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CATA 437 final > Cervical Spine > Flashcards

Cervical Spine Flashcards

1
Q

Name C0-C1

A

Atlanto-occipital joint

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2
Q

Principle motion of C0-C1

A

Flexion-extension (nodding of the head)

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3
Q

Which ROMs are not possible at atlanto-occipital joint?

A

Rotation and SB

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4
Q

Biomechanics of flexion at C0-C1

A

anterior roll/backward slide

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5
Q

extension at C0-C1 is limited by

A

occiput compressing sub occipitals

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6
Q

What happens at the condyles C0-C1 when rotation and SB occurs?

A

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

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7
Q

Most mobile articulation

A

C1-C2

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8
Q

Most weight bearing in cx-spine

A

Axis - C2

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9
Q

Atlas

A

C1

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10
Q

Axis

A

C2

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11
Q

Which structure acts as a pivot point on C2?

A

Odontoid process/dens (transverse ligament)

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12
Q

Dens (odontoid process) is on ant or post aspect of C2?

A

anterior

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13
Q

45-50d cervical spine rotation comes from where

A

C1-C2

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14
Q

Lower cervical spine

A

C3-C7

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15
Q

coupled mvts (law) - C1-C2

A

rotation only

actually C1-C2 is a biconvex joint

meaning it does primarily rotation (50d) but also flex/ext (10d)

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16
Q

coupled mvts (law) - C3-C7

A

follow R=S mechanics
(Law 2: SB and Rot. to the same direction)

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17
Q

greatest flexion and extension of facet joints occurs between ____

A

C5-C6

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18
Q

Symptoms of vertebral artery occlusion

A

vertigo
nausea
tinnitus
drop attacks
visual disturbances
rarely stroke or death

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19
Q

where does the vertebral artery passes in the Cx-spine

A

through the TPs

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20
Q

Vertebral artery is affected by which mvt

A

extension and rotation

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21
Q

80% of blood supply from

A

Internal carotid artery

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22
Q

Internal carotid artery is stressed mainly with which 3 motions

A

rotation
extension
traction motions

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23
Q

Internal carotid artery passes under which structures

A

subclavius
SCM
platysma muscles attached to hyoid b.

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24
Q

25% of height of the cervical spine

A

intervertebral discs

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25
Q

there is no intervertebral discs where

A

between C0-C1 and C1-C2

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26
Q

Accessory nerve number

A

CN XI (11)

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27
Q

Hypoglossal nerve number

A

CN XII (12)

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28
Q

Nerve roots of phrenic nerve

A

C3-C4-C5

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29
Q

Phrenic nerve innervate what important structure?

A

Diaphragm

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30
Q

What muscles does the brachial plexus run between or under?

A

Scalenes
Pec minor
1st rib
clavicle
SCM

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31
Q

Brachial plexus can be compressed by what

A

Clavicle
First rib

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32
Q

S/S of brachial plexus compression

A

N/T/B

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33
Q

What pathologies will affect the brachial plexus?

A

Disc Herniation
Thoracic outlet
Cervical stenosis
Upper Cross Syndrome
Posture

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34
Q

Muscles attached to hyoid bone help with what functional movement?

A

chewing

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35
Q

Risk factors for cx-spine pathologies

A

lack of physical activity
duration of daily computer use
perceived stress
lack of social support
being a female
2x risk if mental disorders

36
Q

Subjective hx questions

A

Age
Radicular symptoms
Weakness/numbness/burning/tingling
Headaches/pain patterns
Dizziness/faintness/seizures
Sympatethic symptoms
Cranial nerve symptoms
Mouth breather
Sleeping position
Cognitive or behavioral changes
Glasses? contacts?

37
Q

Common conditions of the cervical spine

A

various fx
cervocigenic headaches
stenosis
DDD
disc herniation
OA (spondylosis)

38
Q

what is a jefferson fracture

A

Burst fracture = bilateral fracture of anterior and posterior arch of C1 (atlas) due to axial load

39
Q

what is a hangman’s fracture

A

bilateral fracture of the pars interarticularis of C2 + a subluxation of C2 onto C3

name comes from the hangman’s rope going around the neck at C2

40
Q

Flexion tear drop fx

A

MOI: hyperflexion
Fracture of anterior vertebral body

41
Q

Extension tear drop fx

A

MOI: hyperextension
Displaced anterolateral aspect of body
Avulsion of ALL

42
Q

what is a clay shoveler’s fx

A

fracture of SP C6-T1
no neurological implications
presents with pain on palpation of the SP

43
Q

what is a transverse atlantal ligament tear

A

rupture of the transverse ligament of C1, causing C1 to move forward on C2 (instable)

often fatal / needs urgent hospitalization

44
Q

what test would be positive for a transverse atlantal ligament tear

A

sharp purser
aspinall

45
Q

capsular pattern of the cx-spine

A

extension
SB
rotation

46
Q

what is DDD

A

degenerative disc disease
ROM deficits in capsular pattern

47
Q

what is a spinal stenosis

A

narrowing of vertebral canal

48
Q

causes of spinal stenosis (3)

A

bone growth
disc herniation
inflammation

49
Q

what is a torticollis and what are the possible causes

A

neck ROM limitations
either congenital or acute (sleeping awkward, neck muscles injury, neck muscles spasm)
secondary to slipped facets, herniated discs, infection

50
Q

components of upper cross syndrome

A

tight traps/levator scap
tight pectorals
weak neck flexors
weak rhomboids/serratus anterior

51
Q

for the neck extensor endurance test, loss of chin tuck indicates what

A

dominance of superficial extensors muscles

52
Q

for the neck extensor endurance test, neck flexion indicates what

A

weakness of deep and superficial neck extensors

53
Q

name the special tests for neuro sx

A

ULTT
brachial plexus traction test
tinel’s at brachial plexus
shoulder depression tests
shoulder abduction tests
spurling’s test (foraminal compression)
distraction test

54
Q

test performed if patient is complaining of nerve root symptoms

A

foraminal compression (spurling’s)

55
Q

+Ve foraminal compression

A

pain radiates into arm toward side in which the head is flexed

56
Q

test for patients who complain of radicular symptoms in history and show radicular signs during examination

A

distraction test

57
Q

SN and SP of distraction test

A

specificity 90-97%
sensitivity 44%

58
Q

SN and SP of foraminal compression

A

specificity 75-100%
sensitivity 30-100% when rotn and SB combined

59
Q

SN and SP of ULTTs

A

sensitivity 72-83%
specificity 11-33%

60
Q

test to use to rule out cervical radiculopathy given its high SN

A

negative ULTT

61
Q

+ve brachial plexus tension test

A

reproduction of radicular symptoms with elbow flexion*ulnar nerve primarily

62
Q

which test reproduces the MOI and evaluate brachial plexus lesions

A

shoulder depression test

63
Q

+ve shoulder depression test

A

pain increase compressed or distracted side

64
Q

test if you suspect radicular sx especially in C4-C5

A

shoulder abduction test

65
Q

+ve shoulder abduction test

A

decrease in pain or relief of symptoms

66
Q

+ve tinel’s sign for brachial plexus lesions

A

tingling sensation along nerve distribution when tapping

67
Q

vascular clearing tests

A

vertebral artery test (quandrant test/ext+rot)
dizziness test
pronator drift (hautant’s test)

68
Q

dizziness differentiation

A

vascular = check BP
vestibular = head and neck movement
cervicogenic = AROM, ligament test, etc.

69
Q

+ve vertebral artery (quadrant test)

A

provokes reffered symptoms (if opposite artery affected)

70
Q

2 steps of dizziness test

A
  1. rotate head/no torso mvt
  2. rotate torso/no head mvt
71
Q

if head movement only causes dizziness during dizziness test, indicates what

A

inner ear problem

72
Q

wavering of arms during pronator drift test indicates what

A

dysfunction caused by vascular impairment

73
Q

+ve sharp-purser test

A

examiner feels the head slide backward during movement

“clunk”

74
Q

sharp purser test for what

A

integrity of the transverse ligament

trying to cause a subluxation of atlas on axis (C1 on C2)

75
Q

+ve aspinall’s transverse ligament test

A

lump in throat as atlas moves toward esophagus

76
Q

is the force applied anteriorly or posteriorly for aspinall’s

A

examiner applies an ANTERIORLY directed force to the posterior aspect of atlas (C1)

77
Q

rotational alar ligament stress test, describe

A

pt supine or seatedgrip on C2 + stabilize
passively rotate head left/right
+ve if more than 20-30 of rotation is possible without moving C2

78
Q

goal of pronator drift test

A

differentiate between dizziness caused by articular problem vs vascular problems

79
Q

what muscle can shut down following injury and cause segmental instability

A

longus colli muscle

80
Q

Cervical spine pathologie

A

multifactorial disease
acute trauma (whiplash, extreme ROM, axial loading)
insidious onset (posture, age related)

81
Q

common complaints of C-spine pathologies

A

neck stiffness
loss of ROM
headaches
dizziness

82
Q

pain in the cervicobrachial area refers where?

A

the upper extremity (combination of neck and arm pain)

83
Q

what is the order or ROM deficits with DDD

A

extension
SB
ROT

84
Q

cervical disc herniation

A

most common posterior

85
Q

Cranial nerves

A

CATA 437 final (5 decks)

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