Upper C spine Flashcards
what ligament becomes the tectorial membrane up at the skull?
PLL
what ligament becomes the anterior atlantooccipital membrane?
ALL
what ligament becomes the posterior atlantooccipital ligament?
ligamentum flavum
what does the alar ligament do?
connects dens to foramen magnum- it resists flexion, contralat. SB and contralat. rot
how do u test the alar ligament?
test SB in neutral, flexion and extension, must be lax in all 3 positions
what does the transverse ligament do?
holds dens against the atlas and away from the spinal cord, keeps motion between C1 and C2 in rotation, not translation. if dens translates back 3 mm= gross instability, 6-8 mm = cord compression symptoms
superior oblique does what motion?
contralateral rotation, extenstion, ipsilat SB
inferior oblique does what motion?
ipsilateral rotation
what do RCP maj and min do?
extend head, major also does ipsilat. SB and rot
rectus capitis anterior
flex head
rectus capitus lateralis
ipsilat. SB
longus colli
stabilizes vertebrae
what NN supply all structures to the upper C spine?
dorsal and ventral rami of C1-C3
coupling in upper C spine
opposite
OA joint
AA joint
OA= flex/ext AA= rotation
when is soonest u can test VA after an MVA?
6-8 wks
differentiate types of headaches
- vascular: pounding, dizziness, visual disturbances
- neurological:intense nerve pain
- ms: posture, position, activity related
pt profile: neck pain, shoulder pain, non-throbbing-unilateral headache that changes with positioning or motion, eased with lying down
cervicogenic headache
pt profile: pain and headache in base of neck, around cranium, behind ear and on the side of their face
trigeminal headache, bad posture causes disruption to trigeminal nuclei in c spine
patient profile: headache on whole forehead or whole back of head (central)
discogenic headache
patient profile: stressed out pt who can’t sleep, tightness on cranium and sub occipital regions, bilateral
tension headache,
tx: subocc. release, stretching, pt education
whiplash:
gets bad, causes lots of bad things, do an in depth eval of all structures in head and neck, then get imaging to double check
what dislocation is 100% fatal
A-O dislocations
Jefferson’s fracture
fx of ant. and post. arches of C1, 4 breaks, caused by blow to back of head
common in MVAs, pick up in radiography by open mouth x ray?
dens fx
hangman’s fx
fracture of the pedicles of C2 with dislocation of the body of C2 on C3= dens into brainstem… yikes, bad but not always fatal
what subluxation is also known as the face mask injury?
AA subluxation
S&S of cervical myelopathy caused by SC compression
UE/LE weakness
bowel and bladder dysfunction
gait disturbances
*SURGERY!!!
acute phase after sx
sleep in recliner no lifting more than 5-10 lbs. collar no ROM! bed mob stairs ambulation
outpatient after sx
precision of movement
align shoulder girdle and T spine!
precautions after lumbar fusion sx?
log roll, hips at bend of bed, no hip flex >90, no twisting, bending, stooping, rotation, no lifting, no sitting >30 mins
