Cervical spine pain Flashcards
pt has no objective neurological deficits, but has numbness, tingling, weakness
most likely referral from facet joint
fever and neck stiffness
possible meningitis
neck pain associated with severe headache that is worse than any headache ever experienced
red flag for infection, tumor, or vascular
isolated weakness or numbness
nerve root
numbness or tingling in diffuse or ill-defined pattern
referred pain from facet or trigger points
lateral flexion injury causes
compression injury on side of movement
forced flexion injury causes
compression fracture, myelopathy from stenosis
associated urinary dysfunction means
myelopathy
over use injuries are most often
postural injuries
cervical compression test: local pain on extension and/or rotation
facet involvement
cervical compression test: radiating pain down the arm
nerve root involvement
Lhermitte’s causes electric shock sensations
multiple sclerosis or cervical myelopathy
brachial plexus stretch test, aka upper limb tension test, is positive
means cervical radiculopathy
compression injury to top of head or forehead
do xrays to look for fracture
whiplash type injury with radiating pain, numbness, tingling, weakness, and produces radiation into arms
do xrays; cerival disc lesion or foraminal encroachment suspected
lateral flexion injury with weakness, numbness, tingling in the arm
cervical stinger
head trauma with loss of consciousness, associated signs of headache dizziness and memory difficulty
possible subdural or epidural hematoma
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
foraminal encroachment or cervical disc lesion
nontraumatic neck and arm pain with recurrent bouts of pain; but no objective sensory findings, muscle weakness, reflex changes, compression causes local pain
facet irritation
positional related arm numbness/tingling and neck complaint is secondary; TOS test is positive
conservative care
positional related arm numbness/tingling with negative TOS findings; shoulder stability test reproduced complaints
instability may be causing nerve traction
acute onset of pain with severe global restrictions but no fever; active ROM severely restricted while passive ROM only minimally affected
acute muscle spasm
one or two ROM’s restricted with local pain on cervical compression
probable facet syndrome
motor supply to deltoid and biceps, biceps reflex, sensory to outer shoulder
C5 nerve root
motor supply to biceps and wrist extension, brachioradialis reflex, sensory to outer forearm
C6 nerve root
motor supply to triceps, finger extensors, and wrist flexors, triceps reflex, sensory to middle finger
C7 nerve root
motor supply to finger flexors, no reflex, sensory to little and ring fingers
C8 nerve root
motor supply finger abduction/adduction, no reflex, sensory to medial arm
T1 nerve root
disc herniation at C4/C5 affects
C5 nerve root
hypertrophy changes to C5 uncinate process affects
C5 nerve root
disc herniation at C5/C6 affects
C6 nerve root
hypertrophy changes to C6 uncinate process affects
C6 nerve root
disc herniation of C6/C7 affects
C7 nerve root
hypertrophy changes of C7 uncinate process affects
C7 nerve root
disc herniation of C7/T1 affects
C8 nerve root
hypertrophy changes of T1 vertebral body affects
C8 nerve root
pt presents with bilateral symptoms of clumsiness of the hands, difficulty walking, urinary dysfunction, shooting pains into arms
cervical myelopathy
pt presents with diffuse arm symptoms, numbness and tingling, pain down inside of arm to 4th and 5th fingers, made worse by overhead activity
TOS
associated conditions with TOS
cervical rib, scalenus anticus or medius, costoclavicular syndrome, pec minor
pt reports traumatic or insidious onset of neck and arm pain, pain doesn’t follow a specific dermatome
facet or referred pain
