Irat Week 2 Flashcards
All of the following may be damaged in extreme flexion, extension, or lateral flexion of the head EXCEPT
Inner ear (neural structures, soft tissue, cervical spine all can)
The lower cervical spine consists of
C2-7/T1
Like the other regions of the spine, the outer annulus fibrosis is innervated by the ___ nerves as are the vertebral bodies
Sinuvertebral nerves
The cervical discs have less weight to bear than the lumbar disc for which two reasons
- They only bear the head and plus gravity
2. The discs and two facet joints have nearly equal load distribution
The facets of the upper cervical spine are angled approximately ___ to the horizontal plane, whereas the cervical spine facets are orientated at approx ___ angle
35o
65o
The facet joints of the cervical spine are surrounded by a joint capsule that is generaly ___ than in the thoracic and lumbar spine allowing more range of motion
Looser
Facet joints are innervated by the
Medial branch of the posterior rami
Facet joint capsules contain all of the following EXCEPT
Silent nociceptors
Of the following structures below, which ones help to stabilize the dens of C2 to the anterior arch of C1
Denticulate ligament
Deterioration of the __ ligament will allow abnormal movement between C1 and C2
Transverse ligament
According to Souza, “___ muscles including the ___ are essential as antigravity/postural muscles….”
Suboccipital
Obliquus capitis inferior and obliquus capitis superior
Acocrding to Souza, “…contrary to accepted knowledge the ___ does not connect the posterior arch of atlas to the laminae of the axis
Ligamentum flavum
Cervical spine disc herniation’s are
Not common over the age of 50
If Bakody’s sign is present this indicates a radiculopathy because the motion of the test elevates the ____ nerve and relieves traction on the upper brachial plexus
Dorsal scapular
In the thoracic outlet which is NOT a potential site of entrapment or compression
Acromioclavicular articulation
The passive elements of the cervical spine motion include all of the following EXCEPT
Muscle
Flexion and extension occurs ____ in the cervical spine. Select all
Between C4-C6
The atlantooccipital joint
The C1-C2 level
Coupled motions in the cervical spine include all the following except
Below C4-5 extension accompanies rotation
Approximately ____ of axial rotation occurs between C1 and C2
50-60%
According to Souza in reference to hyperextension/hyperflexion injury, although global hyperextension does not always occur, intersegmental hyperextension does appear to occur and may be the most prominent injury mechanism
True
All of the following are common neck pain patient presentations EXCEPT
Acute dizziness
When arm complaints accompany neck pain it is essential to make a determination of whether the ___ or a ____ is the source
Nerve root irritation
Referral phenomenon
Patients with clinical, radiographic, or laboratory evidence of tumor, infection, fracture, or dislocation should be
Sent for medical evaluation
A stinger usually involves a traction injury of either the nerve root or plexus
True
According to souza, a patient presenting with a nontraumatic onset of neck pain without radiationinto the arm possibly accompanied by a ____ could be ____ requiring ____
Neck stiffness; meningitis; immediate MD referral
1 or 2 restricted ROM patterns; facet syndrome; manual therapy/cervica l adjustments
Congenital muscle spasm; torticollis; advanced imaging
According to Souza, recurrent bouts of neck and arm pain in nontraumatic patients should be
Evaluated using orthopedic and neurological exams
According to souza, a patient presenting with neck pain and a history of recent, significant trauma should
Have a cervical radiographic series taken
According to souza, a patient presenting with transient symptoms with other assocaited neurological signs and symptoms should be referred for evaluation for ALL of the following EXCEPT
Compression fracture
According to souza, a patient presenting with positionally related arm numbness/tingling with secondary neck pain complaint should be
Evaluated for TOS
According to souza, a patient experiencing chronic neck pain with restricted cervical ROM and positive cervical orthopedic examination results but no radiating pain should
Be adjusted immediately
According to souza, there is currently strong evidence to substantiate the use of traction for neck pain patients
False
According to Souza, a diagnosis of cervical sprain/strain should be reserved for acute traumatic sprain/strain with all of the following being TRUE except
Management includes mechanical traction
According to Souza, cervical neuritis or radiculitis due to disc usually consists of all of the follwoing except
Weakness in the lower limbs
Non-specific cervical pain is a diagnosis
All og the above (used for patients without cervical trauma, that may be used for unspecific neck pain, that does not require radiography)
Spastic torticollis (wryneck) may be ___ and is ___ or correctable
Congenital
Self-resolving
Which diagnosis can be treated using myofascial therapy and preventative exercises and stretches
Cervical sprain/strain
Non-specific cervical spine pain
Thoracic outlet syndrome
Acute onset pain with severe global restriction to neck movement can be included in nontraumatic neck pain category
True
Any patient with head trauma should be monitored for several
Weeks
According to souza, a chiropractic adjustive technique is the recommended treatment for
Segmental dysfunction of cervical spine joints
Radiographs positive for fracture or dislocation should receive an immediate orthopedic referral
True
According to souza, ___ of cervical radiculopathy patients fully recover or have only mild residual disfunction
90%
According to souza, cervical manipulation at sites other than herniation is used by many chiropractors to manage cervical radiculopathy adjustments. T/F
True
According to souza, MRI or electric diagnostic settings maybe needed after 1 month of care without resolution of cervical radiculopathy symptoms. T/F
True
According to souza, inspection, palpation and ROM testing are clinical approach taken when neck pain and stiffness are the primary complaint. T/F
True
When the complaint involves radiation into the back or extremities souza recommends
Specific orthopedic tests
Specific neurological tests
According to souza, what standard battery of what orthopedic tests includes various forms of the following tests designed to compress or stretch structures on your subject except
Spinal percussion
Burner or stinger are names given to injuries of the brachial plexus or nerve roots often caused by ___. They are very common in sports.
Lateral flexion injuries
According to souza, cervical radiculopathy due to disc herniation may occur in only 20-25% of the cases because of
The natural dehydration of the intravertebral discs in hte cervical spine.
According to souza, which test is specific or the most useful when confirming cervical radiculopathy
Spurling test
According to souza, the neurological examination attempts to rule in or rule out the following except
Non-recurrent pain
According to souza, patient presenting with positionally related arm numbness, tingling with secondary neck pain
Should be evaluated for TOS
Exhibit 2-4 in souza illustrates that the patient has a 45% probability of having a cervical radiculopathy if
3 or more tests are positive
According to souza, when ordering x-rays, ____ should be ordered in suspected cervical radiculopathy patients
Oblique view to determine to the degree of boney parameter encroachment
According to souza, weakness found during the physical exam is actually more than subjective weakness. T/F
True
When the complaint involves radiation into the back or extremities, souza recommends
Specific ortho and neuro test
According to souza, home traction for 30 minutes twice a day will benefit some cervical radiculoapthy patients. T/F
False
According to souza, patients with cervical radiculoaphty may report
All of the above - cervical compression reproduces the neck and arm pain; radiation into the medial scapular area; relief of arm pain by putting the hand behind the head
According to souza, the standard neurological exm attempts to differentiate the cause of the following except
Migraine
According to merck, C6 radiculopathies produce the ofllowing symptoms except
Pain in the rhomboids and latissimus dorsi
According to souza, larger, more diffuse patterns of sensory or motor loss require a search for brachial plexus and spinal cord involvement. T/F
True
According to souza, patients with cervical radiculopathy will have painful restriction in active and passive ROM
More on one side
According to merck, alternative medical treatments such as transdermal electrical nerve stimulation, spinal manipulation, acupuncture, medicinal herbs, may be tried on radiculopathy patients when
All other treatments are ineffective
Valsalva’s test may reproduce radicular symptoms in a patient with cervical radiculopathy due to possible
All of the above -
Inflammation of IVF structures
Cervical disc material in the IVF
Osteophytic growth in the cervical IVF
