Deck 4 Flashcards
On the way to injury prevention screen, a patient was involved in an MVA. Which of the following high risk factors would warrant a referral to the ED for radiograph?
A. Pt age 63
B. Cervical rotation 25˚ to R and 60˚ to L
C. Vehicle speed of 58 mph at time of collision
D. Paresthesias in L arm and into 4th/5th finger
D. Paresthesias in L arm and into 4th/5th finger
40F referred with radicular “pins and needles” radiating from R elbow to 4th and 5th fingers. Which of the following would not cause the pt’s symptoms?
A. Entrapment at the ligament of Struthers
B. Entrapment at the arcade of Struthers
C. Entrapment at the arcade of Frohse
D. Lower cervical radiculopathy
C. Entrapment at the arcade of Frohse
Entrapment at the arcade of Struthers and ligament of Struthers would cause paresthesias in what distribution?
ulnar nerve
60F with chronic neck pain and hand weakness. Cervical ROM limited. Normal reflexes/sensation B. Myotomal assessment unremarkable but pt unable to oppose thumb of R hand to tip of 2nd digit. Symptoms are suggestive of which of the following?
A. Spondylosis resulting in radiculopathy
B. Entrapment of anterior interosseous nerve
C. Entrapment of posterior interosseous nerve
D. Entrapment of radial nerve
B. Entrapment of anterior interosseous nerve
Pt presents on 5th visit of POC. You’ve been treating him for mechanical neck pain. Today he reports he is unable to close his mouth completely. What is the most likely cause?
A. Root canal at dentist that was performed the previous day
B. Trauma by tennis ball that hit him on the L aspect of the mandible
C. MVA with WAD
D. Combo of bruxism and increased stress
A. Root canal at dentist that was performed the previous day
It is common after what for pts to not be able to close their mouth all the way
dental procedures
Inability to close the mouth is common with this type of disc displacement
posterior
What is the best tx for a 4 mo old pt with congenital torticollis when the R orbit appears lower in position to the L?
A. DNF strengthening
B. Stretching L SCM
C. Stretching R SCM
D. Sitting on PB with gentle passive rocking by therapist side to side
C. Stretching R SCM
During your eval of a pt with hand weakness, you note a (+) Froment’s sign. What is true of Froment’s sign?
A. Reduction of pt’s symptoms with shoulder abduction
B. Weakness of adductor pollicis and FPB
C. Inability to adduct the 5th finger
D. Weakness of adductor pollicis, FPB, and 1st dorsal interossei
D. Weakness of adductor pollicis, FPB, and 1st dorsal interossei
Weakness of adductor pollicis, FPB, and 1st dorsal interossei is suggestive of what type of neuropathy or entrapment?
ulnar nerve
Alleviation of pain with shoulder abduction is known as
Bakody’s sign
37M presents with flu-like symptoms, malaise, dec AROM lumbar sidebending, and limited chest expansion. What is the most likely dx?
A. Klippel-Feil syndrome
B. Sheurmann’s disease
C. Ankylosing spondylitis
D. Rheumatoid arthritis
C. Ankylosing spondylitis
Klippel-Feil Syndrome involves what?
fusion of the bones in the cervical spine
All of the following are characteristics of Horner’s syndrome except which of the following?
A. Miosis
B. Ptosis
C. Anhidrosis
D. Exophthalmos
D. Exophthalmos
What is exophthalmos?
protrusion of the eye out of its socket
What disease is exophthalmos seen in?
Graves disease
What is enophthalmos?
posterior displacement of the eye within the socket
Horner’s syndrome: (exophthalmos/enophthalmos) is possibly seen, but not always
enophthalmos
Miosis =
constriction of the pupil
Ptosis =
drooping of the eyelid
Anhidrosis =
inability to sweat
All of the nerves in the cervical spine exit above the designated vertebral level except for which of the following?
A. C1
B. C2
C. C7
D. C8
D. C8
The cervical nerves all exit (above/below) their designated spinal level except C8, which exits between C7-T1
above
Which of the following does not have a spinous process?
A. C1
B. C2
C. C6
D. C7
A. C1
52F presents for preop consultation. Failed tx for cervical radiculopathy, no changes in paresthesias and mm weakness down L arm. If surgery is indicated, what is the most likely one to be performed?
A. Posterior microendoscopic fusion
B. ACDF
C. Artificial disc replacement
D. Laminectomy
B. ACDF
ACDF =
Anterior Cervical Discectomy & Fusion
Why is an ACDF advantageous to a posterior approach?
can remove compressive lesion without having to retract the spinal cord
From anterior to posterior, select the correct order of structures in the mid-lower cervical spine
A. ALL, IV disc, SC, PLL, ligamentum flavum
B. ALL, IV disc, ligamentum flavum, PLL, SC
C. ALL, IV disc, PLL, SC, ligamentum flavum
D. ALL, ligamentum flavum, IV disc, PLL, SC
C. ALL, IV disc, PLL, SC, ligamentum flavum
Pt presents with new onset HA localized to orbit after MVA 3 weeks ago. HA frequency 4x per week that progressively worsen through day. PROM LR increased intensity of HA. Inc’d suboccipital soreness with PROM cervical retraction. Pt with co-complaint of neck pain. Also reports increase in frequency and intensity of dizziness. What dx would best fit this pt?
A. BPPV
B. Tension HA
C. Migraine HA
D. Cervicogenic HA
D. Cervicogenic HA
What is the best test to confirm a cervicogenic HA?
A. Cervical flexion rotation test
B. Palpation of suboccipital region
C. Pt subjective hx
D. Inc in HA with sustained cervical protrusion
A. Cervical flexion rotation test