical- raised eryrocytes sedation rate (ESR)
Stage 2 synovitis- synovial membrane become inflamed
Stage 3 destruction- persistent inflammation causes joint and tendon destruction
Stage 4 deformity- articular destruction, capsular stretching and tendon rupture leads to progressive instability and deformity
age group:
- 40-50
risk factors:
- women more likely than men
CP:
- Swelling, stiffness and increased warmth in the early stage. Tenderness also.
- decreased ROM
- pain
