Final

Question 1

What is the most common form of scoliosis?

Answer 1

Adolescent idiopathic

Question 2

What degree of curvature defines scoliosis?

Answer 2

> 10 degrees (Cobb angle)

Question 3

The risk of scoliosis curve progression is __ times higher in ___

Answer 3

10x higher in females

Question 4

What is adult spinal deformity?

Answer 4

Encompasses scoliosis, kyphosis, lordosis, spondylosis and can lead to imbalance of structural support of spinal column

Question 5

What device is used to assess the spine for imbalances?

Answer 5

Scoliometer

Question 6

Spondylolysis vs spondylolisthesis vs spondylitis vs spondylosis

Answer 6

Spondylolysis- fracture of pars interarticularis of vertebral arch
Spondylolisthesis- fracture of vertebral body that slips forward over another
Spondylitis- inflammation of spinal joints
Spondylosis- degeneration of IV discs

Question 7

What is a Boston brace?

Answer 7

TLSO brace (underarm)

Question 8

What is a Milwaukee brace?

Answer 8

CTLSO brace (under-chin extension)

Question 9

When is surgery for scoliosis indicated? (degree)

Answer 9

> 39-50 degrees

Question 10

What makes the SLR test positive?

Answer 10

Pain in leg, especially between 30-60 degrees

Question 11

What does SLR indicate?

Answer 11

Lumbosacral radiculopathy (usually herniated disc) and/or sciatic neuropathy

Question 12

What is contralateral (crossed) SLR for?

Answer 12

Can increase specificity for radiculopathy due to disc herniation (ipsilateral SLR high sensitivity but low specificity)

Question 13

What is cauda equina syndrome?

Answer 13

Compression of spinal nerve root, usually by disc protrusion, fracture/trauma, or tumor. Usually have LBP, bowel/bladder dysfunction, saddle anesthesia

Question 14

What are sx of myofascial neck pain?

Answer 14

Pain, spasms, decreased ROM, occipital HA

Question 15

Who is SCIWORA more common in?

Answer 15

Kids and elderly

Question 16

What are the Nexus criteria?

Answer 16

Absence of posterior midline cervical ttp
Normal LOC
No evidence of intoxication
No abnormal neuro findings
No painful distracting injuries
–All criteria met = no imaging needed, otherwise apply c-collar and image

Question 17

What are some nonspinal causes of neck pain?

Answer 17

CAD, malignancy, referred shoulder pain, thoracic outlet syndrome, infection, etc

Question 18

What is the most common cause of acute and chronic neck pain in adults?

Answer 18

Cervical spondylosis (degenerative changes)

Question 19

What is myelopathy vs radiculopathy?

Answer 19

Myelopathy - deficit related to SC (emergent MRI)

Radiculopathy - deficit occurring at or near nerve root

Question 20

What are signs of meningeal inflammation?

Answer 20

Nuchal rigidity, Kernig’s and Brudzinski’s signs

Question 21

What structures are involved in thoracic outlet syndrome?

Answer 21

Clavicle and 1st rib

Brachial plexus, subclavian a, subclavian v

Question 22

What are sx of thoracic outlet syndrome?

Answer 22

Arm pain, numbness, weakness. Usually nerves impacted more than vasculature

Question 23

What special tests are done for cervical radiculopathy?

Answer 23

Spurling’s test, manual distraction test

Question 24

What special tests are done for meningeal irritation?

Answer 24

Kernig’s sign and Brudzinski’s sign

Question 25

What special tests are done for thoracic outlet syndrome?

Answer 25

Roo’s or East test

Question 26

What are some causes of neck splinting/stiffness?

Answer 26

Fx, SC injury, ligamentous injury, muscle strain, muscle spasm, meningitis

Question 27

What are HVLA contraindications for the C-spine?

Answer 27

RA or Down syndrome - weak odontoid ligament susceptible to rupture
Also PVD, local metastases, anticoagulated, etc