Neck and Thoracic spine assessment and pathology Flashcards
What is normal cervical extension?
0-80 degrees
What is normal cervical flexion?
0-45-50 degrees
What is normal lateral rotation
0-40 degrees
Flexing head forward can free up….?
Intervertebral foramen
Where does 60% of rotation in the cervical region come from?
Atlantoaxial joints
Where does 40% of rotation in the cervical region come from?
The lower cervical vertebrae’s (below C1)
What cervical movements happen during neck retraction?
Upper region flexes, lower region extends
What cervical movements happen during neck protraction?
Lower region flexes, upper region extends
What are the 4 main ligaments in the neck?
Alar
Apical
Tectorial membrane
Cruciform ligament
What functions do the Alar Apical Tectorial membrane Cruciform ligament do?
Alar - limits ipsilateral head rotation and contralateral side bending
Apical - limits separation of dens from occiput
Tectorial membrane - limits forward flexion
Cruciform - maintains contact between dens and anterior arch of atlas
If a patient reports diffuse nonspecific neck pain exacerbated by neck movements, what could it be?
Mechanical neck pain, cervical facet syndrome, cervical muscle strain or sprain
If a patient reports pain in certain postures that are alleviated by positional changes, what could it be?
Upper crossed postural syndrome
If a patient reports traumatic mechanism of injury with complaint of nonspecific cervical symptoms that are exacerbated in the vertical positions and relieved with the head supported in the supine position, what could it be?
Cervical instability
If a patient reports nonspecific neck pain with numbness and tingling into one upper extremity, what could it be?
Cervical radiculopathy
If a patient reports neck pain with bilateral upper extremity symptoms with occasional reports of loss of balance or lack or co-ordination of the lower limbs, what could it be?
Cervical myelopathy
How can zygapophyseal join pain be described?
Stiffness, pain in extension, pain in rotation, shoulder pain
Explain how whiplash causes neck pain? and what structure is affected?
Hyperextension of the neck and head. Stretch and tear longus capitis and colli
If a patient is lying down, can lift their head up but can’t tuck their chin. What is the likely cause of this?
Deep neck flexor issue
What four categories exist in upper cross syndrome?
Inhibited neck flexors, inhibited rhomboids and serratus anterior, tight pectorals and tight upper traps and levator scapula
A protracted position in upper cross syndrome places stress on which muscles?
Levator scapula and semispinalis capitis muscles
What is thoracic outlet syndrome?
Compression of the neurovascular structures running from the neck to the arm pit through the thoracic outlet