Cervical Spine Flashcards by Alli Volkens

The cervical spine consists of how many joints?

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Which cervical vertebrae are considered typical and which atypical?

C3-C6 are typical

C7 is atypical

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How does C7 differ from the rest of the cervical spine?

It has a much longer spinous process to allow attachment of the nuchal ligament.

It also has a wider transverse process, no inferior facet, and not transverse process

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What structures bear a significant portion of axial loading throughout the cervical spine?

the articular pillars

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How many IVDs are there in the cervical spine?

5 (the first one being between C2-C3)

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The cervical nucleus pulposus constitutes __% of the IVD

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The IVDs make up approximately __% of the height of the cervical spine. What does this allow for?

Greater ROM

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What are the 2 types of articulations in the cervical spine?

Facet Joints

- Uncovertebral Joints

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How many intervertebral foramina are there in the cervical spine? Explain why…

8, because there is a nerve root existing between the occiput and the atlas

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Describe the arthrokinematics of the cervical spine during flexion

Anterior osteokinematic roll
Superoanterior glide
Anterior translation slide

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What restrains the anterior osteokinematic roll that occurs during flexion?

the extensor muscles and the posterior ligaments

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What restrains the superoanterior glide that occurs during flexion?

the joint capsule

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What restrains the anterior translation slide that occurs during flexion?

the IVDs and the nuchal ligament

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Flexion produces an _____ compression and a ______ distraction of the IVD

posterior

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Describe the arthrokinematics of the cervical spine during extension

Posterior osteokinematic roll
Inferoposterior glide
Posterior translation slide

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What restrains the posterior osteokinematic roll that occurs during flexion?

the anterior prevertebral muscles and the ALL

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What restrains the inferoanterior glide that occurs during flexion?

the joint capsule

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What restrains the posterior translation slide that occurs during flexion?

the IVDs

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The superior facets _____ during extension

approximate

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What limits sidebending in the cervical spine?

the contralateral scalenes and intertransverse ligaments

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What direction does the contralateral facet glide during sidebending?

superoanterior

What direction does the ipsilateral facet glide during sidebending?

posteroinferior

What direction does the contralateral uncovertebral joint glide during sidebending?

superolateral

What direction does the ipsilateral uncovertebral joint glide during sidebending?

inferomedial

Uncovertebral and facet arthrokinematic motion is limited by what?

the joint capsule

The vertebra translate _______ on the disk during sidebending

contralaterally

Contralateral translation of the vertebra on the disk is limited by what?

The IVD

What are 2 primary causes of neck complaints?

- IVD herniation | - whiplash

What are 2 secondary causes of neck complaints?

- DDD | - DJD

What is Cervicobrachial Syndrome?

A syndrome in which the patient experiences pain, numbness, weakness, and/or swelling in the neck AND in one or both UEs

What is Cervicocephalic Syndrome?

A syndrome in which the patient experiences pain, numbness, weakness, and/or swelling in the neck AND the head

What is Cervicomedulary Syndrome?

A syndrome in which the patient experiences pain, numbness, weakness, and/or swelling in the neck AND spinal cord symtpoms

What are the cervical spine red flags?

- Unexplained weight loss - Compromise to multiple spinal nerve roots - Gradual increase in pain over time - Regional expansion of pain - Spasm with PROM - Visual disturbances - Painful and weak resistive testing - Hoarseness - Limited scapular elevation - Horner's Syndrome - T1 palsy (weakness of hand intrinsics) - Arm pain in patients less than 35 years old or if it is greater than 6 months in duration

What are the cervical spine yellow flags?

- Recent trauma (occurring up to 6 weeks earlier) - Acute capsular pattern - Severe movement loss - Strong spasm - Paresthesia - Segmental paresis - Segmental or multisegmental hyporeflexia or areflexia - UMN signs and symptoms - Constant or continuous pain - Moderate-to-severe radiating pain - Moderate-to-severe headaches - Tinnitus - History of LOC - Memory loss or forgetfulness - Difficulties with problem solving - Reduced motivation - Irritability - Anxiety or depression - Insomnia

Describe the safest order for the objective examination (1-7)

1) Structural Examination 2) Craniovertebral (UCS) Scan 3) Stability Testing/VBI Testing 4) Neurological Examination 5) Cardinal Plane Movements 6) Special Testing 7) Segmental Mobility Testing

What are the 6 components involved in a cervical scan?

- Neck rotation - Upper Cervical Sidebending - Upper Cervical Flexion - Upper Cervical Extension - Compression - Distraction

Which tests are performed to assess c-spine stability?

- alar ligament test - transverse ligament test - Jefferson fracture test - distraction test - Sharp-Purser test

The distraction test asses ______ plane stability

longitudinal

The Sharp-Purser test asses ______ stability

translational

What does Spurling's test assess?

the possibility of cervical radiculopathy

What is indicated if a patient's symptoms are relieved during the should abduction test?

A cervical extradural compression problem, such as a herniated disc or nerve root compression

What is indicated if a patient's symptoms are worsened during the should abduction test?

The pressure is increasing in the interscalene triangle

What are the 3 thoracic outlet tests?

- Adson's test - Costoclavicular Test - Roos Test

If 3 of the following 4 tests are positive there is a __% prediction rate of cervical radiculopathy +Spurlings Test < 60 degrees of rotation +Distraction Test +ULNT

If all 4 of the following tests are positive there is a __% prediction rate of cervical radiculopathy +Spurlings Test < 60 degrees of rotation +Distraction Test +ULNT

Cervical ROM ``` Flexion = __ degrees Extension = __-__ degrees Sidebending = __ degrees Rotation = __-__ degrees ```

40 70-80 45 80-90

What is the key to anterior stabilization of the cervical spine?

Retraining the deep neck flexors

When performing joint mobilizations what must be done before releasing pressure?

Always come back to neutral before releasing pressure

What are NAGs?

Natural apophyseal accessory glides applied to the cervical spine with the patient passive

What are SNAGs?

Sustained natural apophyseal accessory glides where the patient attempts to actively move a painful or stiff joint through its ROM while the therapist overlays an accessory glide parallel with the treatment plane