Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

OCS Prep > Cervical Spine > Flashcards

Cervical Spine Flashcards

1
Q

Canadian C- spine rules

A
  1. Does the patient have high risk factors
    - age >65
    - paradthesia in UE’s
    - dangerous MOI ( fall from >1 meter, mva speed >100kmh, mva with rollover/ ejection, bicycle or recreational vehicle.
    - 2 or more X-ray required
  2. Does the patient have any factors that permit an assessment f ROM
    - ability to sit up
    - ability to ambulate
    - onset of neck pain not immediate
    - absence of midline tenderness
    - mva that does not include: being pushed into traffic, hit by a bus or truck, hit at high speed
  3. Can the patient rotate neck 45 degrees- if not x ray required
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the CPR for cervical manipulation?

A
  • neck index <11.5
  • bilateral involvement
  • not performing sedentary work > 5 hours
  • feeling better while moving the neck
  • does not feel worse while extending the neck
  • diagnosis of spondylitis without radiculopathy
    • 4 or more variables present = successful outcomes from 60- 89%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the CPR for cervical traction?

A
  1. Peripheralization with lower cervical spine c4-7
  2. Positive shoulder abduction sign
  3. Greater than 55 years
    • ULTT median nerve
  5. Relief with manual distraction test.
    • 4 or more variables present successful outcome from 44- 94.8%
    • 3 variables- successful outcomes from 44-53%
    • 2 variables present- successful outcomes from 44- 79%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the CPR for thoracic spine manipulation?

A
  1. Symptoms < 30 days
  2. No symptoms distal to the shoulder
  3. Looking up does not aggregate symptoms
  4. FABQ PA- <12
  5. Diminished upper thoracic kyphosis T3-5
  6. Cervical extension <30
    • 3 variables present= successful outcomes from 54- 86%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What s the CPR for neck pain with radicular symptoms?

A
  1. Cervical rotation <60 degrees
  2. ULTT median nerve
    • Distraction test
    • Spurlings test
    • 4 test positive- + LR 30.3, 3 positive + LR 6.1
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the chances of radiculopathy if biceps reflex absent?

A

Chance increases from 23-59%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the five neck pain treatment classification categories outlined by Fritz?

A
  1. Mobility
  2. Pain control
  3. Exercise and conditioning
  4. Centralization
  5. Headache
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Mobility treatment classifications:

A
  • Acute Pain (<12 weeks)
  • non radicular symptoms
  • <60 years of age
  • restricted cervical ROM in rotation and sb
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Pain control classification:

A
  • High Pain and disability scores
  • recent onset of symptoms(trauma)
  • radiating symptoms into UE
  • poor tolerance to exam or interventions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Headache treatment classification:

A
  • unilateral headache associated with neck/ sub occipitals
  • HA aggravated by ipsilateral posterior neck structures
  • restricted cervical ROM and segmental mobility
  • poor performance in cranial cervical flexion test
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Centralization treatment classification:

A
  • radicular symptoms into UE
  • peripheralization or centralization with ROM
  • signs of nerve root compresssion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Coordination and exercise classification:

A
  • low pain and disability scores
  • longer duration of symptoms
  • no signs of nerve root compression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are interventions for neck pain in mobility class?

A
  • Cervical or thoracic mobilization

- AROM exercises

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are interventions appropriate for neck pain with HA class?

A
  • cervical mobilization
  • exercise, coordination, strengthening and neck endurance
  • postural education
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are interventions that are appropriate for neck pain centralization class?

A
  • traction and repeated motions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are appropriate interventions for neck pain in the pain control class?

A
  • gentle AROM with pain tolerance
  • ROM to adjacent regions
  • activity modifications
  • modalities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are interventions appropriate for neck pain exercise and coordination class?

A
  • Strengthening and endurance activities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the level of evidence for using cervical mobilization/ manipulations?

A

-Strong evidence for the use of cervical manipulation and mobilization combined with exercise.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the level of evidence to support the use of patient education for patients with neck pain?

A
  • strong evidence for to educate the patient on early return to non provocative pre accident activity
  • strong evidence to assure the patient of good prognosis and full recovery commonly occurs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the level of evidence to support the use of coordination, strengthening, endurance, exercises for cervical pain?

A
  • strong evidence for the use of coordination, strengthening, and endurance exercises.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the level of evidence to support upper quarter and nerve mobilizations for cervical pain?

A
  • moderate evidence to support the use of upper quarter and nerve mobilization techniques.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the level of evidence to support the use of stretching and flexibility exercises for cervical pain?

A
  • weak evidence for stretching and flexibility exercises

- can be considered- (scalene, UT, LS, PMinor, PMajor)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Wha s the level of evidence to support the use of centralization procedures?

A
  • weak- May use repeated movements or procedures to promote centralization
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the level of evidence to support use of thoracic mobilization/ manipulation to treat cervical pain?

A
  • weak

- May use thoracic mobilization/ manipulation in patients with primary complaints of neck pain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are the symptoms of cervical myelopathy?

A
  • multi segmental weakness
  • hyperreflexia,
  • UMN signs
  • Bowel/ bladder dysfunction
  • unsteady gait
  • sensory changes in “ stocking glove distribution”
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the five clinical predictors for cervical myelopathy?

A
  1. Gait deviation
  2. Hoffman’s test
  3. Inverted supination sign when testing c6/reflex
    4 Babinski sign
  4. Age 45 or older
27
Q

What is the dermatone and myotome to test c3/4?

A
  1. Myotome
    - shoulder elevation and C/ S rotation
  2. Dermatone
    - lateral face, supraclavicular region
28
Q

What are the dermatone/myotome for C5?

A
  1. Myotome
    - shoulder abduction and ER
  2. Dermatome
    - lateral shoulder
29
Q

What are the dermatome/myotome for C6?

A
  1. Myotome
    - biceps and wrist extensors
  2. Dermatome
    - distal thumb and index finger
30
Q

What are the dermatome/ myotome for C7?

A
  1. Myotome
    - triceps and wrist flexors
  2. Dermatome
    - middle finger
31
Q

What s the dermatome/ myotome for C8?

A
  1. Myotome
    - Thumb and finger extension
  2. Dermatome
    - little finger
32
Q

What is the dermatome/ myotome for T1?

A
  1. Myotome
    - hand intrinsic
  2. Dermatome
    - medial elbow
33
Q

What is the difference between nerve sliding and nerve tension?

A

Tension- movement of one or several joints to elongate the nerve.
- tensioning increases Intraneural pressure and tension

Sliding- elongation and one joint balanced by reduction in length of nerve bed at adjacent joint
- sliding = > greater nerve excursion

34
Q

What is the appropriate treatment strategy for WAD?

A
  • AROM and exercise based on strong evidence
  • normal activities ASAP
  • NSAIDS
  • progress to isometric and deep flexors as needed
  • chronic >3 months - multidisciplinary Pain management has been found to be useful
35
Q

What is the best outcome measure for WAD?

A

Tampa Scale of Kinesphobia( TSK)

  • higher score = greater kinesphobia
  • TSK > 41; probability of WAD increases to 83%
  • NDI >. 15 raises suspicion to 54%
36
Q

What are cervical spine traction parameters?

A
  1. Occipital wedges- halter that pulls from Occiput instead of chin- reduces causes of TMJ
  2. Force: 25-40 lbs causes joint seperation
  3. Position: supine to promote relaxation
  4. Cervical angle: head and neck in about 15 degrees of flexion
  5. Initial treatment: 15 mi of intermittent traction (60 on 20 off) with initial pull of 10-12 lbs. MAX to 40 lbs.u
37
Q

What is the most reliable indicator of brachial plexus injury?

A

Testing Sensory nerves is the most reliable indicator.

38
Q

What is Erb’s Palsy?

A
  • Affects C5-6 nerve root; superior trunk

- presents as waiter’s tip position ( arm extended, IR and forearm pronation)

39
Q

What are the five nerve roots of the brachial plexus.

A

c5,6,7,8 and T 1

  • has three extra branches: dorsal scapular, first intercostal, long thoracic
40
Q

What are the three trunks of the brachial plexus?

A
  • Superior, Middle and inferior
    • crosses posterior triangle over the first rib and behind subclavain artery
    • has two extra branches: suprascapular and nerve to subclavius
41
Q

How many divisions does the brachial plexus have?

A
  • Six: 3 anterior and 3 posterior
    • located posterior to middle of clavicle
    • anterior innervate the flexors
    • posterior innervate the extensors
42
Q

How many cords in the brachial plexus?

A
  • Lateral, posterior and medial cord
    • contains seven extra branches:
      • medial/lateral pectoral, upper and lower subscap., thoracodorsal, medial cutaneous of arm and forearm
43
Q

What are the terminal branches of the brachial plexus?

A
  • Musculocutaneous, axillary, radial, median, ulnar

- find the “M” shape - for median nerve.

44
Q

What nerve innervates the Rhomboids and lavator scapular?

A

Dorsal scapular- C5

45
Q

What nerve innervate the serrated anterior?

A

Long thoracic C5-7

46
Q

What nerve innervate subclavius?

A

-Nerve to subclavius C5,6

47
Q

What nerve innervates supraspinatus, infraspinatus?

A

-Suprascapular C 5-6, superior trunk

48
Q

What nerve innervates pec major?

A

Lateral pectoral nerve- C5-7 lateral cord

49
Q

What nerve innervates latissimus dorsal?

A

Thracodorsal C6-8, posterior cord

50
Q

What muscle does upper subscap innervate?

A

Superior portion of subscapularis C5-6 posterior cord

51
Q

What muscle does lower subscapular nerve innervate?

A

Inferior portion of subcsapularis, teres major

— c5-6 posterior cord

52
Q

What does the medial pectoral nerve innervate?

A

Pec minor, major

- C8-T1

53
Q

What does the medial cutaneous nerve of forearm innervate?

A

Skin on medial side of forearm

- C8 medial cord

54
Q

What does the medial cutaneous nerve of the arm innervate?

A

Skin on medial side of the arm

- T1 medial cord

55
Q

What muscle(s)does the musculocutaneous nerve innervate?

A

Biceps brachial, brachialis, coracobrachialis,

56
Q

What does the axillary nerve innervate?

A

Teres minor, deltoid, skin over anterior deltoid

57
Q

Describe the cranial cervical flexion test.

A
  • Patient is supine in hooklying
  • biofeedback cuff is inflated to 20 mmhg
  • patient performs cranial cervical flexion and holds for 10 seconds
  • test is repeated at 22, 24, 26, 28, and 30 mmhg
  • 10 second text between tests
58
Q

What is considered to be an abnormal response to the cranial cervical flexion test?

A
  • unable to increase pressure by 6 mmhg
  • unable to hold contraction for 10 seconds
  • uses superficial neck muscles to accomplish cervical flexion
  • uses a sudden movement of the chin or pushes forcefully against the pressure device
59
Q

How do you score the cranial cervical flexion test?

A
  1. Activation score: Pressure achieved and held for ten seconds
  2. Performance index: increase in pressure x number of reps
60
Q

Describe the neck flexor muscle endurance test.

A

The patient lies supine in hooklying and while maintaining the chin maximally contracted, the patient lifts the head until its approx. 2.5 cm off the table

  • clinician places hand on the table below the occiput and gives verbal command “tuck your chin” and “ hold your head up”
  • test is terminated if skin folds separate or if the patients occiput touches the clinicians hand
61
Q

What are Cervical red flags to be aware of?

A
  • blood in sputum
  • alters mental status
  • progressive neurological deficits
  • numbness in perinatal region
  • pathological changes in bowel bladder
  • pulsation abdominal mass
    Symptoms not associated with mechanical neck pain
62
Q

What are factors the require precautionary examination and treatment procedures?

A
  • age >50
  • clonus
  • fever
  • elevated esr
  • gait deficits
  • h/o cancer, unexplained weight loss
  • h/o metabolic bone disease
  • non healing sores
  • long term workman’s comp
63
Q

What factors require further physical testing and differential analysis?

A
  • abnormal reflexes
  • Bilateral or unilateral radiculopathy
  • unexplained referred pain
  • unexplained significant upper/ lower limb weakness

OCS Prep (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions