Cervical spine pain

Question 1

pt has no objective neurological deficits, but has numbness, tingling, weakness

Answer 1

most likely referral from facet joint

Question 2

fever and neck stiffness

Answer 2

possible meningitis

Question 3

neck pain associated with severe headache that is worse than any headache ever experienced

Answer 3

red flag for infection, tumor, or vascular

Question 4

isolated weakness or numbness

Answer 4

nerve root

Question 5

numbness or tingling in diffuse or ill-defined pattern

Answer 5

referred pain from facet or trigger points

Question 6

lateral flexion injury causes

Answer 6

compression injury on side of movement

Question 7

forced flexion injury causes

Answer 7

compression fracture, myelopathy from stenosis

Question 8

associated urinary dysfunction means

Answer 8

myelopathy

Question 9

over use injuries are most often

Answer 9

postural injuries

Question 10

cervical compression test: local pain on extension and/or rotation

Answer 10

facet involvement

Question 11

cervical compression test: radiating pain down the arm

Answer 11

nerve root involvement

Question 12

Lhermitte’s causes electric shock sensations

Answer 12

multiple sclerosis or cervical myelopathy

Question 13

brachial plexus stretch test, aka upper limb tension test, is positive

Answer 13

means cervical radiculopathy

Question 14

compression injury to top of head or forehead

Answer 14

do xrays to look for fracture

Question 15

whiplash type injury with radiating pain, numbness, tingling, weakness, and produces radiation into arms

Answer 15

do xrays; cerival disc lesion or foraminal encroachment suspected

Question 16

lateral flexion injury with weakness, numbness, tingling in the arm

Answer 16

cervical stinger

Question 17

head trauma with loss of consciousness, associated signs of headache dizziness and memory difficulty

Answer 17

possible subdural or epidural hematoma

Question 18

nontraumatic neck and arm pain with recurrent bouts of pain; exam shows any myotomal weakness, dermatomal patterns, hyporeflexia, possible disc disease on xray, reproduction of complaints with compression

Answer 18

foraminal encroachment or cervical disc lesion

Question 19

nontraumatic neck and arm pain with recurrent bouts of pain; but no objective sensory findings, muscle weakness, reflex changes, compression causes local pain

Answer 19

facet irritation

Question 20

positional related arm numbness/tingling and neck complaint is secondary; TOS test is positive

Answer 20

conservative care

Question 21

positional related arm numbness/tingling with negative TOS findings; shoulder stability test reproduced complaints

Answer 21

instability may be causing nerve traction

Question 22

acute onset of pain with severe global restrictions but no fever; active ROM severely restricted while passive ROM only minimally affected

Answer 22

acute muscle spasm

Question 23

one or two ROM’s restricted with local pain on cervical compression

Answer 23

probable facet syndrome

Question 24

motor supply to deltoid and biceps, biceps reflex, sensory to outer shoulder

Answer 24

C5 nerve root

Question 25

motor supply to biceps and wrist extension, brachioradialis reflex, sensory to outer forearm

Answer 25

C6 nerve root

Question 26

motor supply to triceps, finger extensors, and wrist flexors, triceps reflex, sensory to middle finger

Answer 26

C7 nerve root

Question 27

motor supply to finger flexors, no reflex, sensory to little and ring fingers

Answer 27

C8 nerve root

Question 28

motor supply finger abduction/adduction, no reflex, sensory to medial arm

Answer 28

T1 nerve root

Question 29

disc herniation at C4/C5 affects

Answer 29

C5 nerve root

Question 30

hypertrophy changes to C5 uncinate process affects

Answer 30

C5 nerve root

Question 31

disc herniation at C5/C6 affects

Answer 31

C6 nerve root

Question 32

hypertrophy changes to C6 uncinate process affects

Answer 32

C6 nerve root

Question 33

disc herniation of C6/C7 affects

Answer 33

C7 nerve root

Question 34

hypertrophy changes of C7 uncinate process affects

Answer 34

C7 nerve root

Question 35

disc herniation of C7/T1 affects

Answer 35

C8 nerve root

Question 36

hypertrophy changes of T1 vertebral body affects

Answer 36

C8 nerve root

Question 37

pt presents with bilateral symptoms of clumsiness of the hands, difficulty walking, urinary dysfunction, shooting pains into arms

Answer 37

cervical myelopathy

Question 38

pt presents with diffuse arm symptoms, numbness and tingling, pain down inside of arm to 4th and 5th fingers, made worse by overhead activity

Answer 38

TOS

Question 39

associated conditions with TOS

Answer 39

cervical rib, scalenus anticus or medius, costoclavicular syndrome, pec minor

Question 40

pt reports traumatic or insidious onset of neck and arm pain, pain doesn't follow a specific dermatome

Answer 40

facet or referred pain