Cervical Spine Dx Flashcards
C1
C2
othre names
C1–> atlas (OA)
C2–> axis (AA)
Cervical/thoracic and lumbar–> nerves exit _____ the vertebral body
cervical–> above
thoracic and lumbar–> below
Describe anatomy of C1
no vertebral body,
rotates around dens of C2,
axis (c2) anaomty
body extends superiorly to form dens
How is the atlas bound to den
anterior arch
and
posterioly by the transverse atlantal ligament (part of cruciform L)
anterior arch and posterioly by the transverse atlantal ligament (part of cruciform L)
Hangman’s Fracture
hyperextension caused the
traumatic spondylolisthesis of C2 (axis)
with fracture of the vertebral arch of C2,
as well as tearing of the ligaments between C2 and C3
some fractures that are not visible on the lateral radiograph will be visible on the __
AP
witth lateral view of C-spine, how many vertebra can be seen
6
in C-spin, how should spinous processes lie?
should lie in a straight line, except if they are bifid.
If there is malalignment –> unilateral facet joint dislocation
The distance between the spinous processes should be equal. No space should be 50% wider than the one immediately above or below it. If so, this is characteristic of an ____________
anterior cervical dislocation
What is an open mouth radiograph?
lets us assess C1 and C2.
The lateral massess of C1 should not overhand lateral masses of C2. If present–> burst fracture
45 degree view lets us look at
- intervertebral foramina
- Ostephyte encroachment in spondylosis
Atypical articulations and typical articulation of C-spine?
Atypical–> C1 and C2
Typical (C2-C7
C1 Facets Converge _________
anterioly
OA type
Type 1 like (like bc can have a flexion or extension component)
Major motions of OA
-Flexion and extension, which allows for more saggital plane motion
Minor motions of OA
SB and R, which occur opposite directions
AA joint (C___- C___)
C1-C2
AA joint
Primary motion _____
what does it do?
Primary motion is rotation.
The atlas rotates around the dens, with almost no SB or F/E.
AA rotation is d/t what muscles
Obliquus Capitis Inferior Muscles
C2-C7 are Type ___
TYPE 2 LIKE
what way do SB and rotation occur on C2-C7, and why?
SAME SIDE d/t unicinate proceses
TTOSS (type 2 like)
C2-C7 dysfunctions tend to occur in _____ place.
What are these dysfunctions
saggital
Flexion and extension
Cervical segment exam.
Rotational testing occurs in the _______ plane
Translation/SB testing occurs in the _______ plane
transverse
Coronal
how to dx OA on during SB testing
- grash head with both hands, tips of finger 2/3 over occipital articulation
- Move OA joint from R–> L in N to check SB
- Repeat in F and E
how to dx OA on during R testing
- Grab head with both hands and place fingers on the occipital ridge in neutral
- Lift anterior on both sides
- repeat in F and E
- if R and end feel become more systemitric in F/E–> you have a dysfunction in that
AA Dx
- Grab lateral mass of atlast with fingertips
- FULLY FLEX C-spine, locking C2-C7 and isolating rotation to atlas
- Roate
—-do not test F/E, SB here—
C2- C7 rotation dx
- Contact vertebral segment POSTERIOLY on articular pillar
- check for tissue texture
- Look at ease of motion with Rotation
- reassess in F and E
C2-C7 SB Dx
- contact vertebral segment LATERALLY on articular pillar
- look for tissue texture changes
- Look for ease of motion or restriction with translation
- reasess in F and E
Why is translation to R, SB left
Pushing fulcrum to R, causing a left SB
When do you perform HVLA/ART for cervical OMT
Cervical SD with ROM restriction d/t SD in [cervical facet joint], [AA joint] or OA joint
Cervical soft tissue
1.
A 16 y/o male presents to the clinic after going helmet to helmet with another football player. He states he has been having headaches and numbness and tingling in the first three digits on his palmar side. On exam you find that his C6 dermatome seems to be affected. Which of the following spinal segments is likely affected?
C5-C6 OR C6-C7
C5-C6
The nerves in the cervical spine exit ABOVE the spinal segment
