Ch. 37 Neck Problems

Question 1

The antlantoocipital (C0-1) articulation permits ___

Answer 1

10 degrees flexion and 25 degrees extension

Question 2

The C1-2 antlantoaxial joint is responsible for

Answer 2

40-50% cervical axial rotation

Question 3

Below C2-3 level, ____ is coulpled with ____

Answer 3

lateral flexion coupled with rotation in same direction

Question 4

Greatest amount of cervical flexion occurs at

Answer 4

C4-5 and C5-6

Question 5

Lateral bending occurs primarly at

Answer 5

C3-4 and C4-5

Question 6

Cervical joints most commonly to develop OA

Answer 6

Uncoverebral joints or joints of Luschka

Question 7

Joints of Luschka are located ___

Answer 7

Between the uncinate processes of C3-7

Question 8

OA of joints of Luschka narrow ___

Answer 8

intervertebral foramina

Question 9

Intervertebral formina are widest at ___ and narrow to level __

Answer 9

C2-3 narrow to C6-7

Question 10

Annulus fibrosis is innervated posterolaterally but the ___ and anteriorly by the ___

Answer 10

Posteriorlateral: sinuvertebral nerve
Anterior: vertebral nerve

Question 11

Referred pain pattern of C1-2 and C2-3 zygapophyseal joints

Answer 11

Refer rostrally to the occiput

Question 12

Referred pain pattern of C3-4 and C4-5 zygapophyseal joints

Answer 12

Symptoms over posterior neck

Question 13

Referred pain pattern of C5-6 zygapophyseal joint

Answer 13

Supraspinatus fossa of the scapula

Question 14

Referred pain pattern of C6-7 zygapophyseal joint

Answer 14

Spreads caudally over the scapula

Question 15

Bilateral paramidline upper neck pain without associated headaches is secodnary to ___

Answer 15

Cervical intervertebral disc disruption (CIDD)

Question 16

Cervical radicular pain presents as ___ pain >___ pain

Answer 16

upper limb pain > axial pain

Question 17

MCC of cervical radiculopathy

Answer 17

herniated cervical intervertebral disc

Question 18

Cervical strain

Answer 18

Musculotendinous injury from overload injury to spine

Question 19

Cervical Sprain

Answer 19

Overstretching or tearin injuries of spinal ligaments

Question 20

Whiplash treatment

Answer 20

NSAIDs, TENS, soft collar during sleep for 72 hours after injury, gradual return to activities in 2-4 weeks

Question 21

Cervical Radiculopathy

Answer 21

Neurodysfunction of the nerve root

Question 22

Cervical Radiculopathy Sx

Answer 22

Reflex and strength deficits

Question 23

Exacerbating factors for radiculopathy

Answer 23

Inc subarchnoid pressure: coughing, sneezing, valsalva; Cervical Extension

Question 24

Bakody’s Sign

Answer 24

Shoulder abduction relief sign: alleviates radicular pain by ispislateral elevation of the humerus

Question 25

C5-6 involvement produces muscle wasting in __

Answer 25

Suprascapular or infrascapular fossa or deltoid

Question 26

C7 injury produces muscle wasting in ___

Answer 26

Triceps

Question 27

C8 injury produces muscle wasting in___

Answer 27

thenar eminence

Question 28

T1 injury produces muscle wasting in ___

Answer 28

first dorsal interossei

Question 29

L'hermitte's sign

Answer 29

Rapid passive cervical flexion while patient is seated can produce an electric shock sensation down the spine

Question 30

What can L'hermitte's sign indicate?

Answer 30

Cervical cord involvement as a result of tumor, spondylosis, or MS

Question 31

Guidelines for diagnosing radiculopathy on EMG

Answer 31

ABN in 2 or more muscles innervated by the same root but different peripheral nerves with normal findings in muscles of adjacent nerve roots

Question 32

What can US treatment do to cervical radiculopathy?

Answer 32

Inc metabolic response and inflammation further aggravating nerve root injury

Question 33

How is TENS beleived to act?

Answer 33

Gate theory

Question 34

What is the Gate theory?

Answer 34

pain modulation by stimulating large myelinated fibers blocking nocicpetive transmission in smaller fibers at level of spinothalamic neurons

Question 35

What is the functional restoration of spinal biomechanics?

Answer 35

Cervicothoracic stabilization

Question 36

Cervicothoracic stabilization includes

Answer 36

spinal flexibility, postural reeducation and conditioning

Question 37

What is Nucleoplasty?

Answer 37

Coblation energy to vaporize nuclear tissue into gaseous elementary elements

Question 38

What are indications for surgical treatment of CIDH?

Answer 38

Intractable pain, severe myotomal deficit or progression to myelopathy

Question 39

What is provocation discography?

Answer 39

positive test corrobrates production of patient pain pattern with structurally derranged disc