Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MSK > Cervicothoracic spine 2 > Flashcards

Cervicothoracic spine 2 Flashcards

1
Q

what is the etiology of TOS

A

forward head posture creates upper thoracic joint hypomobility into extension

scalenes compress

trauma (WAD)

differential diagnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

how does FHP influence TOS

A

increased tension of subclavian fascia on axillary artery which doesn’t allow clavicle to roll anteriorly

issues specifically with overhead activities bc of the need for the clavicle to roll

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

how does chest breathing influence TOS

A

excessive use of accessory respiratory muscle

scalenes guard and press downward on inferior structures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are spinal nerve symptoms

A

segmental, related to the segment that the nerve exits
slower onset of numbness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are peripheral nerve symptoms

A

nonsegmental, several segments contribute
quicker onset of numbness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what are thoracic outlet syndrome symptoms

A

UE glove/sleeve-like paresthesia’s
coldness and swelling with vascular compromise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what activities increase TOS symptoms

A

raising arms for prolonged perior
sleeping
poor sitting posture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what would you expect to observe during the scan for TOS

A

FHP
possible UW discoloration d/t degree of artery involvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what muscle groups are expected to be weak with TOS

A

posterior shoulder nad posterior throacic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is expected during the scan for TOS

A

ROM: indications of upper thoracic restriction
RST: decreased strength/endurance in post. shoulder/scap
Neuro: non-segmental hypoactivity, ULTT +

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is the cause of dural tension restriction

A

decreased elasticity or inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the PT rx with acute dural tension restriction

A

paresthesia’s at rest

POLICED - NO C
motion w/o resistance/symptoms
STM over segmental level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is the PT rx with persistent dural tension restriction

A

paresthesia’s at resistance

motion with resistance
neural mobilization with resistance at end range once acuity settle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are the S&S of dural tension restriction

A

paresthesia’s increased from both ends

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are the S&S of dural gliding restriction

A

paresthesia’s increased from one end but relieved from the other

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is the cause of dural gliding restriction

A

adhesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is the PT rx for acute dural gliding restriction

A

POLICED - no C
motion w/o resistance/symptoms
STM over segmental level

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is the PT rx for persistent dural gliding restriction

A

motion with resistance
neural mobilizations at mid range

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what factors about the pt determine if the neural mobilizations will be successful

A

absence of neuropathy
older age
small ROM deficits with median nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is expected in accessory motion tests with TOS

A

more often a unilateral upper thoracic hypomobility

less often limited 1st rib inferior glide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is included with PT rx of TOS

A

postural/ergonomic changes

diaphragmatic breathing

MT/MET in cervicothoracic region to improve mobility

MET to increase strength/endurance in post shld/scp muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is dowager’s hump

why does it develop

A

fat pad over upper C/t junction that develops with atrophy and shearing

wedging of vertebra d/t osteoporosis with persistent FHP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what are common thoracic restrictions

A

bilateral loss of thoracic extension that causes lower cervical instability

unilateral loss of upper thoracic extension contributes to unilateral TOS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is the general rx for sitting FHP

A

MT/MET with local muscle focus to improve posture

posture education

ergonomic improvements

breathing training

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what is the cause of an acute internal disc derangement

A

trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

what is the most prevalent IDD

A

chronic or persistent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what sections of the annulus are hyper-/hyponeural

what type of cartilage is each section made of

A

hyperneural: outer portions, type 1 collagen

hyponeural: inner portion, type 2 collagen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

t/f
the inner annulus is vascular

A

false
Th outer portion of the annulus is vascular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what is the function of the nucleus

A

resists compression
dense connective tissue
avascular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

t/f
the annulus and nucleus move independently of each other

A

false
the annulus and nucleus move as a unit

deformation but not migration of the nucleus with motion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

describe the vertebral end plate

A

highly innervated and vascularized
assists with nutrient diffusion for disc
covers nucleus and most of annulus with connective tissue
weak link of intervertebral joint
may calcify which limits diffusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

where is IDD rare in the spine

A

throacic - narrowest canal
C2-6 - additional stability from UV joints

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what area of the disc is IDD most prevalent

A

posterolateral portion of disc

(transition of annulus in to endplate is weak spot)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

what structures are involved with acute IDD

A

most common - annular tear and end plate avulsion

least common - NP herniation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what happens once disc structures are damaged

A

large autoimmune inflammatory response
-increase in water to the area = increases osmotic pressure
-spinal nerve sensitized = paresthesias
extended inflammatory phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

what are typical postlateral IDD symptoms

A

dull/achey spinal pain
radiculopathy
referred pain to respective areas
decreased pain when unloaded
increased neck pain and paresthesia’s looking down
increased pain in morning

37
Q

what radiculopathy symptoms are common with postlateral IDD

A

possible segmental paresthesia

38
Q

what ROM is expected with IDD postlateral IDD

A

all motions can increase pain
FLX and possible contralateral SB and RT from injured area
EXT and possibly SB and RT toward pain less limited

39
Q

why is FLX and contralateral SB/RT away from injured area in IDD less painful

A

pressure from pushing swelling toward spinal nerve
tension on annulus and endplate tear dura

40
Q

what is centralization of symptoms

A

abolition of distal/spinal pain in distal to proximal direction in response to repetitive motions or sustained positions

41
Q

what are typical postlateral IDD signs

A

MMT and RST: vairable
ST: possible + with compression/distraction/PA pressures
Neuro: +

42
Q

what is the PT rx for acute IDD

A

aggressive nonsurgical treatment is successful
POLICED
intermittnet traction
neural mobilizations
MET

43
Q

what is the focus of MET with acute IDD

A

tissue proliferation and stabilization of local muscles

44
Q

what section of the spine most commonly has persistent IDD

A

lumbar

45
Q

what part of the cervical spine is most involved with persistent IDD

A

C5,6
C6 spinal nerve

46
Q

what is the etiology fo persistent IDD

A

acute IDD
sedentary lifestyle
genetics

47
Q

what is the pathogenesis of persistent IDD

A

in-growth of nocicpetive fibers from acute IDD healing can lead to persistent inflammation and nociplastic pain

persistent inflammation brings excessive and destructive proteins and low grade inflammation enters disc

48
Q

what is the process of gradual onset of persistent IDD

A

less GAGs - more fibrotic an dehydrated nucleus
more acidic disc which limited proliferation
annular disorganization
thinning/loss of cartilage at end plates
increased inflammation of fatty deposits in vertebra

49
Q

what are the categories of herniation per Miller

A

protrusion: nucleus migrates but remains contained in annulus
extrusion: nucleus migrates thru outer annulus
free sequestration: nucleus breaks away from annulus

50
Q

what are changes that are likely to happen with disc, facets, and/or foramen with persistent IDD

A

disc: instability can develop
facets: increased load bearing
foramen: stenosis can develop

all narrow, cards in deck with rubberband example

51
Q

is it common for pt to not have symptoms with persistent IDD

if not, why

A

no since the tissues have time to adapt/compensate for the structure changes

52
Q

what is the PT rx for persistent IDD

A

possibly like acute IDD

consider primary driver of symptoms

53
Q

what is the negative outcome predictor for persistent IDD

A

peripheralization

54
Q

what is the MD rx for acute and persistent IDD

A

antibiotic treatment
laminectomy
partial discectomy
cervical fusion
total disc replacement

55
Q

what is functional instability

A

instability that can be stabilized with muscle activity or positioning

56
Q

what is mechanical instability

A

instability that cannot be completely stabilized with muscle activity or positioning

57
Q

what portion of the cervical spine has the highest prevalence of functional/mechanical instability

A

C5-C7

58
Q

what is the etiology of functional/mechanical instability

A

traumatic or recurrent sprains
age related disc changes
repetitive extension activities
creep d/t poor posture
adjacent joint hypomobility
connective tissue disorder

59
Q

what structures are involved with mechanical/functional instability

A

passive restraints
active stabilizers or local muscles inhibited
neurological function

60
Q

what are the symptoms of functional instability

A

predictable pain
recurrent spine and referred pain
decreased pain with position changes
increased pain with prolonged positions, looking up, sudden, and strenuous ADLs
catching
easy self manipulation

61
Q

what ROM is expective with functional instability

A

acute - aberrant motion
limited and painful with ext
better flexion

62
Q

what scan findings are expected with scan for functional instability (CM, RST, neuro)

A

CM: inconsistent block
RST: painful if acute
neuro: _-

63
Q

what is expected with accessory motion with functional instability

A

hypermobile accessory motion with possible adjacent ypomobility

64
Q

what muscles are inhibited with functional instability

A

local muscles

65
Q

what are the symptoms of mechanical instability

A

same as functional instability but worse with:
-unpredictable pattern
-worsening symptoms with more frequent episodes
- increased pain with trivial and lesser ADLs

66
Q

what is the PT rx with functional/mechanical instability

A

like ligamentous sprain
POLICED
postural education of sitting tall
bracing/taping PRN

67
Q

what is the focus of MET for functional/mechanical instability

A

stabilization of local muscles
hyperextension of contraindicated

68
Q

what cartilage is commonly affected with age related joint conditions

A

articular cartilage

69
Q

what are the most common sections affected by age related joint changes

A

C5-7
L4-S1

70
Q

what joints are most commonly affected by age related joint conditions

A

hip and knee

71
Q

what is the general funciton of type 2 collagen

A

resists compression

72
Q

what is the etiology of age related joint changes

A

prior trauma
sedentary lifestyle with underloading
genetics
other disease

73
Q

what happens with age related joint changes

A

articular cartilage thins and joint space narrows

fibrous capsule slackens and becomes more fibrotic and with persistent inflammation and then stiffens

synovial membrane produces less synovial fluid = increase friction

74
Q

what is pain attributed with age related joint changes

A

subchondral bone and injury to marrow
increased interosseous tissue
synovial membrane inflammation
periarticular tissue inflammation
persistent inflammatory response
foraminal narrowing on the spinal nerve

75
Q

what are the cervical symptoms with age related joint conditions

A

gradual onset of neck pain
pain with prolonged position (<30 mins)
morning stiffness
pain and limitation when looking in blind spot
possible paresthesia’s
some movements help and others increase pain

76
Q

what are the cervical scan components of age related joint conditions

A

ROM: P!/limitation with ext, ipsilateral SB/RT
CM: consistent bock in ext quadrant or opposing quadrant
RST: depends on acuity
ST: P! compression, PA (+)
Neuro: (-), could be (+) with radiculopathy

77
Q

what special test can be used for age related joint conditions in cervical region

A

spurlings to test for radiculopathy

78
Q

what is the PT for articular cartilage degeneration

A

improve integrity of cartilage and mobility
POLICED
JM for pain, tissue integrity, mobility

79
Q

what is the focus of MET for articular cartilage degeneration

A

improve motion
cartilage integrity
neuromusclular benefits

80
Q

where is RA most likely in the spine

A

c-spine

81
Q

what is the pathogensis of stenosis

A

narrowing of spinal canal d/t IDD, DJD or age related disc changes

fibrotic spinal nerve d/t persistent inflammation

narrowing form the outside in

82
Q

what population is most affected by stenosis

A

> 65 years

83
Q

does the CNS and PNS have lymphatic vv?

What is the significance?

A

no, longer inflammatory phase when nerve tissue is involved

slows healing process

84
Q

what are lateral stenosis symptoms

A

unilateral UE
spinal pain with segmental paresthesia’s

decreased pain when looking down, standing/walking

increased pain when sitting, looking up, turning to 1 side

85
Q

what would you expect to find in the scan for lateral stenosis

A

increased lordosis
ROM: flx/contralaterl SB/RT lower spinal UE pain
ext/ipsialteral SB/RT increase spinal/UE pain
ST: + compression, spurlings, PA level
neuro: possibly +

86
Q

what special tests are used to confirm lateral stenosis

A

spurlings
wainner’s CPR
stability test - excessive shearing

87
Q

what is the PT rx for stenosis

A

pt education
activity modification
MT - improve thoracic ext and neural mobilizations, mechanical traction

88
Q

what is the MET for stenosis

A

aerobic - improves circulation
local muscle stabilization

MSK (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions