Cervical Spine SD Diagnosis

Question 1

Describe the anatomy of the spine

Answer 1

Cervical: 7 vertebrae (typical are #3-6)
Thoracic: 12 vertebrae
Lumbar: 5 vertebrae

Question 2

Describe the nerve distribution in the spine

Answer 2

Cervical: nerves exit ABOVE vertebral body

Thoracic & lumbar: nerves exit BELOW vertebral body

Question 3

On an exam of a football player, you find that his C6 dermatome seems to be affected. Which spinal segment is likely affected?

Answer 3

C5 to C6 b/c nerves of cervical spine exit ABOVE spinal segment

Question 4

Important features of C1/atlas

Answer 4

NO vertebral body
rotates around dens of C2
bounded anteriorly on dens by anterior arch & posteriorly by transverse atlantal ligament

Question 5

Important features of C2/axis

Answer 5

vertebral body of C2 extends superiorly to form the dens

Question 6

What is the myodural bridge?

Answer 6

true connections between the rectus capitis posterior major & dura mater

Question 7

What are the purposes of the myodural bridge?

Answer 7

monitor dural tension

anchors muscle

role in cervicogenic pathologies

Question 8

What is a hangman’s fracture?

Answer 8

anterior displacement of body of C2 vertebra

hyperextension causes traumatic spondylolisthesis of C2 w/ fracture of vertebral arch of C2 (also tears ligaments btwn C2 & C3)

Question 9

What are the atypical articulations of the cervical spine?

Answer 9

OA

AA

Question 10

What are the typical articulations of the cervical spine?

Answer 10

C2-C7

Question 11

What are the typical biomechanics of C2-C7?

Answer 11

rotation & sidebending occur in SAME direction

Question 12

What are common SD for C2-C7?

Answer 12

occur in sagittal plane

SD may be in flexion or extension

**pain in neutral position common in severely arthritic patients

Question 13

What are the major motions of OA joint?

Answer 13

flexion & extension

Question 14

What type of biomechanics is the OA joint?

Answer 14

Type 1 like (sidebending & rotation occur in opposite directions)

Question 15

What is the primary motion of the AA joint?

Answer 15

ROTATION!

atlas rotates about the dens (almost NO sidebending or flexion/extension)

Question 16

What are the major parts for a cervical TART exam?

Answer 16

Tissue texture changes
Asymmetry of tissues/structure
ROM (restricted?)
Tenderness

Question 17

Normal ROM for cervical spine

Answer 17

Flexion (45-90)
Extension (45-90)
SB (45)
Rotation (70-90)

Question 18

Cervical Segmental Exam for rotation testing

Answer 18

rotation LEFT is induced by anterior pressure on posterior aspect of RIGHT lateral mass

rotation RIGHT is induced by anterior pressure on posterior aspect of LEFT lateral mass

Question 19

Cervical segmental exam for translation/side bend testing

Answer 19

translation from left to right is SB L

translation from right to left is SB R

Question 20

If the movements are more restricted in flexion, what would be the SD?

Answer 20

extension SD

Question 21

Contraindications to soft tissue treatment in cervical spine

Answer 21

fractures
open wounds 
infection
DVT
coagulopathy
neoplasm

Question 22

Contraindications to MET in cervical spine

Answer 22

undiagnosed joint swelling
severe osteoporosis
neoplasm
infection
hematoma
RA
fracture
dislocation

Question 23

Contraindications to HVLA (esp in cervical area)

Answer 23

RA or Down Syndrome (alar ligament unstable)
Vertebral artery disease
Advanced carotid disease

Question 24

Contraindications of HVLA

Answer 24

inflammatory arthritis
malignancy
acute radiculopathy
Klippel Feil syndrome
Chiari malformation
Dwarfism
Osteogensis Imperfecta