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Clinical Interventions > Cervical spine clinical interventions > Flashcards

Cervical spine clinical interventions Flashcards

1
Q

What is the most mobile region of the spine?

A

cervical region

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2
Q

What part of the cervical vertebrae transfers force between posterior and anterior portions?

A

pedicles

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3
Q

What forms a ring for the vertebral artery for protection along with a trough for peripheral nerve roots?

A

transverse processes

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4
Q

What part of the vertebrae protects the spinal cord?

A

lamina

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5
Q

The ratio of intervertebral disc height to a vertebral body height is greater in the ___ spine.

A

cervical

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6
Q

zygapophyseal joints are oriented in the __ plane.

A

frontal

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7
Q

Greater amounts of ____ movements occur at the lower segments of the C-spine. The greatest amount of movement occurs at the ___segments.

A

FLX/EXT, C5/C6

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8
Q

What joints promote FLX/EXT in the C-spine?

A

zygapophyseal joints

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9
Q

Motion of the c-spine occur in __ planes.

A

3

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10
Q

There is a (low/high) contribution of stability from the non-contractile structures of the C-spine.

A

low (20%)

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11
Q

What does the PLL resist?

A

forward bending

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12
Q

What does the ALL resist?

A

hyperextension

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13
Q

What does the cruciform ligament resist?

A

movement of the dens from contacting the spinal cord

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14
Q

What does the ligamentum nuchae resist?

A

FLX

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15
Q

What ligament guides movement in the upper c-spine?

A

alar ligament

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16
Q

What ligament provides upright posture in the C-spine?

A

ligamentum flavum

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17
Q

What are the primary muscles of cervical flexion?

A

SCM and scalenes

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18
Q

What are the secondary muscles of cervical flexion?

A

longus capitis and longus colli

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19
Q

What are the muscles of cervical extension?

A

upper traps, lev scap, splenius capitis/cervicis, erector spinae, semispinalis muscles

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20
Q

What muscle(s) are responsible for extension of the occiput?

A

suboccipital muscles

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21
Q

What muscles perform side bending of the c-spine?

A

scalenes, SCM, upper trap, lev scap, suboccipital muscles

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22
Q

What muscles perform ipsilateral ROT of the c-spine?

A

lev scap, splenius capitis/cervicis, erector spinae, semispinalis, suboccipital muscles

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23
Q

What muscles perform contralateral ROT of the c-spine?

A

scalenes, SCM, upper trap

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24
Q

The line of gravity falls (anterior/posterior).

A

anterior

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25
Q

Vertebral bodies and IV discs bear approx. ___ of the compressive load of the spine.

A

2/3

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26
Q

Zygapophyseal joints bear approx. ___ of the compressive load of the spine.

A

1/3

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27
Q

Loads are highest at ___ range.

A

end

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28
Q

The upper trap and lev scap tend to become tight because they are countering ___ shear forces of the head created by the line of gravity.

A

anterior

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29
Q

What is the annual incidence rate of neck pain?

A

15%

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30
Q

What is the neck pain recurrence rate?

A

~ 25%

31
Q

What factors cause an increased risk of neck pain?

A
  • Females
  • indiv. with high psychological stress
  • prolonged sitting
  • desk jobs
  • poor posture
32
Q

What are the results of neck pain dysfunction?

A
  • atrophy
  • decreased muscular function
  • decreased joint position sense
  • compensation w/ superficial muscles for stability
33
Q

What are the treatment based classifications?

A

mobility
centralization
headache
pain control
conditioning

34
Q

What is the presentation of a patient needing mobility treatment?

A
  • recent onset of central and/or unilateral neck pain
  • limitation in neck motion that produces symptoms
  • limited cervical ROM
  • restricted CT joint mobility
35
Q

What are the primary treatments used for a patient needing mobility treatment?

A

Cervical and thoracic mobilization
AROM exercises

36
Q

Grade I mobilizations are ___ oscillations at the ___ range.

A

small, beginning of ROM

37
Q

Grade II mobilizations are ___ oscillations at the ___ range.

A

small, mid range

38
Q

Grade III mobilizations go from ___ range to the ___ range.

A

end range to mid range

39
Q

Grade IV mobilizations are ___ oscillations at the ___ range.

A

small, end

40
Q

What is the presentation of a patient needing conditioning?

A
  • low pain/disability scores
  • chronic symptoms
  • no centralization or nerve root compression
  • poor motor control
41
Q

What is the treatment used for a patient who needs conditioning?

A

strength and endurance for the neck and upper quarter of the body

42
Q

What is the presentation of a patient with centralization?

A
  • radicular or referred symptoms
  • peripheralization or centralization w/ neck ROM
  • signs of nerve root compression
  • (+) spurlings
  • (+) distraction
  • (+) ULTT
  • ipsilateral ROT < 60 degrees
43
Q

What is the primary treatment methods for centralization?

A
  • manual traction
  • repeated movements
44
Q

What is the presentation of a patient with pain?

A
  • high pain and disability scores
  • acute symptoms
  • MOI
  • poor tolerance for exam and assessment
45
Q

What are the primary treatments used for pain control?

A
  • gentle AROM w/in pain tolerance
  • patient education
46
Q

What are the primary treatments to treat headaches?

A
  • cervical spine mobilizations
  • strength and endurance exercise programming
  • postural education
47
Q

A progressive decrease in intervertebral disc (height/width) increases demands on surfaces facilitating degenerative changes and ligamentous laxity.

A

height

48
Q

When do degenerative changes start to occur?

A

30-50 y/o

49
Q

When does stenosis start to occur?

A

> 50 y/o

50
Q

Degenerative disc disease, degenerative joint disease, spondylosis, and stenosis are most commonly between the __-___ segments.

A

C5-C7

51
Q

What can occur due to disc height decrease, disc herniation/bulging, narrowing of the intervertebral foramen, and/or spondylosis

A

Nerve root compression (centralization)

52
Q

What is the most common cause of centralization?

A

disc herniation and stenosis

53
Q

What population is most commonly affected by disc herniation and/or stenosis?

A

males >50 y/o

54
Q

The most common levels of the c-spine that result in radicular symptoms are __-___ when nerve root compression is present.

A

c5-c7

55
Q

During rehabilitation for nerve root comrpession, the dominant arm (is/is not) involved

A

is not

56
Q

What are treatments for centralization?

A
  • traction
  • ther. ex
  • manual therapy
  • patient education (posture)
57
Q

Who has the highest incidence of acute joint pathologies (sprain/strain)?

A

20-35 y/o

58
Q

pathology:
- may be tender to palpation over the affected muscle
- may be tender to palpation over TP and SP due to involved ligament
- non-radicular
- insidious onset in the morning

A

acute joint pathology

59
Q

definition: damage to a muscle belly and/or tendon

A

strain

60
Q

definition: damage to a ligament

A

sprain

61
Q

What treatments are used for acute joint pathologies?

A

-traction
- retraction
- prone PA glides
- ther. ex.

62
Q

Traumatic neck pain (whiplash) is usually associated with ___.

A

MVA

63
Q

~ ___% of those with whiplash develop chronic symptoms that last at least 1 yr.

A

50%

64
Q

pathology:
- neck pain
- headache
- decreased ROM
- dizziness
- visual disturbances
- radicular symptoms
- cognitive impairment

A

whiplash

65
Q

(true/false) You should use a neck collar after a whiplash injury.

A

FALSE

66
Q

What is the prevalence of cervicogenic headaches?

A

1-4%

67
Q

Cervicogenic headaches account for ___% of all headaches.

A

20%

68
Q

(men/women) are more likely to get cervicogenic headaches.

A

women

69
Q

pathology:
- unilateral
- “ram horn pattern”
- pain originates in neck and progresses up the head
- C1-C3 major contributors
- superficial neck muscle tightness
- tenderness of upper cervical joint and muscles
- decreased ROM
- decreased strength and endurance

A

cervicogenic headaches

70
Q

(true/false) it is best to use ice to treat cervicogenic headaches.

A

FALSE DO NOT USE ICE

71
Q

What are the tight muscles of upper cross syndrome?

A

upper traps, lev scap, pec major, pec minor

72
Q

What muscles are weak with upper cross syndrome?

A

middle/lower traps
deep neck flexors

73
Q

For a general exercise prescription, older and frail individuals should perform __-___ reps for __-__ sets.

A

1-3 sets x 10-15 reps

74
Q

(OKC/CKC) may provide a more functional technique for strengthening of injured muscles and joints in athletes

A

CKC

Clinical Interventions (25 decks)

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