VBI, Cervical Flashcards
Vertebral artery segment - at V1
prevertebral
Vertebral artery segment - V2
Vertebral (c2-6)
Vertebral artery segment - V3
atlantal segment (most mobile, concerns about dissection)
Vertebral artery segment - V4
intracranial (concerns about atherosclerotic plaques)
PICA supplies:
cerebellum and posterior cortex
blood flow to PICA is blocked, what happens?
signs and symptoms of 5D and 3N
5D and 3 N
- dizziness
- dysphagia
- drop attacks
- dysarthria
- diplopia
- nausea
- numbness
- nystagmun
- ataxia
what are most frequently associated with atherosclerosis
hypertension and myocardial infarction
what part of the vertebral artery segment is most frequently the area of arteriosclerosis
V4 - intracranial portion
arterial dissection, is a tear and elevation of what?
tunica intima from arterial wall, results in luminal stenosis
arterial dissection, most commonly occur in what part of the vertebral artery segment?
V3 - atlanto segment (most mobile)
vertebral artery dissection, more common in male or females
64% females
vertebral artery dissection S&S immediately after SMT in ____% of individuals
69
proposed mechanism of vertebral artery dissection
mechanical stretch on the vertebral artery caused by sudden neck movement while playing golf during a golf swing
spontaneous Anterior Circulation Arterial Disease (ACAD) is most likely in where- children
V4 - intracranial
post-traumatic anterior circulation arterial disease (ACAD) is most likely in where - children
V3 - atlanto - extracranial
Wallenberg’s syndrome
- lateral medullar infarct supplied by PICA
- ipsilateral cerebellar ataxia, nystagmus, facial analgesia, Horner’s syndrome, dysphagia and dysphonia
- contralateral limb and trunk analgesia
common site of injury to vertebral artery with rotation/stretching
between C1-C2
common site of injury that compresses Internal Carotid artery
C1 TVP
common site of injury to vertebral artery by compression
C2-C3
common site of injury to vertebral artery causing osteoarthritis
C5-C6 or C4-C5
common site of injury to vertebral artery by rotation
C2
common site of injury to vertebral artery by muscular compression
C1-C2
right nystagmus, left/right side lesion
left-sided lesion
3 types of skew deviation
- type 1 - upward deviation of both eyes
- type 2 - hypertropia in one eye (strabismus) -> brainstem, opthalmoplegia
- type 3 - simultaneous hypertropia in one eye and hypotropia in the other eye -> upper brainstem lesion
3 HINTS tests
- horizontal head impulse
- nystagmus
- skew deviation
____ HINTS test present is dx for Vestibular Neuronitis
3
___ HINTS test present could indicate Stroke
1
T/F anyone with neurological involvement should obtain imaging
T
MC level of cervical herniations is:
C6/7
MC level of degeneration in cervical spine
C5/C6
Cannon’s law of denervation
motor point becomes hypersensitive after period of partial denervation (may be why there are trigger points)
what root is compressed causing occipital, eye pain
C2
what root is compressed causing neck, trapezius pain?
C3, C4
what root is compressed causing shoulder , lateral UE pain?
C5
what root is compressed causing lateral forearm, digits 1&2 pain?C6
C6
what root is compressed causing posterior arm, 3rd digit pain?C7
C7
what root is compressed causing medial forearm, 4&5th digit pain?
C8
for every inch of forward posture = increase in weight on _______ by ________ lbs
spine, 10
brachial neuralgia
severe non-radicular, non-peripheral nerve pattern of upper limb pain
5 spinal cord patterns
- transverse cord
- hemicord lesion
- central cord syndrome
- posterior cord syndrome
- anterior cord syndrome
botox injection for spasmotic torticollis, how many patients improved?
50 out of 60 (83%)
Root and Plexus Traction Palsy (burner and stinger)
sudden electrical jolt, burning pain or paresthesia into arm due to extreme lateral flexion of the neck; temporary neuropraxia
neck tongue syndrome-
- occurence of occipital pain and numbness with ipsilateral paresthesia of the tongue
- afferent lingual nerve -> hypoglossal nerve -> C2 nerve root
- caused by compression of C2 root between C1/C2, on rotation to one side (not both)
cervical sympathetic syndrome
- aka Barre-Lieou Syndrome
- irritation of the cervical sympathetic ganglia/fibers within the carotid or vertebral artery by disease or trauma
- suboccipital headache, vertigo and tinnutus, fatigue, temperature changes, bradycardia
