CERVICAL SPINE MT #1 Flashcards
Cervical Spine–Introduction X 19
List of conditions discussed herein:
1) Sprain/strain
2) Fracture
3) Dislocation
4) Herniations
5) MFPS
6) Radiculopathy
7) Myelopathy
8) Degenerative disease
9) Infection
10) Discitis
KNOW
Cervical Spine–Introduction X 19
11) Muscle spasm
12) “Postural syndrome”
13) Referred pain
MI, carotidynia, throat, ear, teeth, etc…
14) Lymphadenopathy
15) Meningitis
16) Tumor/malignancy
17) Angina
18) Temporomandibular joint syndrome/dysfunction
19) Thoracic outlet syndrome
KNOW
Cervical Spine–Introduction
RED FLAGS– requiring caution, films or referral:
1) Severe trauma
2) ______ ______ trauma with loss of consciousness
3) Nuchal rigidity
4) A NEW, severe headache, or “the worst one I’ve ever had”
5) Associated _______ or _________
6) Associated cranial nerve or CNS signs/symptoms
7) History of cancer, RA or Down syndrome
8) Alcoholism or drug abuse
9) Known immunocompromise
Direct head
dysphaGIA—Difficulty with SWALLOWING is the sensation that food is stuck in the throat, or from the neck down to just above the abdomen behind the breastbone (sternum).
dysphaSIA—-language disorder marked by deficiency in the generation of SPEECH, and sometimes also in its comprehension, due to brain disease or damage.
Cervical Spine–Introduction
The patient has neck pain, and has been in an accident.What possible problems should you be considering?
1) Sprain/strain injury
2) Fracture
3) Dislocation
4) _______________
Disc herniation
Cervical Spine–Introduction
What are some possible injuries for a patient whose head has been forced into FLEXION?
A. Sprain/strain of posterior muscles/ligaments B. Dislocation of \_\_\_\_\_\_\_\_\_ C. \_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_ D. Fractures: 1) Spinous avulsion fractures (Clay shoveler’s) 2) Wedge of body 3) Burst 4) Teardrop
facets
Disc herniation
Cervical Spine–Introduction
What are some possible injuries for a patient whose head has been forced into EXTENSION?
A. _______/_________ of anterior structures
B. Fractures
1) Compression fracture of facets
2) Teardrop fracture (anteroinferior body C2)
3) Hangman’s fracture (bilateral pedicle fracture C2)
Sprain/strain
Cervical Spine–Introduction
What are some possible neural injuries for a patient whose head has been forced into LATERAL FLEXION?
A. ____________ nerve root compression
B.____________ brachial plexus stretch injury
C. Facet fracture
Ipsilateral
Contralateral
Cervical Spine–Introduction
What would cause pain, NUMBNESS, or WEAKNESS in the UPPER extremity?
1--Disc lesion 2--Nerve root \_\_\_\_\_\_\_\_\_\_\_\_ A. weakness or numbness 3--Referred pain 4--Ill-defined, diffuse pattern of pain/numbness 5--Myelopathy 6--Brachial plexus damage A. Numbness/tingling resolved in minutes: “\_\_\_\_\_\_\_/\_\_\_\_\_\_\_” 7--Double crush syndrome
entrapment
burner/stinger
Cervical Spine–Introduction
What would cause a patient to be unable to move his/her head in a particular direction?
1—________________
A. “I just woke up with it”, the dreaded “crick in the neck”, etc.
2—___________
A. Gradual onset over years; older patient
3—Fracture/dislocation
A. Recent trauma
4—______________
A. Symptoms of fever/infection, severe pain on flexion
Torticollis
Osteoarthritis
Meningitis
Cervical Spine–Introduction
What about chronic pain and/or stiffness?
1—Osteoarthritis
2—_________syndrome
A. Forward head posture (anterior head carriage) or other sustained posture
4—Subluxation
A. Local pain with specific movement
Postural
Cervical Spine–Introduction–Cervical Sprain/Strain
1—Whiplash/Acceleration-deceleration Injury
2—SIDE IMPACT
3—FRONT END IMPACT
4–REAR END IMPACT
KNOW EXAMPLES
Cervical Spine–Introduction–Cervical Sprain/Strain
Cervical Sprain/Strain
1---3 Grades- mild, moderate, severe 2---Local pain 3---Palpable spasm and tenderness 4---Decreased and painful \_\_\_\_\_\_\_ 5---Distraction test, Shoulder depression test 6---Negative neurological tests A...--May develop TOS type syndromes
ROM
Cervical Spine–Introduction–Cervical Sprain/Strain
Torticollis
The Latin word tortus means ‘______.’ Collum (collar) means ‘neck.’Torticollis simply means TWISTED NECK. It can have many different causes.
1–Congenital is often from birth trauma
A. Fibrosis of sternal head of SCM
B. 90% respond to stretching in first year of life
2—Spasmodic (CNS disorder)
A. Repeated muscular spasms “_____ _______”
3—Acquired
A. Trauma & spasms
4—Restriction is limited to one side
5–______ spasm-head in rotation and flexion
twisted
cervical dystonia
**Cervical dystonia is characterized by excessive pulling of the muscles of the neck and shoulder. The excessive pulling causes the head to turn or tilt involuntarily. Most commonly, the head turns to one side or the other. Tilting sideways, or to the back or front may also occur. Often, the turning and tilting movements are accompanied by jerky or wobbly movements known as tremor. Also common is soreness of the muscles of the neck and shoulders.—-he cause of cervical dystonia is unknown.
SCM
Cervical Spine–Introduction–Cervical Sprain/Strain
Torticollis Exam Findings
1—-Decreased active and passive ______
2—-______ spasm and trigger points
ROM
SCM
Cervical Spine–Introduction–Cervical Sprain/Strain
Facet Syndrome
1—Minor to moderate traumatic onset of neck and arm pain (___-___________)
A. Can be insidious
2—-Painful extension with ____________
3—Insidious or traumatic
non-dermatomal
rotation
Facet Syndrome Exam Findings
1—All orthopedic maneuvers involving _________ observed to be positive
2—Trigger points
3—Maybe facetal __________ on x-ray
compression
degeneration