Mod 3: Cervical & Thoracic Flashcards by Alyssa Donley

non-synovial clefts between uncinate processes of adjacent vertebral bodies
-joints at sides of cervical vertebral bodies
-guide flex/ext

uncovertebral joints

How well did you know this?

Not at all

Perfectly

cervical flexor antagonist mms

SCM (anterior)
scalenes
(accessory mm)

How well did you know this?

Not at all

Perfectly

cervical extensors agonist mms

upper trapezius
SCM (posterior)
levator scapula
suboccipitals
cervicis capitis & splenius

How well did you know this?

Not at all

Perfectly

cervical mm for ipsilateral side bending & contralateral rotation

SCM
scalenes anterior
multifidus

How well did you know this?

Not at all

Perfectly

atlantooccipital joint motion
with accessory motions (2)
atlantoaxial joint motion

flex/ext
rotation & sidebending
AA: axial rotation

How well did you know this?

Not at all

Perfectly

lower cervical spine motion
C5/6:
C6/7:

significant flexion
significant extension

How well did you know this?

Not at all

Perfectly

cervical ligament that must be screened for damage (life threatening)
location:

transverse ligament
across ring of the atlas & around odontoid process

How well did you know this?

Not at all

Perfectly

Cervical Red Flags
5Ds
2Ts
1N

dizziness, diplopia, dysarthria, dysphagia, drop attacks
tingling, tinnitus
nystagmus

How well did you know this?

Not at all

Perfectly

forward head posture does what to upper & lower cervical spine?

upper: extension
lower: flexion

How well did you know this?

Not at all

Perfectly

upper crossed syndrome
tight mm?
weak mm?

tight pecs, lats, serratus, levator, upper trap, suboccipitals
weak erector spinae, scap retractors, capital flexors

How well did you know this?

Not at all

Perfectly

cervical special test in supine: cradle occiput & C1, push down on C2 arches while lifting C1
-for instability & red flags

Transverse Ligament Test

How well did you know this?

Not at all

Perfectly

cervical test for sagittal stability of the AA segment
-sit w/ short neck flexion, stabilize C2 & force through forehead
+: inc. movement, clicking, dec s/s

Sharp-Purser Test

How well did you know this?

Not at all

Perfectly

cervical test in supine/sitting
-palpate C2 SP, sidebend head to feel SP move opposite direction
+: delay/no movement

Alar Ligament Test

How well did you know this?

Not at all

Perfectly

cervical test in sitting
neck side bent/extended & add compression
+: produce pain/tingling in UE or locally in neck

Spurling Test

How well did you know this?

Not at all

Perfectly

cervical test where clinician provides traction force
+: s/s decrease or disappear

Axial Manual Traction Test

How well did you know this?

Not at all

Perfectly

acute phase of cervical spine rehab goals

control pain, inflamm, spasm
promote healing
inc/maintain ROM
normalize joint mechanics

How well did you know this?

Not at all

Perfectly

subacute to chronic phase of cervical spine rehab goals

stabilization
UE AROM
postural strength
functional retraining

How well did you know this?

Not at all

Perfectly

General Cervical Rehab
Stretch mm?
Strengthen mm?

levator, traps, scalenes, pecs
strengthen deep neck flexors & scapulothoracic mm

How well did you know this?

Not at all

Perfectly

Types of ST injury to cervical spine

strain/sprain
whiplash: strain-counterstrain, acceleration-deceleration injury (MVA)

chronic degenerative condition in cervical spine w/ dec. IVD height & osteophytes
-can compress nerves
-most common in which vertebrae?

Cervical Spondylosis
C5-C6, C6-C7

acute cervical joint lock or facet impingement
difficult to rotate/side bend w/ kink
-joint hypomobility

(Cervical) Facet Dysfunction

compression of neural & vascular structures by cervical rib, scalenes, clavicle, pec minor or subluxed 1st thoracic rib
s/s: arm/shoulder pain above 90*, N/T, weak, skin & temp changes

Thoracic Outlet Syndrome

PT Tx for thoracic outlet syndrom

STM
all UE nerve mob techniques
postural education
stretch scalenes & pec minor

TOS vs. nerve root impingement

TOS: neural & vascular signs (temp & skin changes
NRI: neural only- N/T, motor & reflex changes

narrowed spinal canal d/t disc height or osteophytes -irreversible

cervical spinal stenosis

Cervical disc injury most common where?

C6 & C7

Cervical Disc Injury PT Tx

normalize mechanics & ROM* nerve glides traction cervical stabilization monitor for inc neural involvement

Indications for Cervical Traction

peripheralization w/ lower cervical spine pos. shoulder abduction test positive upper limb tension test positiv neck distraction/traction test >age 55

cervical neurosurgery protocols

weight lifting < 10 lbs wear neck brace scar mobility general rehab

mechanical dysfunction w/ click/pop, locking and pain at temporal fossa & mandibular condyle

TMJ

rib to vertebrae joint rib to transverse process joint

costovertebral jt costotransverse jt

bucket handle motion for ribs pump handle motion

inc. med/lat size of ribcage inc. ant/post size of ribcage for respiration

Variables for thoracic dysfunction? what changes symptoms?

headaches, bowel/bladder, balance/gait/falls cough, sneeze, eating or increased activity change symptoms?

Thoracic tx for: mobility: increasing extension (stretch vs. strengthen)

facet & rib mobility stretch anterior chest (pecs) strengthen scap retractors

Thoracic Neuro Tests: dermatomes T8 for what? t10? T12?

T8- xiphoid T10: umbilicus T12: lower abdominals

Strength test: divide abdomen in quadrants & perform crunch to monitor umbilicus movement -move up/right = ? -move down/right = ? (opposite patterns moving up/down & left)

Beevor's Test/sign for segmental weakness of spine weak lower left abs (T10-12) weak upper left abs (T7-9)

T6-T11 reflex test in supine position -stroke ab skin which should cause mm contraction of umbilicus to stimuli -perform diagonal direction toward quadrants

Superficial Abdominal Reflex

increase in thoracic posterior convexity d/t anatomy or posture or osteoporosis - avoid which activities?

kyphosis avoid flexion

Dowager's Hump vs. Hump Back vs. Round back

DH: kyphotic upper dorsal region w/ multiple anterior wedge compression fractures HB: local posterior angulation (Gibbus deformity) & anterior wedge of 1-2 vertebrae RB: dec. pelvic inclination & excess kyphosis

lateral curvature of spine -w/ rib hump that's more posterior on ___ side of the hump true/structural vs. functional presentation

scoliosis/rotoscoliosis convex

convex side of scoliotic curvature: mm are too ___ concave side " mm too ___

lengthened/weak shortened/tight

thoracic/lumbar flexion w/ forward head -stress on post. longitudinal ligament = _____ pelvic tilt

posterior pelvic tilt

shortened rectus fem, iliopsoas, & weak abs -backward trunk lean, shortened posterior neck muscles, inc. extension of A/O jt = ___pelvic tilt

anterior pelvic tilt

Sternal Deformity: how does barrel chest affect sternum, breathing & scapula?

forward/upward sternum respiratory difficulty shortened scap adductors

Sternal Deformity: how does pigeon chest affect sternum, & trunk musculature?

forward/downward sternum lengthened upper abs & shortened intercostals

Sternal Deformity: how does funnel chest affect sternum, cardiopulm & musculature?

posterior projected sternum resp/cardio abnormalities shortened upper abs, shoulder adductors, pec minor lengthened thoracic extensors & mid/low trap

Thoracic Pathologies

rare disc herniations mechanical/jt dysfunction rib dysfunction costal cartilage injury/inflamm fx spondy stenosis