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Orthopedic Surgery Ultimate > Cervical Spine and Lumbar Spine > Flashcards

Cervical Spine and Lumbar Spine Flashcards

1
Q

What are the components of the functional unit of the spine?

A
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2
Q

What will the common chief complaints for cervical spine?

7

A
  1. Posterior neck pain
  2. Upper trap/ shoulder pain
  3. Pain between the shoulder blades
  4. Weakness
  5. Alterations in fine motor control
  6. Numbness: Very specific or VERY generalized
  7. Too much to drink?: Ataxic gait
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3
Q

Observation

Always pay attention to the patient’s movements and actions

4

A
  1. General appearance
  2. Abnormal pain behaviors
  3. Mood and affect
  4. Gait
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4
Q

What should we palpate for cervical spine PE? 3

A
  1. Cervical point tenderness
  2. Muscle spasms
  3. Lymphadenopathy
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5
Q

Range of Motion

To what degrees should you be able to do the following motions:

  1. Flexion?
  2. Extension?
  3. Lateral bending?
  4. Rotation?
A
  1. Flexion- 80-90
  2. Extension- 70
  3. Lateral bending- 20-45
  4. Rotation- 70-90
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6
Q

What do the following areas test for:

  1. C5?
  2. C6?
  3. C7?
  4. C8?
  5. T1?
A
  1. C5- Lateral upper arm
  2. C6- Lateral forearm
  3. C7- Middle finger
  4. C8- Ulnar border of hand
  5. T1- Medial upper arm
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7
Q

Describe grades 0-5 for muscle strength?

A
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8
Q

Muscle Strength

  1. What muscle and nerve root are involved in abduction of the shoulder?
  2. Elbow flexion?
  3. What nerves are involved in wrist extension? 2
  4. Nerves in wrist flexors?
  5. What muscle and nerve root are involved iin elbow extension?
  6. What nerve is involved in finger extension?
  7. Nerve in finger flexion?
  8. Nerve in intrinsics?
A
  1. Deltoids (C5)- Abduction of shoulder
  2. Biceps (C5,C6)- Elbow flexion
  3. Wrist extension (C6,C7)
  4. Wrist flexors (C7)
  5. Triceps (C7)- Elbow extension
  6. Finger extension (C7)
  7. Finger flexion (C8)
  8. Intrinsics (T1)
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9
Q

Special tests for cervical spine issues?

3

A
  1. Axial loading
  2. Foraminal Compression Test (Spurling’s)
  3. Hoffman’s Reflex
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10
Q

positive Hoffman’s reflex reflects presence of what?

A

an upper motor neuron lesion from spinal cord compression

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11
Q

What are the following reflexes:

  1. C5?
  2. C6?
  3. C7?
A

Biceps

C5

Brachioradialis

C6

Triceps

C7

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12
Q

Describe the following deformities?

A
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13
Q

ROM exercises in cervical movements?

5

A
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14
Q

Lumbar spine pain DDx?

5

A
  1. Back pain
  2. Buttock pain
  3. Leg pain
  4. Weakness
  5. Numbness/tingling
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15
Q

Observation: Lumbar spine

Always pay attention to the patient’s movements and actions

3

A
  1. General appearance
  2. Abnormal pain behaviors
  3. Mood and affect
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16
Q

Palpation for lumbar spine on exam?

3

A
  1. Point tenderness
  2. Trochanteric tenderness
  3. SI joint pain
17
Q

ROM: What degrees will these be normally?

  1. Flexion?
  2. Extension?
  3. Lateral bending?
  4. Rotation?
A
  1. Flexion- 40-60
  2. Extension- 20-35
  3. Lateral bending- 15-20

Rotation

18
Q

What gait exercises should they do for lumbar PE?

3

A
  1. Tip Toe walking
  2. Heel walking
  3. Tandem gait (drunk driver test)
19
Q

Lumbar Sensory Testing

  1. L1?
  2. L2?
  3. L3?
  4. L4?
  5. L5?
  6. S1?
A
  1. L1

Groin

  1. L2

Midanterolateral thigh

  1. L3

Distal anteromedial thigh

  1. L4

Medial ankle

  1. L5

Dorsum of foot

  1. S1

Lateral border of foot

20
Q

Muscle Strength

Which Lumbar nerve roots are associated?

  1. Hip flexors? 3
  2. Hip adductors? 3
  3. Quadriceps? 3
  4. Ankle inversion? 2
  5. Hip abductors? 2
  6. EHL, toe extensors? 1
  7. Ankle eversion? 3
  8. Ankle plantarflexion? 3
A
  1. (L1,2,3)
  2. (L2,3,4)
  3. (L2,3,4)
  4. (L4,5)
  5. (L4,5)
  6. (L5)
  7. (L5,S1,2)
  8. (L5,S1,2)
21
Q

What Motor, Reflex, and Sensory are involved with the following lumbar nerves:

  1. L4?
  2. L5?
  3. S1?
22
Q

Special Tests for lumbar spine?

4

A
  1. Babinski Sign
  2. Ankle Clonus
  3. Supine/Sitting straight leg raise
  4. Femoral Nerve Stretch Test
23
Q

positive Babinski or ankle clonus reflects presence of what?

A

of an upper motor neuron lesion from spinal cord compression

24
Q

When is a supine straight leg test positive?

2

A
  1. Patient lying supine, while the knee remains in extension, raise the leg on the involved side. If pain is reproduced around 40 degrees of hip flexion or less, the test is positive.
  2. Pain exacerbated by adding ankle dorsiflexion while leg is raised.
25
Q

Femoral Nerve Stretch Test

  1. Procedure?
  2. Positive test?
26
Q

Special Tests for SI joint irritation

3

A
  1. Compression
  2. Distraction
  3. Faber’s
27
Q

How would you do the compression test?

28
Q

How would you do the distraction test?

29
Q

How would you do the Faber test?

Orthopedic Surgery Ultimate (88 decks)

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