TEST 3: Cervical Spine SD Dx Flashcards
how many vertebra in cervical spine?
7
which 2 cervical vertebra are atypical?
atlas C1
axis C2
anatomy of atlas
no vertebral body
rotates around dens of C2
anatomy of axis
vertebral body of C2 extends superiorly to form dens
which vertebra in cervical spine are typical?
C3-C7
what is a vertebral segment?
one segment and the one below plus the NV
facets of the cervical spine
- facets are in a plane that points towards the eye in the uppers
- facets are pointing toward the opposite shoulder for the lower segments
C spine x rays
-need to see all 7
what are the 4 lines you need to look at the C spine x ray
- anterior vertebral line–they should all line up here
- posterior vertebral line–they should all line up here
- spinal laminar line–should all line up
- posterior spinous process line–should all line up
why do we get an oblique view of the C spine?
to see the spinal foramen and facets
cervical spine passive and active ROM
- starts in a neutral position
- palpate at C7 and T1
- have pt perform active motion first until motion palpated at your monitoring finger
- repeat for passive motion
- assess degrees of motin
ROM of flexion of C spine
45-90 deg
ROM of extension of C spine
45-90 deg
ROM of side bending of the C spine
45 deg in either direction
ROM of rotation of C spine
70-90 deg in either direction
biomechanics of the occipital atlantal joint
- this is the occiput moving on the atlas
- major motions here are flexion and extension
- shape of joint allows for more sagittal plane motion
- minor motions are SB and rotation
- occiput flex/ext + rotates and SB to opposite sides
- modified type I mechanics
cervical spine OA segmental diagnosis
- contact posterior aspect of occiput with middle finger and lateral aspect with index
- assess rotation R by lifting anterior on L
- assess rotation L by lifting anterior on R
- translate to L for R SB
- translate R for L SB
- reassess each in F and E
- modified type I mechanics
- OA F RR SL
biomechanics of AA joint
- atlantoaxial (AA or C1-2)
- primary motion is rotation
- atlas rotates about dens
- almost no SB or flexion/extension
cervical spine AA segmental diagnosis
- cup occiput and place fingers on AA joint
- fully flex head and neck to take out rotation of vertebra below AA
- rotate R
- rotate L
- is it symmetrical? is there ease of motion?
- AA RR
biomechanics of typical cervical segments (C2-7)
- rotation and SB to same side
- studies have noted clinically, SB and rotation to opposite sides
- currently thought to be due to compensatory patterns for dysfunction from lower parts of spine
- type II spinal mechanics
rotational diagnostic maneuvers of the typical C spine
- rotational
- transverse plane
- induce force ventrally on R lateral mass–rotate L
- induce force ventrally on L lateral mass–rotate R
translational diagnostic maneuvers of the typical C spine
- coronal plane
- translation from L to R–SB L
- translation from R to L–SB R
F and E with typical C spine
- recheck in F and E
- more restricted in F then E dysfunction–when segment is flexed the rotation or translation motions have a harder end feel
- more restricted in E then F dysfunction–when segment is extended then rotation or translation motions have a harder end feel
- change in sagittal plane will allow you to determine the segment is type II–you can infer SB with rotation testing or rotation with SB testing
where to document dysfunctions?
objective portion of SOAP
