SCS Study Guide- Spine Flashcards
dorsal scapular nerve innervates what
rhomboids, levator scap
c4-5
long thoracic nerve innervates what
c5-6-7 SA
suprascap nerve innervates what
infra and supra C5-6
lateral pectoral nerve innervates what
c-5-6-7
pec major and minor
MSK nerve innervates what
c5-6-7
coracobrachialis, brachalis, biceps
upper subscap nerve innervates what
c5-6
subscap nerve (upper)
thoracodorsal nerve innervates what
c6-7-8
lats
lower subscap nerve innervates what
c5-6
subscap lower and teres minor
axillary nerve innervates what
c5-6
anterior deltoid, posterior teres minor and deltoid
radial nerve innervates what
c5-t1
triceps, supinator, extensors for forearm
brachioradialis
medial pectoral nerve innervates what
c8-t1
pec major and minor
ulnar nerve innervates what
c8-t1
2 medial lumbricals, medial digitorum profundus and intrinsics (but not thenar intrinsics)
odontoid view looks at
c1-2 relationship
swimmers view looks at
c7-T1
alantoedntal interval classifications for risk of injury
3.5mm instability
7mm disruption of transverse ligament
>9-10mm risk of neuro injury and needs surgery
Canadian c/s rules
high risk fractures (age over 65, dangerous MOI, paresthesia in UE) then YES
low risk (able to assume sitting position, ambulatory, absences of midline tenderness, delayed onsets of neck pain) IF NO, IMAGING
but if cannot rotate to over 45 degrees to one side: IMAGING
jefferson or burst fracture is to what
c1
odontoid fracture what level
c2
hangman fracture vert fx
c2
clay shovelers fracture fx site
SP c6-T2
MOI and presentation for c/s dislocation
violent flex and rotation,
and neck tilted toward side of dislocation
signs of cervical myelopathy
hoffmans’
hyperreflexive brachioradialis
gait changes
babinski
age over 45
c/s radic test cluster
(+) distraction
(+) Spurling
(+) ULTT median
(+) less than 60 degrees rotation to affected side
what are stingers associated with
cervical stenosis
kyphosis
congenital fusion
cervical instability
herniation
vascular/metabolic abnormalities
when can RTP after stinger
if it is the first, as soon as sxs resolve
dermatomes
c1: top of head
c2: suboccipital
c3: side neck/jaw
c4: top shoulders
c5: latral delt
c6: tip of thumb
c7: tip of middle finger
c8: fifth finger
t1: ulnar side forearm
myotomes
c1: neck flexion
c2: neck flexion
c3: lateral neck flexion
c4: shoulder elevation
c5: abduction
c6: elbow flexion and wrist extension
c7: elbow ext and wrist flexion
c8: finger flexion
t1: finger abduction and extension
modified sharp purser
tests transverse ligament >1mm neuro sxs
alar ligament test
c2 SP does not move to opposite side
vertebral artery test
dizziness, drop attack, diplopia dysarthria, dysphagia
cervical flexion and rotation test
movement dysfucntion, at c1-2, restricted ROM and firm resistance
spurlings
reproduction of c/s radic
ULTT
pain, tingling, numbness
cervical distraction
symptoms decrease with distraction
diaphragm referral
c4
heart referral
t3-4
esophagus referral
t4-5
stomach referral
t8
small intestine referral
t10
colon referral
t11
liver and gallbladder referral
t8-11
kidney and testes referral
t10-11
bladder referral
t11-l1
murphy’s sign if for the
gall bladder t8-11 lower border of the ribs
mcburney’s point
appendix, half way between ASIS and umbilicus
what are some functional and structural causes of scoliosis
functional: muscle spasms or LLD
structural: idiopathic and irreversible curves
tests for scoliosis
adam’s bend test and Cobb angle
treatment over ___ degrees may need surgery for scoliosis
45
R thoracic scoliosis can compromise what
cardiopulmonary function
Scheurmann’s disease
example, exam and treatment
thoracic kyphosis from wedge fracture 5 degrees or more than 3 or more consecutive vertebrate
kyphosis, TTP at SP
treat: prevention, extension exericses and postural education
who is at greatest risk of scheurmans
swimmers and gynmasts
dermatomes lumbar spine
l1: iliac crest
l2: anterior thigh
l3: anterior lower thigh
l4: medial calf and big toe
l5: lateral leg and anterior foot
s1: lower 1/2 posterior calf , sole of foot and lateral 2 toes
s2: posterior thigh, sole and plantar aspect of the heel
myotomes of lumbar spine
l1: psoas (hip flexion )
l2: psoas (hip flexion)
l3: quads (hip and knee ext )
l4: tibialis anterior (knee ext and DF)
l5: extension hallicus (DF)
s1: Flexor hallucis and gastroc (PF and EVE)
s2: Hamstrings
patellar tendon reflex what levels
l3-4
achilles reflex level
s1
red flags
urinary incontinence, cauda equina, loss of sphincters
decreased sacral sensation, gait changes
stork test
shows pain in area of spondylolisthesis
SLR 30degrees
hip or nerve irritation
SLR 30-60
scaitic nerve irritation
SLR 70-90
SIJ involvement
Kernig’s sign
back pain may be a nerve root irritation
Brudzinski’s
lumbar disc involvement or nerve irritaiton
FABER
pain in inguinal region: hip patholgy
pain with overpressure may be SIJ
prone instability test
test for liklihood of responding positively to spinal stabilization program
SIJ provocation test
distracction, compression, thigh thrust, sacral thrust , gaenslen’s
spondylolysis cause, exam and treatment
cause: repetitive hyperextension pars interarticualris defect
exam: pain with extension, scotty dog on oblique x-ray
treatment: activity modification, rest and surgery
ankylosing spondylitis
cause, exam and treatment
cause: inflammation that can cause fusing in the spine
exam: insidious onset of LBP before 40 years old and worse in AM, BETTER WITH ExERCISE
treatment: ROM, positionning and NSAIDS
cauna equina syndrome cause, exam and treatment
cause: nerve root compression shutting off movement and sensation herniation, tumor and infection
bowel and bladder changes, sensation changes and low back pain and weakness
ROM positioning and NSAIDs
disc herniation cause, exam and treatment
cause: forward bend/twist (lifting and collision sports)
exam: decreased lumbar motion, abnormal gait, weakness and decreased reflexes
treatment: directional preference
vertebral osteomyelitis cause, exam and treatment
cause: bacterial infection, pain and febrile loss of lordosis, and immobilization and antibiotics
CPR spinal manipulation
no pain below the knee
less than 16 days
less than 19 on FABQ
(+) PA glide
>35 hip IR
cluster for stabilization exercises
age <40
ASLR>91
(+)PITT
aberrant movement (catch, arc, gower’s sign)
cluster for mechanical traction
FABQ<21
no neuro deficit
age over 30
non-manual job
cluster for stenosis
bilateral sxs
leg sxs> back sxs
pain during walk/stand
relief with sitting
over 48 years old
