Cx spine

Question 1

T/F

In cx spine SPs are not at the level of the facet joints of the same vertebra. Where are they?

Answer 1

F.

SPs are at the level of the facet joints of the same vertebra

Question 2

Which vertebras don’t have a disc?

Answer 2

occip-C1

C1-C2

Question 3

Which structure is larger in Cx vs Lx

• nucleus
• annulus
• Vert foramen

Answer 3

• nucleus (Lx)
• annulus (Cx: more fibers)
• Vert foramen (Cx)

Question 4

Describe the stages of the cx nucleus. What does it imply

Answer 4

Birth: gelatinous nucleus
Midteens: fibrocartilage
30 y.o.: fibrocartilaginous cushion

Disc herniation doesn’t happen after middle age

Question 5

What other structure is developping in youth (cx spine)?

Answer 5

U joint (9-14y.o.)

Question 6

T/F the uncovertebral clefts are found in the medial and transverse aspect at first.

Answer 6

F
First: postero-lateral
With age: penetrate more medially, then break through transversally

Question 7

T/F

IVD are similar in terms of morphology in cx and lx spine

Answer 7

F
Cx IVD should not be thought of as similar to a Lx IVD
It has a distinct morphology which reflects the biomechanics of this region (more rotation/shearing vs compression in Lx spine)

Question 8

Uncovertebral joints
1- Are they synovial joint?
2- Which cx vertebrae have one?
3- What are the 2 functions?

Answer 8

1- Are they synovial joint? Some consider them as synovial jts others as degenerative clefts in the disc
2- Which cx vertebrae have one? C3-C7
3- What are the 2 functions?
They reinforce the anterolateral aspect of the disc.
They allow for flex & ext & limit SF.

Question 9

Name ALL tx for hypo cx spine (5)

Answer 9

HEP in the limited movts 
Passive accessory glides ant to post
PPIVM
Postural correction
Education

Question 10

The neural control subsystem has what 3 responsibilities

Answer 10

Timing of contraction
Recruitment pattern
Strength of contraction

Question 11

What are the 7 symptoms and 4 signs of clinical Cx spine instability?

Answer 11

Symptoms

1. Intol to prolonged static posture
2. Fatigue & inability to hold head up
3. Better with ext support (collar, hands)
4. Freq need of self-manip (twsting their head)
5. Feeling of instability, shaking or lack of control
6. Frequent episodes of acute attacks
7. Sharp pain with sudden mvt

Signs

1. Poor coordination/neuromusc control (poor recruitment and association of cervical segments with mvt)
2. Abnormal joint play = increase joint play
3. Motion not smooth, throughout range, including segmental hinging (all flexion mvt occurring at one moment), pivoting or fulcruming
4. Abberant movement (shaking during mvt)

Question 12

What are the tx for hypermobility/instability

Answer 12

Training of the subsystems, neuromuscular control of the deep neck flexors
Education on proper posture
Cx spine mobilisation

Question 13

Pain in the arm with neck extension and ipsi side flexion. What does that suggest?

Answer 13

Lateral stenosis

Question 14

What are the 3 tx with lat stenosis

Answer 14

Education (avoid ext SF, HEP in flex/contralat SF)
Traction
PPVIM
HEP unilat flexion

Question 15

What are the tx for radiculopathy (5)

Answer 15

Cx manual traction (5 prediction rules)
Deep neck flexors ms
Postural ms retraining
Manual therapy
ULNT