cervical spine intervention Flashcards
what levels are upper cervical injuries?
c0-c2
what levels are lower cervical spine injuries?
c3-c7
loss of lordotic curve in the cervical spine is often a result of …
muscle spasm
moving more distally, or worsening of symptoms
peripheralizing
more more centrally, improvement of symptoms
centralizing
unfavorable signs of neck injury
paresthesia, muscle weakness, radicular signs, neurological deficit
the first goal of treating a patient with radicular signs and symptoms
relieve the pressure from the nerve!!!
what is an injury from whiplash called?
whiplash associated disorders (WAD)
which type of whiplash is the worst?
hyperextension
rotation of the head during a whiplash incident may injury these ligaments
alar ligaments
strain and spasm of the cervical flexors may also limit this action, produced by upper traps
shrugging shoulders
imaging results and motor dysfunction are good prognostic indicators of WAD. t or f
False
cervical spondylosis is both inflammatory and degenerative. t or f
True
Spondylosis: As the disc degenerates and loses bulk, a reduction of the ____ in the nucleus pulposus occurs, leading to an increase in collagen in the nucleus pulposus.
GAGs, glucosaminoglycans
is the scientific word for the balance between pliability and stiffness or rigidity in something living.
turgor
__________ subluxation is the most common type of cervical spine instability in patients with rheumatoid arthritis, with a quoted incidence of 50% to 70%.
atlantoaxial
the symptom identifier that was most related to cervical instability
intolerance to prolonged static postures
bulging of the disc without rupture of the annulus fibrosus
protrusion
the outermost fibers of the annulus fibrosus contain the nucleus
prolapse
the annulus fibrosus is perforated and discal material moves into the epidural space
extrusion
discal fragments from the annulus fibrosus and nucleus pulposus outside the disc proper
sequestration
most common population to have disc herniation
males in 30s
most commons areas in cervical spine for disc herniation
c5-6, c6-7
most common disc herniations in cervical spine
posterior, posterolateral
disc bulge that may produce bilateral symptoms in the limbs
posterior (central)
spinal stenosis is diagnosed if the sagittal diameter of the spinal canal is less than
13mm
Clinical Prediction Rule for Cervical Myelopathy
Gait deviation Positive Hoffmann’s test Positive inverted supinator sign Positive Babinski test Age > 45 years
Classic Signs and Symptoms of Vertebrobasilar Insufficiency
5Ds, 1A,3Ns
dysarthria dysphagia drop attacks dizziness diplopia ataxia nausea numbness nystagmus
The best available evidence indicates that the C2-3 _______ joints are the most common source of cervicogenic headache, accounting for approximately 70% of cases.
facet
Cervical Flexion-Rotation Test is usually negative in patients with cervicogenic HA. t or f
False, positive
cervicogenic HA is usually…..
tension-type HA is usually….
cervicogenic; unilateral
tension type; bilateral
a combination of therapist-applied cervical manipulation and mobilization with ___________strengthening was most effective for decreasing pain outcomes in those with cervicogenic headache
cervicoscapular
Limited motion with a ______ capsular end feel requires rhythmical oscillations that stretch the capsular tissues.
hard
Limited motion with a pathomechanical end feel (i.e., abrupt and lightly springy) requires nonrythmical techniques, such as high-velocity, low-amplitude thrusts (________) or minithrusts (oscillations).
manipulation
grade 1 and 2 mobilizations should be used during these pain states
acute and subacute
Following whiplash, active mobilization has been found to be better than rest and cervical collar. T or f
True
If a cervical collar is used, it should be time limited. T or f
True
Static cervical traction is indicated for patients with
High joint or nerve root irritability
Intermittent traction produces 1/2 as much separation as static, t or f
False, intermittent creates 2x separation compared to static
Centralization of symptoms is a good thing. T or f
True, movements that centralize symptoms should be repeated
