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PCM II > Cervical Spine Examination > Flashcards

Cervical Spine Examination Flashcards

1
Q

What is the synovial joint between articular processes of the cervical vertebrae?

A

Facet joint or Zygapophyseal joint

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2
Q

What are the primary movements of the OA joint?

A

Flexion and extension

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3
Q

What are the primary movements of the AA joint

A

Rotation

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4
Q

What are the primary movements of C2 - C7

A

Rotation and sidebending Both occur to the same side

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5
Q
A
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6
Q

What pulse needs to be assessed and what’s importnat to remember about that pulse?

A

carotid pulse. Don’t measure both pulsees at once.

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7
Q

How do you measure jugular venous pressure?

A

patient lying at 30° with pillow under head

turn head away from side of examination

identify IJV using tangential lighting

find the highest point of pulsation an extend a line out horizontally

Centimeters above the sternal angle is the jugular venous pressure

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8
Q

How do you palpate the thyroid?

A

stand behind pt. have pt flex neck slightly

place fingers below cricoid cartilage

have pt swallow

assess symmetry

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9
Q

What muscles are responsible for flexion?

A

SCM

Scalenes

Paravertebral muscles

(45° - 90°)

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10
Q

What muscles are repsonsible for extension?

A

Splenius capitus

splenis cervicis

intrinsic spinal muscles

(70° - 90°)

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11
Q

What muscles are responsible for rotation?

A

SCM

Intrinsic spinal muscles

(70° - 90°)

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12
Q

What muscles are responsible for sidebending?

A

Scalenes

Intrinsic spinal muscles

(20° - 45°)

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13
Q

Compression Test (Spurling’s Maneuver)

A

pt. head in neutral position

Introduce axial load (caudally)

positive test: pain in upper extremity

Diagnosis: central neuropathy

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14
Q

Neck Distraction Test

A

pt. seated, head neutral.

SD places hand under pt chin

SD places hand around occiput

SD distracts (lifts) the head

Positive Test: neuropathy pain relieved

Diagnosis: central neuropathy

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15
Q

Valsalva Test

A

pt holds breath and bears down (valsalva maneuver)

as a result intrathecal pressure increases

Positive Test: increased pain/paresthesia in the problematic nerve root

Diagnosis: space occupying lesions (within the cervical canal)

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16
Q

Define Parestheisa

A

an abnormal sensation, tingling or prickling

17
Q

what are the boundaries of the thoracic outlet?

A

1st rib

1st thoracic vertebra

manubrium

18
Q

what structures run through the thoracic outlet?

A

brachial plexus

subclavian vein

subclavian artery

thoracic duct

19
Q

EAST Test (Roos)

A

pt flexes elbow 90° and external rotates shoulder 90°

pt opens and closes fist for 3 minutes

Positive Test: Reproduction of pain/paresthesia

Diagnosis:

  • thoracic outlet syndrome (subclavian a compression)
20
Q

Adson Test

A

SD palpates radially pulse

SD abducts, extends, and externally rotates shoulder while maintaining palpatation

pt head extended and rotated towards pulse

Pt head extended and rotated away from pulse

Positive Test: loss/change in pulse or pain/paresthesia

Diagnosis:

  • Thoracic Outlet Syndrome (chiefly)
  • compression of subclavian artery between scalenes (when looking away)
  • compression of subclavian artery between 1st rib (when looking towards)
21
Q

Wright’s Hyperabduction Test

A

SD finds radial pulse

Pt arm abducted above head

Positive Test: loss/change in pulse, pain/paresthesia

Diagnosis:

  • Thoracic Outlet Syndrome (chiefly)
  • neurovascular entrapement by pectoralis minor
22
Q

Costoclavicular Test (Military/Halstead Test)

A

SD finds radial pulse

elbow extended and supinated

extend shoulder while SD applies a caudal pressure to the shoulder

Positive Test:

  • loss/change in pulse
  • pain/paresthesia

Diagnosis:

  • Thoracic Outlet Syndrome (chiefly)
  • neurovascular entrapement between 1st rib and clavicle
23
Q

Nuchael Rigidity (Kernig Sign)

A

pt supine

SD flexes pt neck until chin touches chest

Positive Test: neck stiffness/resistance to flexion

Diagnosis:

  • inflammation in subarachnoid space (chiefly)
  • meningitis
  • subarachnoid hemorrhage
24
Q

Brudzinski’s Sign

A

pt supine

SD flexes pt neck until touches chest

Positive Test: flexion in hips and knees

Diagnosis:

  • inflammation in subarachnoid space (chiefly)
  • meningitis
  • subarachnoid hemorrhage
25
Q

Kernig Sign

A

pt supine

flex hip and knee 90°

attempt to extend pt knee from 90° to 180°

Positive Test:

  • increased resistance to extension and pain behind knee
  • radiating back pain to thigh
26
Q

What is a Jefferson Fracture?

A

axial compression of C1 leading to fracture

27
Q

What is a Wedge Fracture?

A

flexion and compression injury

28
Q

Clay Shovelers’ fracture

A

C6 or C7 fracture

29
Q

What is Hangman’s Fracture?

A

C2 bilateral arch fracture (hyperextension injury)

PCM II (3 decks)

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