Neck and C spine Flashcards
uncovertebral joint
C3-7
OA joint- motion
flexion and extension primarily -rotation and SB to opp sides
AA joint- motion
rotation primarily
C2-7- motion
Rotation and SB to same side
anterior triangle
mandible, SCM, midline
posterior triangle
SCM, trapezius, clavicle
C1- motor
resisited rotation rOM
C2-4- motor
scapular elevation
C5- motor
shoulder abduction
C6- motor
elbow flexion, wrist extension
C7- motor
elbow extension, wrist flexion
C8- motor
finger flexion
T1- motor
finger abduction
compression test/ spurling’s maneuver
- compression test- axial loading force caudally- + if upper extremity pain/ numbness
- spurling’s test-axial force in neutral, then extension, SB/rotation toward
neck distraction test
- place one hand under pt’s chin and other hand around occiput- distract the head
- test if alleviation of symptoms- indicates central compression or central neuroapthy
valsalva test
-pt holds breath and bears down- + test if increaed pain in nerve root distribution
thoracic outlet boundaries and structures
- 1st ribs, 1st thoracic vertebra, manubrium
- structures- brachial plexus, subclavian a and v
Roos or EAST test
EAST test (elevated arm stress test)
- compression of subclavian a
- abduct shoulder to 90, externally rotate with elbow flex to 90
- instruct pt to open and close fist for up to 3 min
- test if pain down arm, arm pallor, swelling, and cyanosis
Adson test
- neurovascular bundle (subclavian a) compressed by tight scalene m’s or 1st rib
- locate radial pulse. pt breathes deeply. doc abducts, extends, and externally rotates shoulder while palpating radial pulse; head is extended and rotated TWD affected side (1ST RIB)
- pt’s head is then extended and rotated AWAY rom affected side (SCALENES)
- test- change in pulse- compression of subclavian a. between scalenes, cervical rib, or 1st rib
wright’s hyperabduction test
NV bundle compressed by tight pectoralis minor
- Dr monitors radial pulse. stand behind seated pt and palpate radial pulse with 1 hand. abduct the pt’s arm above their head
- test- change in pulse, pain- NV entrapment by pectoralis minor m.
costoclavicular test (military/halstead) test
- extended shoulder and caudal pressure on shoulder, note radial pulse- NV bundle compressed by clavicle and rib 1
- pt seated with dr behind. contact ipsilateral wrist at radial pulse, extend shoulder, with elbow extended and wrist supinated and apply caudal pressure on the shoulder
- test- decrease in radial pulse- thoracic outlet syndrome due to decreased space between rib 1 and clavicle
nuchal rigidity
- place hands behind pt’s head and flex neck forward until chin touches chest. normally neck supple and easily bends forward
- test- marked neck stiffness/ resistance to flexion- found in cases of acute bacterial mengititis and subarachnoid hemorrhage
Brudzinski’s sign
- place hands behind pt’s head and flex neck forward until chin touches chest. normally neck supple and easily bends forward
- test- flexion in both hips and knees
C1 burst fracture
jefferson fracture
C2 odontoid fracture at jxn of process and body
dens fracture
hyperextension, bilateral arch fracture
hangman’s fracture
hyperextension or avulsion force from muscle contraction
spinous process fracture
-clay shoveler’s- C6 or 7
compression, flexion leading force
wedge fracture
diving injury (comminuted)
burst fracture
dermatomes- C1- T1
-C1-4- lesser occipital, greater auricular, cervical cutaneous
C4- superior shoulder/lateral neck
-C5- lateral upper arm (deltoid)
-C6- lateral forearm
-C7- middle finger
-C8- right/little finger, medial wrist and forearm
-T1- medial elbow and upper arm
