Cervical spine Flashcards
What are the 2 causes of a cervical strain/sprain?
- Forced mvmt past end range
- Violent high velocity mvmt
What is the clinical presentation of what:
- Non-radicular, non-focal neck pain anywhere from base of skullto cervicothoracic junction
- c/o neck spasm and limited ROM
- +/- cervicogenic HA
Cervical strain/sprain
What are the 6 indications to get a cervical spine radiograph for non-trauma related?
- >50y/o w/ new sxs
- Constitutional sxs (F, weight loss, etc)
- mod-severe neck pain >6wks
- Infectious risk (IVDU, etc)
- h/o malignancy
What are the 5 components of the Nexus criteria?
(no cervical x-rays needed in traumatic injury)
- Posterior midline tenderness
- No altered consciousness
- No abnormal neuro
- No intoxication
- No painful distracting injuries
What are the 2 criteria used to determine if x-rays are NOT needed in a traumatic c-spine injury?
- Nexus Criteria
- Canadian C-spine rule
What are the 3 C-spine views?
- A/P
- Lateral
- Odontoid
What test is used to eval for a cervical strain/sprain? Should it be pos or neg?
- Spurlings (tests for radicular pain)
- Should be NEG
Which C-spine levels are routinely checked during a neuro exam (MC to be injured)
C5-T1
What is the Spurling’s test used to help dx (2)?
Cervical disc herniation
Cervical Spondylosis
(radicular pain)
Which condition?
- Cervical pain/stiffness 12-24hrs after injury
- Pain peaks day 3-5
- dramatic ROM loss greatest w/ flexion and extension
“Whiplash”
Whiplash:
- Pain w/ axial loading?
- Nml or abnl neuro exam?
- Pain w/ axial loading? NO
- Nml or abnl neuro exam? NML
What condition?

Whiplash
(straightening from mm. spasm)
How do you tx Strain/Sprain/Whiplash? (6)
- Soft cervical collar
- NSAIDs/Tylenol
- Muscle relaxers (Cyclobenzapine, Metaxalone)
- Cervical pillow
- Heat/ice
- PT
What are the 2 causes of Cervical Facet Dysfunction?
- Prolonged positional stress
- Traumatic injury
What is cervical Facet Dysfunction?
Shift in vertebral alignment–> “locking” of facet joint
Clinical presentation?
- Insidious onset
- Unilateral–> sharp in C-spine, Achey in referral zone
- Focal facet TTP
-
ROM limitations:
- ipsilateral- sharp pain increases w/ extension
- Contralateral–> tightness
Cervical Facet Dysfunction
How do you tx Cervical Facet Dysfunction? (3)
- Analgesics
- Muscle relaxers
- Early referral to PT/DC/DO
What is the main complication of Cervical manipulation/
Cerebral artery occlusion/dissection
What are the 4 sxs of cerebral artery occlusion/dissection (complication of cervical manipulation)
- Cervical/suboccipital pain
- Dizziness
- N/V
- Vision loss
What is cervical radiculopathy?
Neurogenic pain in the distribution of cervical roots
+/- numbness and tingling
What are the 2 causes of cervical radiculopathy and what age groups are they MC in?
- Cervical disc bulge/herniation (young and old)
- Cervical foraminal narrowing (old)
Abrupt onset of cervical radiculopathy indicates what as the cause?
disc bulge/herniation
What is the hallmark sx of cervical radiculopathy?
Cervical radicular pain increased w/:
- rotation, lateral flexion and extension to involved side
What is the name of the test used to test for cervical radiculopathy?
Will this test be pos or neg?
Positive spurlings


