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Ortho III > Upper Cervical Spine > Flashcards

Upper Cervical Spine Flashcards

1
Q

The OA joint includes

A

CO-C1

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2
Q

The AA jt contains..

A

Atlantis C1 & Axis C2

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3
Q

Transverse ligament restrains..

A

Primary restraint for posterior –> ant translation at the AA jt

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4
Q

Alar ligament is the primary means of …

-what does the alar ligament attach?

A

the ROTARY STABILITY of the CV unit (AA jt)

-attaches the skull to C2 vertebra (VIA THE DENS) and functions to check side to side movements of the head

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5
Q

Primary motion at OA jt is ..

A

flex/ext

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6
Q

Occipital condyles glide — with extension

A

anteriorly (downhill)

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7
Q

what’s the primary motion at the AA joint?

A

ROTATION

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8
Q

IF a patient has less than 45 deg of head rotation, what would you suspect?

A

possible restriction at C1/C2 (AA jt)

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9
Q

how do you test CN 8?

A

hear watch ticking?

balance test

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10
Q

To test CN III..

A

look at upward, downward and medial gaze

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11
Q

To test CN V, look at ..

A

corneal reflex, face sensation & clench teeth

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12
Q

what are the 4 Cervical spine clearing tests? (NOT pure VBI testing)

A
  1. Sharp-Purser Test (sublux of C1 on C2)
  2. Transverse Ligament Test (A-P translation of AA jt)
  3. Alar Ligament Test (rotation)
  4. Vertebral Artery Test
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13
Q

What is a positive test of Sharp-Purser?

A

IF the patient’s sx are RELIEVED by pushing back on the forehead (means that C1 is subluxing on C2)

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14
Q

IF the alar ligament is too lax, during the alar ligament test..

A

C2 does not move as soon as the head is sidebent (the alar lig rotates C2 with the skull VIA the dens)

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15
Q

The transverse ligament test (+) sx =

A 
lump in throat
lip paresthesias
nausea
vomiting
sever HA/ms spasm
dizziness 
INDICATES transverse ligament NOT resisting the ant shear of C1 on C2 (AA jt)
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16
Q

what exam is HIGHLY indicated as a test for cervicogenic HA?

A

Cervical flexion-rotation test of the AA jt (PIVM)

17
Q

IF you perform a PAIVM of the OA joint into EXT & SB L, what are you testing?

A

the L OA joint

18
Q

when performing a POST CONDYLAR GLIDE PAIVM of the OA jt and you want to assess the L OA..

A

rotate 30 deg to L
add post glide
assess end feel

19
Q

IF your patient presents with decr flex, decr R rotation & decr L SBing

A

R restriction b/c SBing to OPPOSITE SIDE when in passive flexion
POSITIONAL DX is an ERS

20
Q

Spinal stenosis is..

A

narrowing of spinal canal, IV foramina OR radicular canals

–space b/t SC & vertebral elements is compromised

21
Q

When measuring the ratio of A-P to transverse diameter of the SC, you are measuring —-
-a ratio of — indicates substantial SC flattening

A

measuring the CORD FLATTENING & severity of stenosis

–a ratio of < 0.4 indicates substantial SC flattening (neuro impairment & myelopathy)

22
Q

IF a patient has ipsilateral motor deficits with contralateral sensory deficits, they most likely have what kind of spinal stenosis..

A

Brown-Sequard syndrome

23
Q

“cervicogenic headache” is actually a subgroup of HA patients with..

A

concomitant head AND neck pain

24
Q

What % of tension-type HA is of ms origin?

A

90%

25
Q

What do you do if a pt presents with a HA assoc w HIGH FEVER, STIFF NECK or RASH

A

RED FLAG do not treat

26
Q

when examining for cervicogenic HAs, what does your exam include?

  • ms length?
  • ms strength & actvation?
A

AROM
-ms Length: tightness of SCM, UTrap, Lev scap, scalenes, suboccipitals, pec major & minor
-ms strength & activation: weak deep neck flexors, active neck flexion test, CCF - deep neck flexor performance
VBI testing

27
Q

What cervicogenic HA exam should you perform of the manual assessment?

A

assess AA jt rotation

also AA flexion & rotation – AA rotation to side of HA about HALF of the opposite side!!!

28
Q

what myofascial trigger points are often present in pts w cervicogenic HAs?

A

SCM

29
Q

IF a pt has neurological signs s/p WAD, what is their classification?

A

Grade III

30
Q

If a patient has WAD with signs of musculoskeletal dysfunction, what grade are they?

A

Grade II

31
Q

What is the CUT OFF TIME for increased risk of chronicity s/p WAD?

A

complaints of pain after 45 days increases the risk of chronicity

32
Q

What ms generates the greatest contraction during a rear end impact?

A

SCM generated up to 179% of MAX voluntary contraction

33
Q

in a LATERAL IMPACT accident, what ms is activated the most?

-awareness of impending impact does what?

A

the splenius capitis contralateral to impact

-decr ms response

34
Q

What sort of stress tests are used s/p WAD eval

A

Upper Cervical Ligament Stress Tests

  • Alar ligament
  • Transverse ligament
  • Sharp-Purser
  • Vertebral Artery Test
35
Q

what interventions are more effective - active or passive?

A

ACTIVE (exercise, normal activities, mobilization/manipulation)

36
Q

should patients use cervical collars?

A

NO EVIDENCE TO SUPPORT IT - prolonged sx & poor outcome

37
Q

what ms should be trained s/p WAD?

A

deep cervical flexors
cervical extensors
rotation & lateral flexion
** LINK b/t ms fatigue & impaired postural control **

Ortho III (5 decks)

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