Neck and Arm pain

Question 1

What percent of people who develop neck pain will have it chronically?

Answer 1

10%

Question 2

Over what age is a red flag for neck pain?

Answer 2

Over 50

Question 3

Pain lasting greater than how long is a red flag?

Answer 3

one month

Question 4

Neck pain with associated HA, shoulder or hip girdle pain in an older person = ?

Answer 4

Rheumatologic disease

Question 5

Neck pain with a h/o fever, chills, unexplained weight loss = ?

Answer 5

Cancer

Question 6

Neck pain with neurological signs or symptoms (arm clumsiness, gait difficulty, bowel or bladder dysfunction) = ?

Answer 6

Cervical myelopathy

Question 7

A shock-like paresthesia occurring with neck flexion suggesting compression of the cervical cord by a midline disc herniation = ?

Answer 7

Cervical myelopathy

Question 8

What are the neuro signs that should be elicited when evaluating neck pain?

Answer 8

DTRs
UMN testing
Provocative maneuvers

Question 9

The majority of neck pain has what origin?

Answer 9

Muscular

Question 10

What is the degenerative cascade model?

Answer 10

Discogenic conditions (dysfunction phase)
Stenotic phase (stabilization of the chronic SD)

Question 11

What is a sprain?

Answer 11

Injury to the ligament

Question 12

What is a strain?

Answer 12

muscle tendon unit injury

Question 13

What is cervical strain?

Answer 13

Overload injury to the muscle tendon unit of the neck.

Question 14

What is cervical spondylosis?

Answer 14

Degenerative changes in the neck, followed by osteophyte formation

Question 15

How do you diagnose cervical spondylosis?

Answer 15

Cervical x-ray

Question 16

Do x-ray findings for cervical spondylosis correspond well to the pain patients experience

Answer 16

No

Question 17

What are the three common x-ray findings with cervical spondylosis?

Answer 17

• Loss of disc height
• Anterior osteophytes
• Narrowing of the foramina

Question 18

What is degenerative disc disease? What causes it?

Answer 18

Degenerative process causing a loss of disc height, nuclear degradation, and disc bulging

Part of natural aging, but also a consequence of poor nutrition

Question 19

What is internal disc disruption?

Answer 19

When the disc develops a rip or tear, usually caused by cervical trauma

Question 20

What is a herniated nucleus pulposus?

Answer 20

When the nucleus pulposus squeezes out of the vertebrae

Question 21

True or false: degenerative disc disease is a radiologic diagnosis

Answer 21

True

Question 22

What are internal disc disruptions?

Answer 22

symptoms exaggerated with neck helo in one position for prolonged periods

Question 23

What is radicular pain?

Answer 23

When pain shoots down a lumb and courses down a dermatome

Question 24

What is the sign that may be elicited with a cervical disc herniation?

Answer 24

Spurlings sign

Question 25

What areas of the spine are most commonly affected with cervical disc herniation?

Answer 25

C5-C6, followed by C6-C7

Question 26

What are the radiological findings of disc degeneration?

Answer 26

Loss of white coloring | Protrusion into the spinal cord

Question 27

What is the relation of UE pain with neck pain?

Answer 27

Compression of the brachial plexus

Question 28

What is cervical radiculopathy?

Answer 28

nerve root injury in the presence of spondylosis or stenosis

Question 29

What are the ssx of cervical radiculopathy?

Answer 29

Sensory, motor, or reflex abnormalities

Question 30

Which cervical levels are usually affected by radiculopathy?

Answer 30

Lower (C7, C6)

Question 31

What is spinal stenosis?

Answer 31

Progressive narrowing of the central spinal canal

Question 32

What can cause spinal stenosis?

Answer 32

Bulging or protrusion of the intervertebral disc annulus posteriorly Hypertrophy of spinal ligaments or facet joints

Question 33

What are the primary ssx of spinal stenosis?

Answer 33

Chronic pain Numbness Motor weakness

Question 34

UMN occur with spinal stenosis or neural foraminal stenosis?

Answer 34

Spinal stenosis

Question 35

Cervical stenosis is associated with an AP diameter less than what?

Answer 35

Less than 10 mm

Question 36

What are the UMN reflexes like?

Answer 36

Hyperreflexive

Question 37

What is cervical spondylotic myelopathy?

Answer 37

Defined by degenerative changes narrowing the spinal canal

Question 38

What are the ssx of cervical myelopathy?

Answer 38

- Weakness - Coordination impairment - Gait disturbances - Bowel or bladder dysfunction

Question 39

What is thoracic outlet syndrome?

Answer 39

Compression injury or irritation by the brachial plexus

Question 40

What is neurogenic thoracic outlet syndrome?

Answer 40

Brachial plexus is injured

Question 41

What is vascular thoracic outlet syndrome?

Answer 41

Subclavian and/or vein is damaged

Question 42

What is nonspecific thoracic outlet syndrome?

Answer 42

Patients have ssx but no abnormal tests to document the lesion clearly

Question 43

What are the boundaries of the brachial plexus?

Answer 43

Scalenes Clavicle and first rib Beneath the pec minor

Question 44

Cervical radiculopathy is most commonly found involving which cervical root? Where would you sensory test for this?

Answer 44

C7 | Proximal phalex

Question 45

What are a myofascial trigger points?

Answer 45

Hyperirritable spots in skeletal muscle that respond painfully to stretch and is TTP

Question 46

What is the major etiology of most neck pain?

Answer 46

Biomechanical stress