LG4.13 Clinical Considerations of the Cervical/Thoracic Spine – Dr. Steffans Flashcards
Deep Neck Infection Red Flags
-Pain out of proportion to physical findings may suggest the presence of a deep neck infection.
Observe “advanced airway signs” such as:
-Voice changes
-stridor, dyspnea, shortness of breath
-use of accessory muscles signify impending airway obstruction or respiratory arrest.
Meningitis red flags
Inflammation of the meninges
Cause can be viral, bacterial, fungal
Physical Exam:
Fever> 38°C (100.4°F)
Altered mental status exam
Nuchal rigidity by tests
Occipito-Atlantal Dislocation (OAD) Cranio-cervical Ligaments red flags
Ligamentous instability
What imaging study should be done on chronic neck pain?
A five-view radiographic examination should initially be performed in patients of any age with chronic neck pain
(i.e., anteroposterior, lateral, open-mouth, & both oblique views)
(w/ or w/o history of remote trauma, w/ history of malignancy, or w/ history of neck surgery in the remote past.)
Patients with normal radiographic findings & no neurologic signs or symptoms need no further imaging
What is the most common for of spinal cord disorder from spondylosis?
Cervical spondylotic
Cervical Spondylosis with Myelopathy characteristics
The hallmark symptom of CSM is weakness or stiffness in the legs.
Patients with CSM may also present with unsteadiness of gait.
Weakness or clumsiness of the hands in conjunction with the legs is also characteristic of CSM.
Symptoms may be asymmetric, particularly in the legs.
Characteristics of functional thoracic kyphosis?
-Pectoralis, latissimus dorsi, levator scapula muscle hypertonicity
-Rhomboid, serratus anterior & lower trapezius inhibition &/or weakness
-Result … internally rotated, flexed & adducted position
“Stress Posture”
A 24-year-old female medical student presents with thoracic back pain. On exam, her pectoralis muscles are ______ and her rhomboid muscles are ________.
hypertonic, weak
