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CATA 437 > cervical spine > Flashcards

cervical spine Flashcards

1
Q

C0-C1 is what type of joint and is a stable or unstable joint

A

stable, antlanto-occipital joint

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2
Q

principal motion of antlanto-occipital joint

A

Principle motion of this joint is flexion-extension (15-20°)
Nodding of the head

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3
Q

is rotation and SB physiological motion of C0-C1

A

no

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4
Q

C0-C1 mechanic in flexion, extension

A

flexion: ant roll, backward slide
extension: backward roll, ant slide

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5
Q

flexion of C0-C1 is limited by

A

posterior structure, submandibular tissue

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6
Q

extension of C0-C1 is limited by

A

occiput compressing sub occipitals

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7
Q

how does rotation and SB C0-C1 occurs

A

Condyles must slide out/lift out of their socket tension on atlanto-occipital ligaments and joint capsule

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8
Q

what is the most mobile articulation of neck

A

C1-C2

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9
Q

axis most weight bearing in C-spine

A

C1-C2

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10
Q

C1-C2 is which type of joint

A

biconvex

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11
Q

how munch rotation occurs at C1-C2

A

Rotation is ~50° contralateral alar ligaments, capsules, impaction of anterior arch of atlas on dens of axis

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12
Q

how munch flexion/ext occurs at C1-C2 joint

A

Flex-ext ~10° restricted when post arch hits occiput or C2 not ligament restriction

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13
Q

what is the role of odontoid process

A

Odontoid process of C2 acts as pivot point
Transverse ligament

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14
Q

Pain in this area commonly referred to upper extremity

A

cervico-brachial area (C3-C7)

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15
Q

pathology in C3-C7 area can lead to what

A

combination of neck and arm pain

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16
Q

C1-C2 have rotation, SB or both

A

rotation only

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17
Q

C3-C7 follow which rule

A

law 2 -> rotation and SB same direction

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18
Q

Greatest flexion and extension of facet joints occurs between

A

C5-C6
Almost as much movement at C4-C5 and C6-C7

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19
Q

vertebral artery passed where and role

A

Vertebral artery- part of vertebrobasilar system
Passes through TPs of C-spine
Starting at C6
20% blood supply to brain (hindbrain

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20
Q

vertebral artery affected which ROM of C-spine

A

extension + rotation

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21
Q

symptom of vertebral artery

A

Symptoms- vertigo, nausea, tinnitus, “drop attacks”, visual disturbances, or rarely stroke or death

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22
Q

internal carotid is mainly stressed with which ROM

A

with rotation, extension and traction motions

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23
Q

where in C-spine there’s no disc

A

btw C0-C1 and C1-C2

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24
Q

intervetrebral disc take how many % of height of cervical spine

A

25%

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25
Q

how does nerve root is named

A

from cervical vertebra below it

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26
Q

how many cervical root is there

A

8 cervical nerve roots
Nerve root existing between C0-C1
Names C1 nerve root

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27
Q

what act on atlas

A

muscle that act on the head

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28
Q

What muscles does the brachial plexus run between/under?

A
  • scalene, pec minor
  • 1st ribs, clavicle
29
Q

What are common signs/symptoms of compression of brachial plexus?

A

N/T/B

30
Q

What pathologies will affect the brachial plexus?

A

disc degeneration, cervical stenosis, TOS, upper cross syndrome

31
Q

what is multifactorial disease risk factor

A

Risk factors: lack of physical activity, duration of daily computer use, perceived stress, lack of social support and being female
2x risk of neck/back pain with people with mental disorders compared to people without mental disorders

32
Q

Subjective History for cervical spine

A
  • age
    -radicular symptom
  • weaknes, numbness, burning, tingling
  • headache/pain partern
  • dizziness, faitness, seizure
  • sympathetic symptom
  • mouth breather
  • sleeping position
  • cognitive or behavioural change
  • glasse/contact
33
Q

type of cervical fracture

A

Jefferson fracture (burst fracture), hangman fracture, flexion/extension tear drop fracture, clay shoveler fracture

34
Q

MOI of extension tear drop fracture and what happen

A

hyperextension
Displaced anterolateral aspect of body
Avulsion of ALL

35
Q

MOI of flexion tear drop fracture and what happen

A

hyperflexion
fracture of anterior vertebral body

36
Q

what is clay shoveler fracture. + Moi

A

fracture of SP C6-T1, hyperextension

37
Q

ROM deficit with DDD

A

extension, SB and rotation

38
Q

different cause of spinal stenosis

A

Bone growth
Disc herniation
Inflammation

39
Q

torticolis acute cause

A

Sleeping awkward, neck muscle, injury that causes heavy scarring, neck muscle spasm
Secondary to slipped facets, herniated disc, infection

40
Q

what is upper cross syndrome

A

tight upper trap + levator scap + pec

inhibited rhomboid + serratus anterior + neck flexor

41
Q

what are the clinical criteria for diagnosis of cervicogenic headache

A
42
Q

neck extensor endurance test positive

A

Loss of chin tuck=dominance of superficial extensor muscles
Neck flexion=weakness of deep and superficial extensors

43
Q

Special Tests- For Neurological Symptoms

A

ULTT
Brachial plexus traction test

Tinel’s@ brachial plexus
Shoulder depression test
Shoulder abduction test
Spurling’s test (Foraminal Compression)
Distraction test

44
Q

which test is the best to use for cervical radiculopathy

A

foramina compression (spuling test)

45
Q

+ve of foraminal compression test

A

Positive: pain radiates into arm toward side in which the head is side flexed
Pain without radiating pain into arm is NOT A POSITIVE

46
Q

when do you do foramina compression test

A

Performed if patient is complaining of nerve root symptoms
At time of test should be diminished or absent
Provoke symptoms

47
Q

when do you do distraction test and +ve

A

Patients who complain of radicular symptoms in history and show radicular signs during examination

+ve: pain is relieved or decrease

48
Q

ULTT 1 test which nerve

A

median nerve, anterior interosseous nerve, C5-C6-C7

49
Q

ULTT 2 test what

A

median nerve, musculocutaneous nerve, axillary nerve

50
Q

ULTT 3 test which nerve

A

radial

51
Q

ultt 4 test what

A

ulnar nerve, C8-T1 nerve roots

52
Q

which test would you use to rule in cervicalradiculopathy

A

the Spurling’s test, traction/neck distraction, and Valsalva’s manoeuvre

53
Q

which test would you use to rule out cervical radiculopathy

A

ULTT

54
Q

brachial plexus tension test is a modification of which test

A

ULTT 4

55
Q

shoulder depression test evaluate what + +ve

A

brachial plexus tension, Positive: pain increases compressed or distracted side
Osteophytes?
Adhesions around dural sheaths, hypomobility of joint capsule

56
Q

what shoulder abduction test indicate

A

radicular symptom especially C4 or C5 nerve root,Cervical extradural compression (herniated disc), nerve root compression

57
Q

vascular clearing test

A

Vertebral Artery test
Dizziness Test
Hautant’s test (pronator drift)

58
Q

how to differentiated dizziness

A

Vascular- check BP
Vestibular- head and neck movement
Cervicogenic-AROM, lig test etc

59
Q

when should vascular clearing test should be done

A

before doing PROM

60
Q

+ve finding with vertebral artery quadrant test

A

Positive: provokes referred symptoms (if opposite artery affected)
Dizziness, nystagmus (eyes jumping, twitching), light-headedness, visual disturbances, artery is being compressed

61
Q

if dizziness test produce symptom only with head movement what does it means

A

inner ear problem

62
Q

if dizziness test is positive with both head and shoulder movement what does it indicate

A

vertebral artery dysfunction

63
Q

pronator drift test help to differentiate what

A

Help to differentiate between dizziness caused by articular problem vs vascular problems

64
Q

in which case pronator drift test indicate a vascular problem or doesnt indicate a vascular problem

A

If arm moves= non vascular
Pt then rotates, or extend and rotates the neck, and maintain position with eyes closed again
Wavering of arms=dysfunction caused by vascular impairment

65
Q

positive sharp-purser test

A

Positive: examiner feels the head slide backward during movement
Reduction of atlas, may feel “clunk”
-> transverse ligament of atlas on axis

66
Q

which test do you completed if sharp-purse is negative

A

Aspinall’s tranverse ligament

67
Q

positive test with Aspinall tranverse ligament

A

Positive: lump in throat as atlas moves toward esophagus

68
Q

positive rotational alar ligament stress test

A

If more than 20-30° of rotation is possible without moving C2
=positive for injury to contralateral alar ligament

-> can be do with SB also

CATA 437 (12 decks)

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