cervical spine musculoskeletal pathologies

Question 1

What are the types of segmental joint dysfunctions?

Answer 1

hypomobility
hypermobility

Question 2

What joints are affected with segmental joint dysfunction?

Answer 2

Facet joints (zygopophyseal joints)

Question 3

Acute disc herniations are more common in the _____ spine.

Answer 3

lumbar

Question 4

definition: Lack of normal joint glide present at a segment that leads to symptoms of pain or movement loss ( Joint Not moving Enough)

Answer 4

segmental joint dysfunction (hypomobility)

Question 5

Segmental joint dysfunction: hypomobility has a (gradual/quick) onset of symptoms

Answer 5

gradual

Question 6

Segmental joint dysfunction: hypermobility has a (gradual/quick) onset of symptoms

Answer 6

quick

Question 7

What is greater in segmental joint dysfunction: hypomobility… Limited movement or intensity of pain

Answer 7

limited movement is greater

Question 8

Segmental joint dysfunction: hypomobility has limited movement of the neck in ___ directions

Answer 8

one or two

Question 9

Segmental joint dysfunction: hypermobility has limited movement of the neck in ___ directions

Answer 9

all

Question 10

With hypomobility in the upper C-spine, SB and ROT are restricted in (opposite/same) directions

Answer 10

opposite

Question 11

With hypomobility in the mid-lower C-spine, side bending and ROT are restricted in the (opposite/same) direction.

Answer 11

same

Question 12

With C-spine hypomobility, joint glide that is present at the segment can be even more restricted when the segment is tested in what movements?

Answer 12

FLX/EXT

Question 13

What segment is most commonly hypomobile in EXT (stuck in FLX)?

Answer 13

C2/C3 segment

Question 14

The AO joint is common to be restricted in ____ with upper C- spine FLX/EXT.

Answer 14

ROT

Question 15

What areas in the C-spine are more common to have hypomobility?

Answer 15

• CT junction
• C2/C3 segment
• AO joint

Question 16

definition: Excessive joint glide present at a segment that leads to symptoms of pain or movement loss (Joint Moving Too Much)

Answer 16

segmental joint dysfunction: hypermobility

Question 17

What type of segmental joint dysfunction common affects people of younger age (<50 yrs)?

Answer 17

hypermobility

Question 18

What segmental joint dysfunction presents with the following symptoms:
- locking/catching symptoms with quick neck movements
- moderate referral
- localized neck pain

Answer 18

hypermobility

Question 19

(true/false) When you see a segment that is hypermobile, there are typically hypomobile segments close by that are creating more stress on the hypermobile segment.

Answer 19

true

Question 20

What segments in the C-spine are more commonly hypermobile?

Answer 20

• C4/C5
• C5/C6

Question 21

With acute disc herniation, The nucleus pulposus of a cervical disc typically herniates________through the annulus fibrosis and often compresses on the nerve root located on the side of herniation.

Answer 21

posterolaterally

Question 22

(true/false) Irritation of the nerve root w/ an acute disc herniation can occur directly from the disc pressing on it. It can also occur from the release of chemicals and inflammatory mediates that come in contact with nerve root due to the herniation.

Answer 22

true

Question 23

Is it more common to get an acute disc herniation in a younger or older population? why?

Answer 23

younger b/c there is more water in their IV discs

Question 24

Who is at risk for an acute disc herniation?

Answer 24

• Ages 25-40
• women >men

Question 25

What are the symptoms present with acute disc herniations?

Answer 25

• severe unilateral arm and neck pain
• radicular pain or dermatomal paresthesia often into the hand
• severe ROM loss in ALL directions
• UE weakness
• intense pain with cervical AROM

Question 26

Acute disc herniations present with significant C-spine AROM loss in ___ direction(s).

Answer 26

ALL

Question 27

Symptoms of acute disc herniation increase with cervical ___ and decrease with cervical ___.

Answer 27

compression, distraction

Question 28

You (will/will not) see positive finding from a Neuro Screen when a disc is herniated

Answer 28

You will:
- myotomal weakness
- dermatomal parasthesia
- DTR changes
- radicular pain

Question 29

What are common elements presented when there is a cervical radiculopathy?

Answer 29

> 50 y/o
- unilateral arm and neck pain
- complaint of numbness/tingling/weakness
- pain be exacerbated with prolonged postures
- can be irritated with both neck and UE movements

Question 30

What are the common causes of cervical radiculopathies?

Answer 30

1. disc herniation (<50 y/o)
2. foraminal stenosis (>50 y/o)

Question 31

What are objective findings with cervical radiculopathies?

Answer 31

• unilateral diminished DTRs at the affected level
• paresthesia in UE (dermatomal distribution)
• myotomal weakness

Question 32

Most radiculopathies involve the ____ segments of the cervical spine

Answer 32

Lower 4 segments (C5-C8)

Question 33

What is the most common nerve root to present with cervical radiculopathy? Why?

Answer 33

C6… it is the largest root

Question 34

What is the presentation of symptoms when a C5/C6 radiculopathy is present?

Answer 34

• motor loss of strength
• fatigable weakness in wrist EXT
• diminished brachioradialis reflex
• loss of sensation in palmar aspect of the index finger, thumb, and middle finger

Question 35

What is the presentation of symptoms when a C7radiculopathy is present?

Answer 35

• diminished reflex of triceps
• triceps myotomal weakness
• paresthesia in the index finger