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722: Clinical Management of the Musculoskeletal System II > Cervical Spine > Flashcards

Cervical Spine Flashcards

1
Q

The cervical spine consists of how many joints?

A

37

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2
Q

Which cervical vertebrae are considered typical and which atypical?

A

C3-C6 are typical

C7 is atypical

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3
Q

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

A

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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4
Q

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

A

the articular pillars

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5
Q

How many IVDs are there in the cervical spine?

A

5 (the first one being between C2-C3)

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6
Q

The cervical nucleus pulposus constitutes __% of the IVD

A

25

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7
Q

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

A

25

Greater ROM

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8
Q

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

A
  • Facet Joints

- Uncovertebral Joints

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9
Q

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

A

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

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10
Q

Describe the arthrokinematics of the cervical spine during flexion

A
  • Anterior osteokinematic roll
  • Superoanterior glide
  • Anterior translation slide
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11
Q

What restrains the anterior osteokinematic roll that occurs during flexion?

A

the extensor muscles and the posterior ligaments

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12
Q

What restrains the superoanterior glide that occurs during flexion?

A

the joint capsule

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13
Q

What restrains the anterior translation slide that occurs during flexion?

A

the IVDs and the nuchal ligament

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14
Q

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

A

anterior

posterior

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15
Q

Describe the arthrokinematics of the cervical spine during extension

A
  • Posterior osteokinematic roll
  • Inferoposterior glide
  • Posterior translation slide
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16
Q

What restrains the posterior osteokinematic roll that occurs during flexion?

A

the anterior prevertebral muscles and the ALL

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17
Q

What restrains the inferoanterior glide that occurs during flexion?

A

the joint capsule

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18
Q

What restrains the posterior translation slide that occurs during flexion?

A

the IVDs

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19
Q

The superior facets _____ during extension

A

approximate

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20
Q

What limits sidebending in the cervical spine?

A

the contralateral scalenes and intertransverse ligaments

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21
Q

What direction does the contralateral facet glide during sidebending?

A

superoanterior

22
Q

What direction does the ipsilateral facet glide during sidebending?

A

posteroinferior

23
Q

What direction does the contralateral uncovertebral joint glide during sidebending?

A

superolateral

24
Q

What direction does the ipsilateral uncovertebral joint glide during sidebending?

A

inferomedial

25
Q

Uncovertebral and facet arthrokinematic motion is limited by what?

A

the joint capsule

26
Q

The vertebra translate _______ on the disk during sidebending

A

contralaterally

27
Q

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

A

The IVD

28
Q

What are 2 primary causes of neck complaints?

A
  • IVD herniation

- whiplash

29
Q

What are 2 secondary causes of neck complaints?

A
  • DDD

- DJD

30
Q

What is Cervicobrachial Syndrome?

A

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

31
Q

What is Cervicocephalic Syndrome?

A

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

32
Q

What is Cervicomedulary Syndrome?

A

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

33
Q

What are the cervical spine red flags?

A
  • 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
34
Q

What are the cervical spine yellow flags?

A
  • 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
35
Q

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

A

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

36
Q

What are the 6 components involved in a cervical scan?

A
  • Neck rotation
  • Upper Cervical Sidebending
  • Upper Cervical Flexion
  • Upper Cervical Extension
  • Compression
  • Distraction
37
Q

Which tests are performed to assess c-spine stability?

A
  • alar ligament test
  • transverse ligament test
  • Jefferson fracture test
  • distraction test
  • Sharp-Purser test
38
Q

The distraction test asses ______ plane stability

A

longitudinal

39
Q

The Sharp-Purser test asses ______ stability

A

translational

40
Q

What does Spurling’s test assess?

A

the possibility of cervical radiculopathy

41
Q

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

A

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

42
Q

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

A

The pressure is increasing in the interscalene triangle

43
Q

What are the 3 thoracic outlet tests?

A
  • Adson’s test
  • Costoclavicular Test
  • Roos Test
44
Q

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

A

65

45
Q

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

A

90

46
Q

Cervical ROM

Flexion = \_\_ degrees
Extension = \_\_-\_\_ degrees
Sidebending = \_\_ degrees
Rotation = \_\_-\_\_ degrees
A

40

70-80

45

80-90

47
Q

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

A

Retraining the deep neck flexors

48
Q

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

A

Always come back to neutral before releasing pressure

49
Q

What are NAGs?

A

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

50
Q

What are SNAGs?

A

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

722: Clinical Management of the Musculoskeletal System II (12 decks)

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