cervical spine screening for serious pathologies Flashcards
The Canadian C-Spine Rule is ___% sensitive
100%
Cervical fractures have a (slow/quick) onset of pain
quick
Cervical fractures have severe loss of movement in ____ direction(s)
ALL
(true/false) those with a cervical fracture have a slow onset of loss of function.
False (immediate loss of function accompanies a cervical fracture)
What is a common symptom of an odontoid fracture?
feeling of a lump in the throat/difficulty swallowing
A simple compression fracture is a ___ injury.
Flexion
definition: the wedging of 3mm+ of the superior end-plate of the vertebral body segment involved.
simple compression fracture
Who has an increased risk of experiencing a simple compression fracture?
Older Females
Long term use of ___ can lead to vertebral compression fractures
corticosteroids
What is the most common Fracture of the C1 vertebrae?
Neural arch fracture (of C1)
A Neural arch fracture of C1 is a ____ injury.
hyperextension injury
(true/false) Neural arch fractures of C1 are associated with a neurological deficit
False (they are not)
What is the most common cause of a neural arch fracture of C1?
It gets pinched in between C2 and occiput
What kind of fracture is the most common cervical spine fracture?
hangman’s fracture of C2
Hangman’s fracture of C2 is a ___ fracture.
hyperextension/compression
Definition: A fracture in the PEDICLES of C2 with an ANTERIOR SLIP of C2/C3
hangman’s fracture of C2
(true/false) Hangman’s fractures are not associated with neurologic deficits.
True/false…. they are not assoc. with a neurological deficit if they are isolated fractures.
A ____ fracture of the inferior aspect of C2 or C3 is due to the diagnosis of Hangman’s fracture
Teardrop
Dens fractures are a type of ___ fracture.
hyperextension
definition: fracture that is most associated with forward subluxation of C1 on C2
dens fracture
What type of dens fracture is most commonly seen?
base of the dens (65%)
sub-dentate (30%)
Tip of dens (5%)
definition: avulsion fracture of the spinous process of C6 or C7 that occurs as a result of repetitive and forceful ROT of the trunk relative to the neck
clay-shoveler’s fracture
(true/false) Clay Shoveler’s fracture has no neurologic deficit.
true
What are the most common symptoms of cervical arterial dysfunction?
neck pain
headache
definition: compromise of the spinal cord, brainstem, thalamus, cerebellum, or cerebrum (5Ds and 3Ns)
cervical arterial dysfunction
What should you do to test if a cervical arterial dysfunction has a cardiovascular component?
Assess the patient’s vitals
What artery is the most vulnerable to compression and stretching at the C1/C2 spinal level? Why?
vertebral arteries because the transverse foramen of C1 is more lateral than C2 which makes it more vulnerable for impingement during ROT at the AA joint and EXT at the AO joint.
What is considered as the gold standard imaging study to diagnose Cervical artery dysfunction?
MRA
What are the biggest risk factors of Cervical Arterial Dysfunction?
- recent trauma
- smoker
- HTN
- high cholesterol
What are the most common symptoms of cervical arterial dysfunction?
- headache
- neck pain
- unsteadiness/ataxia
- ptosis (eyelid drooping)
definition: eyelid drooping
ptosis
definition: compression of the spinal cord that has a gradual progression and can lead to gait/balance deficits
cervical myelopathy
Cervical myelopathies are commonly found in (younger/older) people
older
What is the clinical presentation of cervical myelopathies?
- sensory impairments of U/LE that are bilateral but NOT dermatomal
- LE/UE weakness that is often bilateral but NOT myotomal
- gait incoordination
- babinski reflex
- hoffman’s reflex
- loss of fine motor control
- atrophy of intrinsic hand muscles
What is the cook cluster findings that help identify a cervical myelopathy?
- gait deviation
- (+) hoffmans
- inverted supinator sign
- (+) babinski
- Age > 65 years
*3+ findings is indicative of a higher likelihood of cervical myelopathy
Thyroid cancer can cause ___ of the SCM.
torticollis
What type of cancer is characterized by anterior neck pain that is worse with swallowing?
thyroid Cancer
When inspecting for thyroid cancer, palpate for a ___ deviation of the TRACHEA
lateral
What are s/s of lung cancer?
- recurrent pneumonia and bronchitis
- hemoptysis
- persistent cough
- hoarseness/dysphagia
- fecal breath
definition: A tumor in the superior apices of the lungs
Pancoast tumor (lung cancer)
What are the associated s/s of pancoast tumors?
- unilateral constricted pupil
- loss of facial sweating
- ptosis
- hand muscle wasting
What is the most common bone infection of the cervical spine?
vertebral osteomyelitis
definition: infection in the vertebral body caused by either a bacteria or fungus
spinal osteomyelitis
Spinal osteomyelitis is most common in a patient’s ___s and the pain increases within 1-3 weeks.
30s
Fever is common in (adults/children) when spinal osteomyelitis is present.
children
definition: collection of pus in the back of the throat due to a bacterial infection
retropharyngeal abscess
