Cervical Spine SD

Question 1

what does the atlas lack?

Answer 1

vertebral body

Question 2

what’s another name for the dens?

Answer 2

odontoid process

Question 3

the facets of the upper cervical vertebrae face?

Answer 3

point toward eyes

Question 4

facets of lower cervical vertebrae point toward?

Answer 4

opposite shoulder

Question 5

what’s the major motion of the OA joint?

Answer 5

flexion/extension

Question 6

what kind of mechanics does the OA joint have?

Answer 6

modified type 1 mechanics, rotates and SB to opposite sides

Question 7

what is the primary motion of the atlantoaxial joint?

Answer 7

rotation; almost no SB or flexion/extension

Question 8

mechanics of C2-7?

Answer 8

type II, rotation and SB to same side (although some studies say otherwise, thought to be due to compensatory patterns)

Question 9

what movement is used to determine side bending?

Answer 9

translation

Question 10

what is the OMM technique with the most risk?

Answer 10

HVLA

Question 11

who would have contraindications to HVLA?

Answer 11

elderly (risk of osteoporosis), frightened pts, recent trauma or acute process (MVA), RA pts (week odontoid ligament, susceptible to rupture), down syndrome (weak odontoid log, some incomplete/missing odontoid), Klippel-Feil Syndrome, known peripheral vascular disease, pts on anticoagulants (shear stress–> intracranial bleed)

Question 12

what are the most frequent serious complications result from HLVA to c-spine?

Answer 12

occipitobasilar strokes (Wallenberg Syndrome), vertebral a compression with thrombosis, arterial dissections, cerebellar infarctions

Question 13

what is the primary cause for complications with HVLA to c-spine?

Answer 13

hyperextended and hyper-rotated, ages for injury to vert. a. are 35-40yo

Question 14

torticollis

Answer 14

SCM spasm=rotation and side bending

Question 15

laterocollis

Answer 15

trapezius spasm= lateral tilt

Question 16

anterocollis

Answer 16

spasm of any ant. neck m.s= neck flexion

Question 17

retrocollis

Answer 17

post. neck spasm= neck ext.

Question 18

rotation torticollis

Answer 18

rotator spasm= rotation only to one side

Question 19

common muscles involved?

Answer 19

trap, SCM, splenius capitis, levator scap, hyoids, scalene

Question 20

what are some presentations of congenital torticollis?

Answer 20

facial distortions, cranial dysfunction (plagiocephaly: abnormal shape to head)

Question 21

tx for congenital torticollis?

Answer 21

OMM cranial treatment, helmets

Question 22

acute torticollis is caused by what type of things?

Answer 22

sleeping wrong, neck strain at work, etc.

Question 23

congential torticollis is typically seen by when?

Answer 23

2 months age

Question 24

in congenital torticollis is associated with what feeling in SCM?

Answer 24

KNOW THIS!* ropy muscle with olive type structure (said 3x during lecture)

Question 25

at what point does pt need to be referred to ortho?

Answer 25

1-2 months with no response

Question 26

what does the treatment for congenital torticollis stretching SCM look like?

Answer 26

one hand stabilizes chest/shoulders, other tiles head away from contracted m and rotates chin toward contracted side, hold 10 sec, 15 reps

Question 27

when may surgery be needed for SCM release?

Answer 27

if initial presentation is over 1 year of age

Question 28

what kind of OMT technique can be used on adults for torticollis?

Answer 28

indirect tx, then muscle energy as tolerated (PT-if refractory case)

Question 29

what medications can be used if conservative tx is not helping?

Answer 29

botox, anticholinergics, benzodiazepines, muscle relaxants

Question 30

what are the two surgical interventions for torticollis?

Answer 30

muscle resection, nerve ablation