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MSK 3 > Cervical Thoracic Anatomy and Pathology > Flashcards

Cervical Thoracic Anatomy and Pathology Flashcards

1
Q

At any given time, what percentage of the population reports neck problems?

A

10-20%

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2
Q

How high did neck pain rank in the 2010 Global Burden of Disease study?

A

4th

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3
Q

If a patient is reporting high pain intensity in their neck which clinical tool is most recommended?

A

Numeric Pain Scale (0-10) and consider a score of 6 or greater a useful cut score for prognosis

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4
Q

If a patient has high self-reported disability what clinical tool is recommended for prognosis?

A

Neck Disability Index, you can use a score of 30% or more as a good cut off score for prognosis

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5
Q

What is considered the ‘upper’ cervical spine?

A

Joints between occiput, atlas, and axis with C3 being the transitional segment

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6
Q

Which cervical vertebra has no vertebral body?

A

C1

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7
Q

True or false: the C1 superior and inferior articulating facets are both convex.

A

False, both are concave

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8
Q

Which vertebrae has the dens as a landmark?

A

C2

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9
Q

What is considered the lower cervical spine?

A

Joints between C3 and C7/T1

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10
Q

What forms the joints of luschka?

A

The uncovertebral joints located on the superior surface of the vertebral body which articulate with the inferior surfaces of the body above

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11
Q

true or false: The C1 and C2 vertebrae do not have uncovertebral joints.

A

True

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12
Q

What are the functions of the Joints of Luschka?

A
  • limit side bending to protect the cervical nerve roots
  • support intervertebral discs from protruding
  • form medial wall of the intervertebral foramen/canal
  • become weight bearing with age and disc dehydration
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13
Q

What other structure along with the uncovertebral joints helps limit excessive movement and protect the IVD from severe torsion strain?

A

the zygopophyseal joints (ZPJ)

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14
Q

What symptoms are consistent with the uncovertebral joints?

A
  • very little pain-more of a vague discomfort
  • stiffness more than pain
  • No referred or neurological symptoms
  • Morning stiffness
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15
Q

What physical signs may be present with an injury to the uncovertebral joints?

A
  • loss of extension
  • neck in forward flexed position
  • limited side bend in flexion, neutral and extension
  • decreased rotation
  • crepitus/”grinding”
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16
Q

when does the uncus usually grow upward from the lateral edge of the vertebral body? When does uncovertebral clefts appear?

A

at 8 years old

~12 years old

17
Q

At what age does the nucleus and posterior annulus usually completely fissure? What remains intact?

A

By around 35-40 years old

anterior annulus and longitudinal ligaments

18
Q

True or False: Disc fissuring is normal for patients over 35 years old.

A

True

19
Q

True or false: Lower cervical discs are fissured before upper cervical discs, but disc C7-T1 is often spared completely from fissuring

A

False, upper cervical discs are fissured before lower cervical discs

C7-T1 is often spared from fissuring though

20
Q

What structures can be compressed as the cervical disc space narrows and uncovertebral osteophytes project into the spinal column?

A
  • nerve roots
  • vertebral arteries
  • spinal cord
21
Q

As we age what does sclerosis from the UVJ occlude?

A

the foramen, which can cause foraminal stenosis

22
Q

What nerves innervate the cervical IV discs?

A

cervical sinuvertebral nerves supply the disc at their level of entry and the disc above

23
Q

Why is fissuring of the upper cervical spine not as harmful as fissuring of the lower cervical spine?

A

Upper cervical spine has no disc, which contains irritant chemicals that can harm the spinal cord

24
Q

What is the one main factor related to progression of degeneration of the cervical spine?

A

Age

25
Q

What are 3 common structural damages related to cervical trauma such as whiplash?

A
  • annulus tears
  • end-plate injuries
  • annulus bruising
26
Q

What are the 3 main discogenic symptoms of the cervical spine?

A
  • cervical spine is relatively pain free (may be stiff or sore)
  • Deep burning toothache pain around the scauplar border, supraspinous fossa and scapula
  • referral to the shoulder
27
Q

If a patient is having referred pain to the area of the traps, what disc(s) could be injured?

What about referred pain to the medial scapular border?

Referred pain directly over the scapula?

A

C5 or C6

C7

C8

28
Q

What symptoms indicate an injury to the facet joint injury?

A
  • Sharp, localized
  • unilateral
  • spasms
  • referral into the UE (but neck pain is worse)
29
Q

What physical limitations are associated with facet joint injuries?

A
  • limited extension
  • limited rotation to the same side as injury
  • limited lateral flexion to the same side as injury

MSK 3 (19 decks)

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