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MSK > Spine Check Off C-Spine > Flashcards

Spine Check Off C-Spine Flashcards

1
Q

what types of cancer refer to the spine?

A

breast, prostate and lung

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2
Q

Explain the progession of myelopathy

A

it affects the LE first and then the UE.

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3
Q

What is the best test for myelopathy?

A

Babinski

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4
Q

What is the most common sx of caude equine syndrome?

A

urinary retention

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5
Q

what are sxs of caude equine syndrome?

A

urinary retention, urinary and fecal incontinence, saddle anesthesia

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6
Q

Can spinal fractures happen from non-traumatic injuries?

A

Yes, in elderly people with severe osteoporosis they can simply step down and their spine can fx

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7
Q

what are some sxs of spine fractures?

A

neck and back pain. Muscle spasms, weakness, bowel/bladder changes, paralysis

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8
Q

What are the symptoms of VBI?

A

5 D’s (dizziness, drop attacks, dysarthria, dysphagia, diplopia)
3 N’s (nystagmus, numbness, nausea)

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9
Q

Can PTs do anything for osteomyelitis?

A

Yes, they can help screen for it and provide education on nutrition to fight infection (vitamin C&D, iron, zinc, protein). They can also help prevent it by properly treating open wounds or fractures.

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10
Q

what are the 5 most important questions, according to the MDT method?

A

Location
Time
constant/intermittent
consistent/inconsistent
obstruction

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11
Q

what are some differences between derangement and dysfunction classifications?

A

Derangement has a directional preference. it can be acute or chronic, constant or intermittent. It is inconsistent.
Dysfunction is chronic, intermittent and consistent.

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12
Q

What is the difference between constant and consistent?

A

constant is 24/7. Consistent is when the pain occurs consistently during specific motions.

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13
Q

What is the normal ROM for c-spine flexion and extension?

A

50 degrees and 60 degrees

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14
Q

What is the normal ROM for c-spine lateral flexion and rotation?

A

45 degrees each side and 80 degrees each side

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15
Q

what is the lumbar spine extension progression according to MDT?

A

prone lying
prone lying in extension
extension in lying
extension in lying w/ clinician overpressure
extension mobs
extension in standing

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16
Q

What is the flexion progression according to MDT?

A

flexion in lying
flexion in sitting
flexion in standing
flexion in lying w/ clinician overpressure

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17
Q

what are signs and sxs of a posterior herniation?

A

BL sxs. Multi-segmental.

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18
Q

What are signs and sxs of a posterior-lateral herniation?

A

UL sxs. Dermatome and myotome patterns.

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19
Q

what do you do if a pt reports trauma to the neck?

A

rule out fractures and instability. Make sure appropriate images and referrals have been made prior to performing cervical manipulation.

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20
Q

Why are we cautious with performing cervical rotation?

A

We don’t want to go past the ROM because this will close off the transverse foramen which contain the vertebral artery. this can lead to Wallenburg syndrome

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21
Q

What are signs and sxs of Wallenburg syndrome?

A

difficulty swallowing and speaking. Contralateral sensory deficits. Loss of ipsilateral facial sensation. Facial pain, numbness, Homer’s syndrome, nystagmus.

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22
Q

why do we palpate the c-spine?

A

hypermobility and hypomobility. Feeling for a loss of lordotic curve in the c-spine

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23
Q

explain the unique orientation of the cervical vertebrae and their nerves compared to the other areas of the spine?

A

C1-C8 exit above their vertebrae. the rest of the nerves exit below their vertebrae.

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24
Q

what are the muscles responsible for cervical flexion?

A

rectus capitis anterior. Rectus capitis lateralis. Longus capitis. SCM. Longus colli.

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25
Q

What are the deep cervical neck flexors?

A

rectus capitis anterior and lateralis. Longus colli and longus capitis.

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26
Q

what are the muscles that help with cervical extension?

A

erector spinae muscles of c-spine.
Obliques capitis superior.
Rectus capitis.
Semispinalis capitis and cervicis
Semispinalis capitis and cervicis
Upper trap

27
Q

What are the muscles that help with cervical rotation?

A

semispinalis cervicis.
Multifidus.
Scalene anterior
Splenius cervicis and capitis
SCM

28
Q

What is the main ROM for C0-C1 (OA joint)?

A

10-15 degrees of flexion/extension

29
Q

What is the main ROM for the C1-C2 (AA joint)?

A

45 degrees of rotation

30
Q

What ligament does the tectoral mebrane turn into and where does it change names?

A

It becomes the posterior longitudinal ligament at C2

31
Q

What is the function of the alar ligament?

A

secondary stabilizer of C1-C2

32
Q

what is the function of the transverse ligament?

A

retains the dens of C2 in place against the anterior arch of C1/atlas

33
Q

what muscles attach to the ligamentum nuchae?

A

trapezius and splenius capitus

34
Q

explain the relationship of lateral flexion and rotation in the cervical spine

A

These movements are coupled for C2-C7. But these movements are opposite for C1-C2

35
Q

Explain the relationship of lateral flexion and rotation in the lumbar spine

A

These movements are opposite

36
Q

If we want to palpate the left transverse process of C1, which way should the pt side flex?

A

Right side bend

37
Q

explain the signifigance of the atlanto-dens interval

A

this is the motion of the dens and the atlas. This shouldn’t be greater than 3mm

38
Q

which joint in the spine are we trying to manipulate?

A

the facet/zygopophyseal joint

39
Q

what is the outer and inner layer of the intervertebral disc?

A

inner layer: nucleus pulposus
outer layer: anulus fibrosis

40
Q

what are some treatments for FHP?

A

corner stretch for pecs. cervical retraction. 1st rib mobs. stretching levator scap

41
Q

what is the conservative treatment for spondylolysis?

A

cessation of aggravating tx, NSAIDs, spinal braces and light exercises

42
Q

if a pt presents with parasthesia and pain that does not follow a dermatomal pattern, what do we suspect and what can we rule out?

A

Suspecting a neural issue, can rule out nerve issues.

43
Q

What are some tests for neural involvement?

A

DTRs, MMTs, assess autonomic NS, loss of hot/cold discrimination

44
Q

How does/can cervical radiculopathy occur?

A

it can occur d/t traction, compression, irritation or lesion of the nerve root. These can be caused by hernations, foraminal narrowing, spondylosis.

45
Q

what is cervical myelopathy?

A

impingement of the spinal cord

46
Q

what can cause cervical myelopathy?

A

osteophytes, herniation, degeneration of spine or facet, tumors, infection

47
Q

what would the presentation of a cervical myelopathy pt look like?

A

Primarily has UMN sxs. Positive Hoffman and Babinski

48
Q

what radiograph is best when checking for c-spine instability?

A

open mouth view XR

49
Q

what pathology can often lead/cause cervical instability?

A

Rheumatoid arthritis

50
Q

what pathologies can present with Grisel’s syndrome?

A

Downs syndrome, RA, Marfans

51
Q

what are some findings associated with WADs?

A

ULNTT +
thermal sensitivity changes in UE and LE
Weak deep cervical neck flexors
ligamentous injury

52
Q

what is a grade 1 whiplash disorder? How about a grade 2?

A

grade 1 is self-limiting. the pt has sxs but no physical signs. grade 2 the pt has physical signs

53
Q

what is the difference between grade 2 and 3 whiplash disorders?

A

grade 3 has neuro findings. a grade 2 has physical signs

54
Q

what is a grade 4 whiplash disorder?

A

a pt with sxs and a fracture

55
Q

what are some signs of intracranial pathologies?

A

sudden onset of severe HA
HA increasing over a few days
Persistently UL HAs
HAs that wake the pt
Stiff neck or other signs of meningitis (like fever)
System sxs (weight loss, fever, malaise)

56
Q

What is the Rams horn pattern and what pathology is it associated with?

A

It is associated with cervicogenic HAs. It begins in the posterior base of skull and comes up and curves towards the temples or to the area behind your eyes. Can be BL or UL

57
Q

what structures can cause cervicogenic HAs?

A

joints, muscles, fascia and neurological structures of the c-spine

58
Q

what are txs for cervicogenic HAs?

A

manual therapy, manips, retraction

59
Q

what is the most effective medical tx for cervicogenic HAs?

A

facet nerve ablation

60
Q

what are signs and sxs of syrinx/syringomyelia?

A

UMN changes
Insidious onset
reflex changes
Loss of temp and pain sensation
Axial pain
Spasticity in LE

61
Q

What are signs and sxs of chiari malformation?

A

HAs, neck pain, fatigue, dizziness, visual sxs, parasthesia, balance issues, memory loss

62
Q

What manual therapy techniques would be appropriate for midline or BL pain?

A

Central posterior anterior mobs, seated chin retractions

63
Q

what manual therapies are good for UL c-spine pain?

A

transverse glides, unilateral PAs.

64
Q

What manual therapies are good for nerve root issues?

A

lateral glides, traction

MSK (3 decks)

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