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MSK II > Cervical Spine Evaluation > Flashcards

Cervical Spine Evaluation Flashcards

1
Q

Canadian C-Spine Rule’s for Acute Trauma Patient

A
  1. Are they cognitively intact?
  2. Are they under 65 y.o.
  3. Can they move more than 45 d Rot (even with pain)
  4. No crazy MOI
  5. No midline pain at rest
  6. No paresthesia in arms following trauma
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2
Q

Checking ligament integrity in Upper Cervical Spine

A
  1. Modified Sharp-Purser Test
  2. Alar Ligament Stress Test
  3. Transverse Ligament of Atlas Test
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3
Q

S/S of Cervical Instability

A
  1. Severe Muscle spasm
  2. Resistance and apprehension to movement (esp. flexion)
  3. Lump in throat
  4. Lip/fascial paresthesia
  5. Severe HA
  6. 5 D’s And 3N’s
  7. Soft end feel
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4
Q

Cervical Instability Clearing Tests used for what?

A

Tests to determine if patient should even be in our office. We want to clear or filter them to rule out rare but serious pathology

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5
Q

Positive finding for Modified Sharp-Purser Test

A

Feel a clunk

Patient feels relief of symptoms

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6
Q

Transverse ligament is also part of what ligament

A

Cruciform ligament

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7
Q

Transverse ligament test positive findings

A

Soft end feel, VBI symptoms, lump in the throat

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8
Q

Failure of transverse ligament causes what symptoms

A

Dizziness, nausea, lip/face/limb paresthesia, nystagmus, myelopathy

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9
Q

What is a positive finding when doing Anterior shear or sagittal stress test

A

Nystagmus, pupillary changes, dizziness, soft end feel, nausea, fascial/lip paresthesia, lump sensation in the throat…. excess displacement during the shearing movement

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10
Q

How to perform Alar Ligament Stress Test

A

Slightly flexed
Hold C2
SB or rotate
C2 should move opposite direction isntantly or within first 20-30 degrees…. IF NOT THEN STOP

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11
Q

Positive Test for Rotational Alar Ligament Stress Test

A

more than 20-30 deg without moment of C2 - contralateral alar ligament tear..
2. excessive motion in opposite direction indicates instability due to increase in neutral zone in joint

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12
Q

Positive sign of Pettman’s distraction test

A
  1. symptom reproduction

2. > 1 mm distraction

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13
Q

Jefferson’s Fracture

A

Fracture of C1

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14
Q

Nodding vs. flexion

A

Nodding in UCS during flexion movement… Flexion occurs in LCS

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15
Q

Upper limb scan to see if there is anything else causing complaint

A
  1. peripheral joints
  2. Myotomes
  3. Sensory Scan
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16
Q

C1-C2 Test Action

A

Neck Flexion

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17
Q

C1-C2 Muscles

A
  1. Rectus lateralis
  2. Rectus capitis anterior
  3. Longus Coli
  4. Longus Cervicis
  5. SCM
18
Q

C3 Test Action

A

Neck Lateral Flexion

19
Q

C3 Muscles

A
  1. Longus capitis
  2. Longus Cervicis
  3. Trapezius
  4. Scalenus medius
20
Q

C4 Test Action

A

Shoulder elevation

21
Q

C4 Muscles

A
  1. Diaphragm
  2. trapezius
  3. levator capulae,
  4. scalenus anterior
  5. scalenus medius
22
Q

C5 test action

A

shoulder abduction

23
Q

C5 muscles

A
  1. Rhomboid major/minor
  2. Deltoid
  3. Supraspinatus
  4. infraspinatus
  5. teres minor
  6. biceps
  7. scalenus anterior and medius
24
Q

C6 test action

A

elbow flexion and wrist extension

25
Q

C6 Muscles

A
  1. Serratus anterior
  2. Latissimus dosi
  3. Pectoralis major (sternal head)
  4. Triceps
  5. Pronator teres
  6. Scalenus medius/posterior
26
Q

Sensory Scan

  1. Myelopathy
  2. Nerve root lesion
  3. Peripheral nerve lesion
A
  1. UMN lesion
  2. LMN lesion
  3. LMN lesion
27
Q

Biceps reflex spinal segment

A

C5, C6

28
Q

Brachioradialis reflex spinal segment

A

C6

29
Q

Triceps spinal segment reflex

A

C7/ maybe C8

30
Q

Hoffmann Sign

A

UMN lesion suspected. flick fingernail of middle finger and check for flexion of thumb

31
Q

Functional Assessment

A
  1. ADL
  2. Functional strength tests
  3. Whiplash disability questionnaire (WDQ)
  4. Bournemouth questionnaire
  5. neck disability index
32
Q

2 types of special tests

A

Provocative

Symptom relief

33
Q

Provocative tests

A

ULNT
Foraminal compression (spurlings, jacksons)
cervical flexion rotation test

34
Q

Symptom relief test

A

distraction test

shoulder abduction

35
Q

Cloward’s Sign

A

Referred pain to medial scapula - pain from a disc/nerve root issue

36
Q

Maximal foraminal compression test

A

need some radiating symptoms in order to be positive. Negative test if just feel neck pain

37
Q

Clincal prediction rule for cervical radiculopathy

A

positive spurlings
positive relief with distraction
less than 65 deg ROM w/ rotation
Positive upper Limb Tension Test

  • All present 90% certain
  • 3 present - 60%
38
Q

Bakody’s Sign

A

Shoulder abduciton relief test for C4-C5 or C5-C6.

Decreased neurological symptoms

39
Q

Upper limb tension test 1

A

Median nerve

anterior interosseous nerve

40
Q

Upper limb tension test 2

A

median, axillary, and musculocutaneous nerves

41
Q

upper limb tension test 3

A

radial nerve

42
Q

upper limb tension test 4

A

ulnar nerve (c8-T1)

MSK II (4 decks)

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