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Canadian Exam > Cervical Spine > Flashcards

Cervical Spine Flashcards

1
Q

Cervical spine roots

A

Above vertebrae

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2
Q

Discs in our C spine?

A

No disk in the upper C spine

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3
Q

Disc shape

A

Thin (for greater mobility)
Thicker anterior (for lordosis)

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4
Q

Cervical radiculopathy- etiology

A

Disc herniation
Stenosis
Swelling/ inflammation

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5
Q

Dynamic disc theory

A

Disc contents can move do to movements
Nucleus paplposis move posterio lateral (weakest part of the annulus)

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6
Q

Cervical myelopathy

A

When the disc compresses onto the spinal cord

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7
Q

Stenosis definition

A

Narrowing

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8
Q

Stenosis causes

A

Osteophytes- lateral stenosis, degeneration of the spine (spodylosis)- lateral stenosis ,ligamentum flavum thickening (central stenosis)

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9
Q

Neuro scan

A

Dermatome
Myotome
Reflexes
Special tests

Perform when you see any S & S, or want to rule out

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10
Q

Dermatome procedure

A

1) get comfy
2) expose (not over clothing)
3) confirm understanding by testing sensation on another area
4) ask patient to close eyes
5) test entire Dermatome (proximal to distal)
6) bilateral
7) start light
8) if impaired test further with sharp blunt

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11
Q

Dermatome Tricks

A

Star Trek sign (C5 radial- T1 ulnar)

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12
Q

Cervical myotomes

A

Hold position and don’t let me move you (therapist should resis 5-8 sec)
Test bilaterally

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13
Q

Cervical myotomes

A

C1,2- neck flexion S
C3- side flexion
4- shoulder elevation
5- shoulder abduction
6- elbow flexion, wrist extension
7- elbow extension, wrist flexion
8- thumb extension, ulnar deviation
T1- finger abduction/ adduction

Important to know alternatives as sometimes someone is limited abilities (comorbidities)

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14
Q

Cervical reflexes

A

Deep tendon reflexes

If unable to get response- distract
- Jendrassik Maneuver( sit cross legged and try to pull apart)
- or count down from 99

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15
Q

Cervical reflexes- areas

A

C5- deltoid
C6- biceps/ brachioradialis
C7- Triceps
C8- Pronator quadratics
T1- Abductor digit Minimi

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16
Q

Reflex grades

A

0- no response
1- decreased response
2- normal response
3- exaggerated response
4- highteed

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17
Q

UMN reflexes test - possible lesion of spinal cord, brain stem or brain

A

Clonus
Babinski

18
Q

Cervical special tests

A

Cervical distraction test (positive- if symptoms reduced)
Spurling’s (reproduction of symptoms)

19
Q

Upper limb tension test- procedure

A

Supine
Test unaffected side first
Shoulder- forearm- wrist- fingers- ELBOW
Sensitize
Positive- reproduction of symptoms

20
Q

Median nerve test (ULTT1)

A

Shoulder depression, abduction (110 ULTT1, 40 ULTT1)
Supination forearm
Wrist extension
Finger thumb extension
Elbow extension

21
Q

Radial nerve

A

Shoulder depression abduction
Forearm pronation
Wrist flexion and ulnar deviation
Fingers and thumb flexion
Elbow extension

22
Q

Ulnar (C8- T1 nerve roots)

A

Depression abduction (10-90)
Forearm pronation
Wrist extension and radial deviation
Fingers and thumb ext
Elbow flexion

23
Q

Stenosis intervention

A

Open up intervertebral forman (flexion, traction, ipsilateral side flex and rotation)

24
Q

Herniation interventions

A

Retraction progressions

25
Q

Ebb-Duchene paralysis

A

Brachial plexus injury (upper)
Upper nerve root c5-6.
waiters tip position
Shoulder elbow paralysis
Deltoid and radial surface and hand
Shoulder dystopia during birth

26
Q

Klumke’s Paralysis

A

C8, T1 lower brachial plexus.
Forearm, hand, triceps paralysis
Looks like an arm in a cast and a claw hand deformity
From childbirth due to traction on an abducted arms as child being pulled out of birth

27
Q

Facet Syndrome

A

Pain is worse with compression stress on the facet joint
Pain in neck and/ or scapula region

28
Q

Cervical facet arthrokinetmatics

A

Cervical facet joints are angle towards the eyes
Side bending and rotation occur towards the same side
Coupled mints into extension may be used to rule out facet joint involvement

29
Q

Non-physiocological coupled movements (C spine)

A

Side flexion and rotation are performed i the opposite side

30
Q

Vetebrobasilar insufficiency (VBI)- 5Ds 3Ns

A

Dizziness
Diplopia
Drop attacks
Dysphagia (NOT dysphasia as that is a learning impairment)
Dysarthria

Nystagmus
Nausea or vomiting
Other neurological symptoms

31
Q

Vertebral artery test (Cervical Quadrant test)

A

Patient supine position
Take head into extension and side flexion and hold for 10-30 secs (eyes open )
If no symptoms, ipsilateral side flexion for another 10-30 secs
Positive test- dizziness or nystagmus, indicates that the contalateral side is obstructed

32
Q

Torticollis (congenital or acquired)

A

Unlateral shortening of the SCM muscle: ipsilateral side flexion and contra lateral rotation of the C-spine causing decreased AROM and PROM in the opposite side
Rx: stretch the affected side SCM, strengthening exercises to improve balance between both sides

33
Q

Congenital torticollis

A

Positional in uterus or trauma in childbirth
Handling can help.
Positional plagiocephaly- flat head syndrome when laying on one side and get flatter

34
Q

Upper crossed syndrome

A

Chin poking (forward head)
Tight- pec and upper trap and lev scap
Weak- deep flexor and lower trap, rhomboids and serratus anterior

May lead to alignment issues due to stress (ex. Facet joints and posterior discs)

35
Q

Upper crossed- treatments

A

Postural correction
Stretch tight
Strengthen weak

36
Q

Cervical instability

A

Excessive motion b/w two adjacent vertebrae
Due to ligament damage, #, dislocation, joint damage, or weak muscles- from trauma, congenital malformations, long term corticosteroids, or secondary to other pathologies (ie. RA, or Down syndrome)
If instability is suspected, no mobs or manipulations

37
Q

S&S of cervical instability

A

Dizzy
Lip or facial parenthesis
Lump in throat
Nausea/ vomiting
Nystagmus
Patient hesitant to move head or neck
Pupil changes
Severe headache
Severe muscle spasm
Soft end feel

38
Q

Cervical spine tests

A

Antior shear or Sagittarius stress test
Lateral flexion alar ligamanet stress test
Lateral shear test
Sharp-purser test
Cervical flexion rotation test

39
Q

Cervical spine muscular control

A

Inner unit muscles
- attach segmentally and are tonic muscles that maintain posture
- includes deep neck flexors, deep neck extensors, and suboccipital S
- can often become weak and result in compensation from elsewhere

40
Q

Special test for segmental stability

A

Craniocervical flexion test (increase pressure cuff)
Hold for 10 secs
Shoulder get at least 26 mmHg when starting at 20mmHg

41
Q

How to improve segmental instability

A

Deep neck flexors training
- aids in coordination and timing
- analgesic effect

Canadian Exam (55 decks)

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