Cervical Spine Flashcards
What are some common symptoms associated with a Cervical Strain/Sprain?
Pain
Neck stiffness
cervicogenic headache (radiating pain in the head)
Which rules are used to determine is a healthy patient should obtain cervical radiography?
Canadian C-spine rules
What are physical exam findings that would be seen with a cervical strain/sprain?
Tenderness to palpitation over injured area
ROM limitations
What views are ordered for a cervical x-ray?
Lateral
AP
Dons
What symptoms are associated with sprains/strains vs muscle spasms?
Sharp pain = strains/sprains
Tightness + pain = muscle spasms
During examination what levels of spine are tested for a cervical sprain/strain?
C5-T1
What does the Range of motion Spurling’s Test assess?
Helps diagnose cervical disc herniation or cervical spondylosis
How is the Spurling’s test performed and what is considered a positive test?
Patient laterally flexes the neck to the affected side
Downward compression is applied
Positive Test= reproduction of radicular arm pain
What is the method of injury for a Whiplash injury?
MC is a stopped vehicle rear ended
Acceleration–deceleration of the neck with rapid flexion and extension
Classic presentation seen with Whiplash
- Delayed pain for 12-24 hours
- Pain peaks on the 3-5th day
- Pain and stiffness with flexion and extension
What are treatments given for Whiplash injuries
Cervical collars
NSAIDS
Muscle relaxers - Cyclobenaprine, Metaxalone
What is a cervical facet dysfunction and how is it caused?
Caused by a shift in the vetebral column that causes “locking of facet joints”
What is a common phrase associated with a Cervical Facet Dysfunction
“When i woke up i couldn’t turn my head”
What is the clinical presentation of a Cervical Facet Dysfunction?
Sharp unilateral pain
TTP at the focal facet
ROM limitation –> sharp pain that increases with added cervical extension
Treatment for Cervical Facet Dysfunction?
Anti inflammatories & muscle relaxers
Referral to PT/DO
What structure is damaged with a cervical manipulation complication?
What symptoms then occur?
Cerebral artery occlusion can occur
Symptoms:
Cervical pain
Dizziness
Vision loss
What is Cervical Radiculopathy?
Pain at the cervical roots
What are causes to radiculopathy?
Which ones are more common in young vs older adults
Traumatic stretching of the nerve root
Cervical disc bulge (young/ old adults)
Cervical foraminal narrowing (older adults)
How do symptoms of cervical radiculopaty occur in a young vs older adult
Young adult –> abrupt pain
Older adult –> gradual
What are Hallmark symptoms associated with Cervical Radiculopathy?
- Cervical pain increased with extension
2. Pain with lateral flexion and rotation towards effected side
What are 3 neurological deficits that can occur with Cervical radiculopathy based on nerve root compression/inflammation?
- Burner-stinger syndrome
- Disc buldge/herniation
- Foraminal narrowing
What are x-ray views ordered for suspected cervical radiculopathy
AP
Odontoid
Lateral
R & L oblique views
What part of the cervical spine and cause compression of the nerve roots?
The uncinate process
Treatment for cervical radiculopathy?
Anti-inflammatories
Physical therapy
What is Cervical spondylosis?
Wear and tear of the spine
Degenerative disease
What are possible causes of cervical spondylosis?
- Oseophyte formation
- Ligementum flavum thickenening
- Disk space narrowing
- Vertebral subluxation
What the most common locations for cervical spondylosis to occur
c5-c6
c6-c7
What is the clinical presentation of cervical spondylosis?
Progressive ROM loss/stiffness
Pain is intermittent at initial onset but becomes gradual
Cervcial crepitus
Diffuse tenderness along spinous processes
What is myelopathy?
What are complications associated with?
Compression of the spinal cord tissue
Weak hands,
Leg weakness
Unstead gait
Hyperreflexia
What sign, when positive is associated with possible myelopathy?
Lhermitte’s sign
Electric shock like sensation down the center of the back following flexion of the neck
Treatment for Cervical spondylosis?
NSAIDS
Duloxetine (Norepinephrine/serotonin reuptake inhibitor)
Amitriptyline helps with sleep
Neurotontin
Cervical pillow and Physical therapy
