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PTRS 845 Final > Upper Cervical Spine > Flashcards

Upper Cervical Spine Flashcards

1
Q

Define the structures classified as USC

A

Occiput

Atlas (C1)

Axis (C2)

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2
Q

Describe the shape of the superior and inferior facets of C1

A

Superior = concave

Inferior = convex

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3
Q

List the 3 points of articulation b/t C1 and C2

A

Odontoid process

2 facet joints

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4
Q

Describe the shape of the inferior facet of C1 and the superior facets of C2

A

Both are convex

Only joint in body with 2 convex surfaces which along with the lack of a cervical disc decreases stability of the joint, stability mainly comes from ligaments

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5
Q

List the 3 features that allow the majority of rotation ROM to come from the USC

A

Biconvex joint surface

Downward slope of C2 facets

Lack of disc

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6
Q

Describe what the amount of cervical rotation can tell you about the pathology of the pain

A

In acute USC they have limited and painful rotation

In chronic USC they have functional rotation due to compensation of the rest of the spine

If rotation is not compromised = LCS

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7
Q

The following ligaments are renamed in the USC

  1. ALL
  2. Ligamentum flavum
  3. PLL
A
  1. Anterior atlo-occiput membrane
  2. Posterior alto-occiput membrane
  3. Tectorial membrane
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8
Q

List the AA ligaments

A
  1. Transverse: behind dens, stabilizing dens to atlas, control AP motion
  2. Alar: lateral dens, stabilizing dens to occiput, controls bilateral flex contralateral SB/Rot
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9
Q

List the 4 deep posterior neck mm

A
  1. Rectus captiis posterior major (extend, SB, rot)
  2. Rectus capitis posterior minor (extend, SB, rot)
  3. Superior oblique (ipsi SB, contral rot)
  4. Inferior oblique (ipsi rot)
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10
Q

List the 4 anterior neck mm

A
  1. Rectus capitis anterior (flexion)
  2. Rectus capitis lateralis (Ipsi SB)
  3. Longus capitis (posture control, eccentric ext control)
  4. Longus colli (posture control, eccentric ext control)

Longus mm = “deep flexors” (aid with sagittal anterior rot w/flex)

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11
Q

Describe the primary role of the small anterior neck mm

A

Important for proprioception of head position on neck

(large spindle to fiber density)

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12
Q

Describe the innervation of the neck mm, OA, AA, C2-3 Z jt, ligaments, vertebral arteries

A

Doran and ventral rami of C1-3

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13
Q

Describe the arthrokinematics of

OA flex

AA flex

A

OA: convex occipital condyle glide POST on concave atlas

AA: C1 moves inferiorly on C2; C2 glies forward on C3

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14
Q

Describe the arthrokinematics of

OA ext

AA ext

A

OA: convex occipital condyle glide ANT on concave atlas

AA: C1 moves superiorly on C2; C2 glides backward on C3

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15
Q

Describe the arthrokinematics of

OA rot

AA rot

A

OA: ipsi condyle glide posterior

AA: ipsi facet moves POST, contra facet moves ANT, C1 translates to OPPOSITE side

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16
Q

Describe the arthrokinematics of OA SB

A

Ipsi condyle glides ANT

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17
Q

Describe the osteokinematics of the OA and AA joints

A

OA: primarily flex/ext (yes jt)

AA: primarily rot (no jt)

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18
Q

Describe the coupling of the OA and AA joint

A

OA: OPPOSITE

AA: OPPOSITE

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19
Q

LIst the causes of injury to the VA

A
  1. MVA (ext)
  2. Trauma
  3. Cervical instab, fx
  4. Suddent neck movement, manip
20
Q

List the 5 D’s for VA

A
  1. Drop attack
  2. Dizziness
  3. Dysphagia
  4. Dysarthria
  5. Diplopia

Also ask about lip/face parasthesia

21
Q

Describe motions from least to most occulsion of the VA

A

Rotation > rot + ext > Rot + ext + traction

22
Q

Describe the pattern of pain for

USC

C4-5

C5-7

A

USC: base of neck, head and face

C4-5: base of neck and top of shld

C5-7: scapula, across the shld jt, and post/lat aspect of upper arm

23
Q

List some aggravating factors of the USC

A

sustained posture, rotation, TMJ issues

24
Q

Describe the treatment guidlines for USC

A

Restore mobility > posture > movement impairment > stability and coordination

25
Q

Describe the effect of forward head posture

A

Puts shear on LCS and the center of pressure moves anteriorly

Inhibits deep neck flexors (longus) – not longer in optimal position to function > leads to atrophy

Head tilts backext USC to keep eye level which increases pressure on posterior eliminates and DRG resulting in HA

Tightens ligamentus nuchae and other mm leading to adoptive changes

26
Q

Describe the first exercises to address forward head posture?

A

Look at the thoracic spine:

Chest out moves neck back

Scap squeeze

27
Q

Condition: head and face pain arising from the UCS

A

Cervicogenic headache

28
Q

Condition: pounding headache associated with dizziness and visual distrubances

A

Vascular headache

29
Q

List the 3 most common types of headach

A
  1. Migraine
  2. Tension (PT)
  3. Cervicogenic (PT)
30
Q

Condition:

  • Hx of neck or shld pain
  • Unilateral, associated pain in neck, shld, arm
  • Variable pain, moderate intensity, dependent on movement
  • NOT throbbing
A

Cervicogenic HA

31
Q

Condition:

Agg: neck movement, posture, position,

Ease: meds, modalities, change in posture, lying down, tx

Decreased ROM

Pattern: occipital/suboccipital

A

Cervicogenic HA

32
Q

Condition: HA with redness under eyes

A

Cluster HA (vascular)

33
Q

List the cases of cervicogenic HA

A
  • Pressure on OA, AA, C2-3
  • Hyper/hypo mobility
  • Mm shortening
  • DDD
  • Trauma
34
Q

Condition

  • Tightness anywhere on the cranium or suboccipital region
  • Bilat and trigeminal distribution
  • W > M
A

Tension HA

35
Q

List the causes of tension HA

A

Stress

Lack of sleep

36
Q

List the CC following MVA/whiplash injuries

A

Neck pain

Neck stiffness

Neck pain + HA

37
Q

Condition: acceleration-deceleration injury to the neck, injury to soft tissues

A

Whiplash injury

38
Q

List the special Q’s specific for trauma/MVA

A

Hearing/vision disturbances

Dizziness

Feeling of unsteadiness

Depression/fatigue

Irritability

Insomnia

39
Q

Condition:

Pain as dominant complaint

Apprehensive with AROM of neck

Shld/arm movement tolerated

Dizziness with active movement

A

Acute stage of MVA/whiplash

40
Q

Condition:

AROM to end range limited by stiffness/spasm

A

Subacute stage of MVA/whiplash

41
Q

Condition:

Sx intermittent

Limited active movements

weak mm

postural changes

A

Chronic stage of MVA/whiplash

42
Q

Describe the goal of intervention in each stage following an MVA/whiplash injury

A

Acute: protect structures and mobility within tolerace

Subacute/Chronic: gain mobility and stability

43
Q

Condition: rupture of transverse lig.; may result in cord compression

A

AA dislocation

44
Q

Condition: vertical compression resulting in massive suboccipital HA

A

Fx of posterior arch of atlas (C1)

45
Q

Condition: fx of anterior and posterior arch of C1

A

Jefferson fx

46
Q

Condition:

Fx of C2 pedicles with disolcation of C2 on C3

Dens migrates into brainstem

A

Hangman’s Fx

PTRS 845 Final (11 decks)

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