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Osteopathic Skills--Lexie > TEST 3: Cervical Spine SD Dx > Flashcards

TEST 3: Cervical Spine SD Dx Flashcards

1
Q

how many vertebra in cervical spine?

A

7

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2
Q

which 2 cervical vertebra are atypical?

A

atlas C1

axis C2

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3
Q

anatomy of atlas

A

no vertebral body

rotates around dens of C2

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4
Q

anatomy of axis

A

vertebral body of C2 extends superiorly to form dens

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5
Q

which vertebra in cervical spine are typical?

A

C3-C7

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6
Q

what is a vertebral segment?

A

one segment and the one below plus the NV

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7
Q

facets of the cervical spine

A
  • facets are in a plane that points towards the eye in the uppers
  • facets are pointing toward the opposite shoulder for the lower segments
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8
Q

C spine x rays

A

-need to see all 7

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9
Q

what are the 4 lines you need to look at the C spine x ray

A
  • 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
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10
Q

why do we get an oblique view of the C spine?

A

to see the spinal foramen and facets

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11
Q

cervical spine passive and active ROM

A
  • 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
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12
Q

ROM of flexion of C spine

A

45-90 deg

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13
Q

ROM of extension of C spine

A

45-90 deg

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14
Q

ROM of side bending of the C spine

A

45 deg in either direction

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15
Q

ROM of rotation of C spine

A

70-90 deg in either direction

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16
Q

biomechanics of the occipital atlantal joint

A
  • 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
17
Q

cervical spine OA segmental diagnosis

A
  • 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
18
Q

biomechanics of AA joint

A
  • atlantoaxial (AA or C1-2)
  • primary motion is rotation
    • atlas rotates about dens
  • almost no SB or flexion/extension
19
Q

cervical spine AA segmental diagnosis

A
  • 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
20
Q

biomechanics of typical cervical segments (C2-7)

A
  • 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
21
Q

rotational diagnostic maneuvers of the typical C spine

A
  • rotational
    • transverse plane
    • induce force ventrally on R lateral mass–rotate L
    • induce force ventrally on L lateral mass–rotate R
22
Q

translational diagnostic maneuvers of the typical C spine

A
  • coronal plane
  • translation from L to R–SB L
  • translation from R to L–SB R
23
Q

F and E with typical C spine

A
  • 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
24
Q

where to document dysfunctions?

A

objective portion of SOAP

Osteopathic Skills--Lexie (16 decks)

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