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MSK 3 > Medical Screening For Cervicothoracic (2) > Flashcards

Medical Screening For Cervicothoracic (2) Flashcards

1
Q

What are the risk factors that indicate imaging in a cervical fracture?

A

Age>65

Dangerous mechanism

Upper extremity paresthesia

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2
Q

What type of test are the high risk factors for cervical fracture?

A

High sensitivity (good at ruling out)

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3
Q

What are the mechanical causes of cervical myelopathy?

A

Trauma

Spinal cord compression

Degenerative changes

Bulging disc

RA

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4
Q

What are the 5 tests to see if cervical myelopathy is present?

A

Gait deviation

+Hoffmanns test

Inverter supinator sign

+ babinski test

Age >45

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5
Q

When can you rule in cervical myelopathy using the 5 tests?

A

If 3 out of 5 are positive you can rule in cervical myelopathy

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6
Q

What is upper cervical ligamentous laxity?

A

Problems with the transverse and alar ligaments

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7
Q

What are symptoms of upper cervical ligamentous laxity?

A

Occipital headaches and numbness

Severe limitation during neck AROM

Signs of cervical myelopathy

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8
Q

What are causes of upper cervical ligamentous laxity?

A

Trauma

RA/Down syndrome

Os odontoideum

Odontoid fracture

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9
Q

What are some key signs of spinal infection?

A

Pain worse at night and does not change with position

Fever, chills, fatigue

Redness, swelling, warmth

Local tenderness

Spinal percussion painful

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10
Q

What do you do if you suspect a spinal infection?

A

Refer for imaging

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11
Q

What is used to treat a spinal infection?

A

Antibiotic therapy or surgical decompression

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12
Q

What are the symptoms of a possible cardiovascular event?

A

Chest pain

Abdominal pain

Shortness of breath

Heart palpitations

Dizziness, nausea

Peripheral edema

Syncope

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13
Q

What are the musculoskeletal complaints associated with a cardiovascular event?

A

Jaw, neck, shoulder, arm, and back pain (poor exercise tolerance)

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14
Q

What are the symptoms of cervical arterial dysfunction?

A

(5 D’s and 3 N’s)
Dizziness

Drop attacks

Dysphagia

Dysarthria

Diplopia

Ataxia

Nausea

Numbness

Nystagmus

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15
Q

What are the pain descriptors of a pulmonary event?

A

Sharp and localized pain

Aggravated by breathing, coughing, sneezing, or laughing

Better in upright

Better with autosplinting

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16
Q

What is pneumothorax?

A

Collapsing of the lung

17
Q

What are symptoms of pneumothorax?

A

Shortness of breath

Sharp pain in chest

Ipsilateral shoulder/upper trap referred pain

Drop in BP

Better in sitting/worse in recumbent positions

18
Q

What is pulmonary embolism?

A

Blockage of a pulmonary artery

19
Q

How do you determine if pulmonary embolism is present?

A

Use predictor variables (wells)

20
Q

What are symptoms of stomach, duodenal, or pancreatic conditions?

A

Sudden weight loss, nausea, vomiting, or fever

Pain waves related to eating or drinking

Heartburn

21
Q

What are causes of stomach, duodenal, or pancreatic conditions?

A

Gastric, pyloric, or duodenal ulcers and stomach cancer

22
Q

What is the most common site for metastases?

A

Skeleton

23
Q

Where do metastases occur?

A

60% thoracic and 40% lumbosacral

24
Q

What are the main signs to look for in cancer?

A

Prior history of cancer

Age>50

Unexplained weight loss

Failure to improve after 1 month

25
Q

Where does the alar ligament attach to?

A

Dens to skull

26
Q

Where does the transverse ligament attach to?

A

Around the dens

27
Q

How does neck being brought to end range (trauma) cause a stroke?

A

Causes artery to tear on inside and when healing process occurs inflammation can block artery leading to stroke

28
Q

What are some signs to rule out cervical arterial dysfunction?

A

Ipsilateral neck pain and headache

Horners syndrome

Pulsatile tinnitus

CN palsies (CN 9-12)

Trauma in past 72 hours

Headache of new feeling

29
Q

What is Horner’s syndrome?

A

Ptosis (drooping of eyelids)

Anhidrosis (lack of sweat on one side of face)

Miosis (shrinking of pupil)

30
Q

What are the signs that someone has a cervical fracture?

A

Age>65

Dangerous mechanism

Parasthesisias in extremities any time since trauma

Acute cervical trauma

Patient unable to rotate neck 45° both ways

31
Q

What are considered dangerous mechanisms?

A

Fall from > 1 m or 5 stairs

Axial load to head (diving)

High speed MVA

Bicycle collision

32
Q

What are the buckets for cervical injury?

A

Neck pain with mobility deficits

Neck pain with radiating pain (radicular)

Neck pain with headache (cervicogenic)

Neck pain with movement coordination impairments

33
Q

What are treatments for neck pain with mobility deficits?

A

Thoracic manipulation

Cervical mob/manipulation

ROM/stretching/strengthening

34
Q

What are treatments for neck pain with radiating pain?

A

Traction

Centralizing exercises

Strength exercises

CT mob/manipulation

35
Q

What are interventions for neck pain with headache?

A

C1-2 self-SNAG

CT mob/manipulation

ROM/stretching/strengthening

36
Q

What are interventions for neck pain with movement coordination impairments?

A

Education

Minimize collar use

AROM/strength exercises

Proprioceptive exercises

Cervical mobs

Ice/heat/TENS

MSK 3 (15 decks)

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