test 2 - cervical disc disease

Question 1

what is the annulus fibrosus innervated by

Answer 1

sinuvertebral nerve - ventral ramus (somatic root)

vertebral nerve - sympathetic nervous system (autonomic root)

Question 2

what movements is the annulus of the disc most susceptible to injury

Answer 2

rotation and translation movements

Question 3

the annulus is ____ water

Answer 3

65%

Question 4

hydrated gelatinous structure located in the center of each intervertebral disc that has consistency of toothpaste

Answer 4

nucleus pulposus

Question 5

traps and holds water, which is what gives the nucleus its strength and resiliency; can trap and hold over 500 times their weight in water

Answer 5

proteoglycan aggrecan

Question 6

this type of tear is often cause of strain/sprain to spine

Answer 6

circumferential tear

Question 7

what type of tears allow nucleus to come out

Answer 7

radial tears

Question 8

which disc in the cervical spine is most common to degenerate/ be damaged

Answer 8

C5

Question 9

____ disc is felt in the inferior angle of the scap

Answer 9

C6-7

Question 10

_____ disc was felt in the center of the medial scapular border

Answer 10

C5-6

Question 11

____ disc was felt in the region of the spine of the scap and superior angle

Answer 11

C4-5

Question 12

____ disc was referred to the C7 spinous process and the posterior border of the trap

Answer 12

C3-4

Question 13

C4 disc bulge/herniation most likely affects the _____ root

Answer 13

C5

Question 14

what is the most common cause of cervical radiculopathy

Answer 14

foraminal encroachment (70-75%)

Question 15

incidence of specific nerve root radiculopathies

C7

C6

C8

C5

Answer 15

C7 - 70%

C6 - 20-25%

C8 - 4-10%

C5 - 2%

Question 16

annular fissuring within the disc without external disc deformation

Answer 16

internal disc derangment

DDD can progress into IDD

Question 17

pain generation of DDD

Answer 17

chemical - all the time

ishemic

mechanical - intermittent

Question 18

pain wihtout nerve root involvement typically is vague, diffuse, and distributed axially

Answer 18

discogenic pain

• act. that increase IAP intensify symptoms

Question 19

what area of the disc has the highest amount of phospholipase A2

Answer 19

nucleus pulposus

Question 20

area of sensory disturbance with root pathology

Answer 20

dermatome

Question 21

area where pain is experienced with root pathology

Answer 21

dynatome

Question 22

T/F: dermatomes do not correspond with dynatomes

Answer 22

TRUE

Question 23

radic pain

exacerbated by:

improves with:

Answer 23

exacerbated with neck ext and rotation

improves with flexion and abduction of symptomatic upper limb (bakody’s sign)

Question 24

increased upper and lower limb reflexes or other upper motor neuron signs suggest ____ and mandate _____

Answer 24

myelopathy

aggressive diagnostic evaluation

Question 25

nerve root with the most consisten clinical sign will be pain

Answer 25

C1-C4

Question 26

nerve root with pain along the clavicle and top of scap

Answer 26

C4

Question 27

nerve roots that are the most testable due to muscular innervation

Answer 27

C5-T1

Question 28

nerve root with deltoid and biceps m is tested

Answer 28

C5

Question 29

reflex testing: tapping the brachioradialis and biceps tendon

sensation: superior aspect of shoulder and lateral arm

Answer 29

C4-C5 disc

Question 30

what neurologic level checked by

wrist ext

brachioradialis tendon

and sensation of lateral forearm

Answer 30

C6

Question 31

neurologic level that sensory changes down the posterior aspect of the arm

assoc with weakness of wrist flexors, triceps, and pronators

Answer 31

C7

Question 32

neurologic level that is tested by

finger flexion

Answer 32

C8

Question 33

pancost tumor in a smoker will affect this neurologic level

may have horner’s syndrome due to damage to pre-ganglionic sympath

Answer 33

T1

Question 34

cervical disc rx

Answer 34

e-stim

supplements

acumpunct

ice/heat