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OCS Prep > Cervical Spine > Flashcards

Cervical Spine Flashcards

1
Q

Describe the Cervical Rotation Lateral Flexion Test

A
  • Used to detect First Rib Hypomobility in patients with Brachialgia
  • Cervical Rotation and Lateral flexion (Ear Towards Chest). When lateral flexion motion is limited, test is positive.
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2
Q

Describe a typical clinical presentation of a patient with Ankylosing Spondylitis affecting the Thoracic Region

A
  • Thoracic Spine Stiffness
  • Reduced Chest Expansion (difficulty breathing)
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2
Q

Describe a typical clinical presentation of a patient with Ankylosing Spondylitis affecting the Thoracic Region

A
  • Thoracic Spine Stiffness
  • Reduced Chest Expansion (difficulty breathing)
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3
Q

What thoracic segments are implicated and can possibly mimic Angina?

A

T4-T7

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4
Q

Describe T4 Syndrome

A
  • A Group of Symptoms including dysfunction within the T2-7 Segments.
  • Pain in Upper Limbs, neck , upper thoracic, and scapular region and headaches.
  • May have Glovelike Parasthesias in one or both hands
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5
Q

Can Hip pain be caused by thoracic dysfunction?

A

Yes
Dorsal Rami that innervate the lower thoracic segments become cutaneous over the buttock and pnt can report Greater Trochanter type pain because of this.

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6
Q

Describe Postherpetic Neuralgia

A
  • Pain that persists for > 1 months after acute rash of Herpes has resolved
  • Can manifest itself along dermatomal patterns in thoracic spine and mimic thoracic pain or radiculopathy
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7
Q

What is Costochondrtitis, what is the preferred treatment?

A
  • Inflammation or irritation at the CostoChondral Junction.
  • Preferred treatment is Segmental Mobilization or Manipulation
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8
Q

If patient having difficulty activating the lower trapezius, what portion of the Thoracic Spine should you consider evaluating?

A
  • T8-T12
  • Manipulation or mobilization in this area to correct extension restriction has been shown to increase firing of the lower trap
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9
Q

If pnt has difficulty firing the Serratus Anterior, what portion of the Thoracic spine should you consider evaluating?

A
  • T3-T7
  • Manipulation or mobilization in this area to correct Flexion restriction has been shown to increase firing of the Serratus Anterior
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10
Q

What are the Rule of 3’s in relation to Thoracic Vertebral Anatomy

A
  • Spinous Processes of T1-3 are at the same level of the transverse processes
  • Spinous Processes of T4-6 are one half vertebral level below Transverse Processes
  • Spinous Processes of T7-9 are one full vertebral level below the Transverse Processes
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11
Q

What is the Disk Height to Vertebral Body Ratio of different portions of the spine, and how does it affect movement of the T Spine?

A
  • Cervical- 2:5
  • Thoracic- 1:5
  • Lumbar- 1:3
  • Due to the small disk ratio, the T Spine is less mobile
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12
Q

Describe True Ribs vs False Ribs

A
  • Ribs 1-7 are True because they attach directly to Sternum
  • Ribs 8-12 are False Ribs because they attach distally to Costochondral Cartilage
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13
Q

What effect can shortening of the Pec Minor have on Scapular Motion?

A

Can cause protraction and anterior tipping and potentially affect the normal scapular motion during elevation of the arm

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14
Q

What area is known as the Critical Zone in the T Spine and why?

A
  • T4-T9
  • Because of the small diameter of the spinal canal and reduced blood supply compared to other parts of the spine
  • Significant Pathology such as a large herniated disk, may lead to central spinal cord compression
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15
Q

What is T4 Syndrome?

A
  • Constellation of signs and symptoms associated with stiffness of upper back and T Spine
  • Symptoms include headaches, neck pain, upper extremity pain, and bilateral “stocking glove” parasthesias
16
Q

Describe a Flexion Impairment of the T Spine

A
  • Commonly in upper to middle T Spine (T3-7)
  • Relative Straightening or loss of kyphosis
  • Occurs often after whiplash
  • Decreased Flexion, Decreased Contralateral SB and ROT
17
Q

Describe an Extension Impairment of the T Spine

A
  • Commonly in upper T Spine and Cervicothoracic Junction (C7-T2)
  • Increase in Kyphosis
  • Occurs d/t poor postural habits, degenerative changes, disk height loss etc
  • Loss of Extension, Ipsilateral Side Bending and Ipsilateral Rotation
18
Q

How would a Peptic Ulcer produce Musculoskeletal pain?

A
  • Boring pain from the epigastric area to the Middle Thoracic Spine
  • Typically Relief after eating, Occasionally worsens after eating
19
Q

How would a Inflamed Gall Bladder (Cholecystitis) produce Musculoskeletal pain?

A

Pain in Right Upper Quadrant and Right Infrascapular region
Sx often occur 1-2 hours after ingestion of heavy meal
Pain often accompanied with moderate fever, nausea, vomiting
(+) Murphy Sign

20
Q

How would Pancreatitis produce Musculoskeletal pain?

A

Pain around Thoracolumbar Junction

21
Q

How would a Pyelonephritis (Kidney Infection) produce Musculoskeletal pain?

A
  • Pain referred to Costovertebral or flank area
  • Often accompanied by fever, nausea, vomiting and renal colic
22
Q

What is Renal Colic?

A

Flank Pain accompanied by lower abdominal pain that spreads to the labia in women and testicles in men

23
Q

What are the Clinical Prediction Rule factors for diagnosing Anylosing Spondylitis?

A
  • Stiffness > 30 minutes duration
  • Improvement of back pain with exercise and not rest
  • Awakening because of back pain during the SECOND half of the night
  • Alternating Buttock Pain
24
Q

What is the Key Physical Examination finding of Ankylosing Spondylitis?

A

Limited Chest Expansion

25
Q

What is the Cervical Rotation Lateral Flexion Test?

A

Test used to assess the presence of an elevated First Rib in patients with brachialgia

26
Q

What T Spine Manipulation would you use to increase Flexion vs Extension (theoretically)?

A
  • To Increase Extension- Prone
  • To Increase Flexion- Supine

OCS Prep (13 decks)

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