WEEK 5&6 Cervical & Thoracic Spine

Question 1

What are some other names for cervical disc pathology?

Answer 1

Cervical degenerative disc disease, herniated nucleus pulposus

Question 2

What disease includes annular tears, nuclear disc material degradation, & loss of disc height?

Answer 2

Cervical DDD

Question 3

What are the 2 primary causes of cervical disc pathology?

Answer 3

Degenerative processes, space-occupying lesions

Question 4

Cervical spine herniated nucleus pulposus can occur when disc material extends beyond which margin of vertebral body?

Answer 4

Posterior

Question 5

Which class of HNP is when nucleus pulposus bulges into annulus fibrosis & disc margin extends beyond endplates of adjacent vertebral levels?

Answer 5

Disc bulge

Question 6

Which class of HNP is when nucleus pulposus from disc tears through a small portion of annulus fibrosis?

Answer 6

Disc protrusion

Question 7

Which class of HNP is when nucleus pulposus breaks past outer lamina of annulus fibrosis & into space beyond?

Answer 7

Disc extrusion

Question 8

Which class of HNP is when nucleus pulposus becomes detached from annulus & resides within SC canal?

Answer 8

Disc sequestration

Question 9

In which decade of life does disc degeneration occur?

Answer 9

2nd

Question 10

In which direction is limited cervical spine ROM with cervical disc pathology seen?

Answer 10

Flex/extend

Question 11

In cervical disc pathology, there’s morning stiffness for >___ minutes.

Answer 11

30

Question 12

What are the 2 surgical options for cervical disc pathology?

Answer 12

Discectomy/microdiscectomy, anterior or posterior fusion

Question 13

What are the 4 common classes of thoracic disc pathology?

Answer 13

Protrusion, prolapse, extrusion, sequestration

Question 14

Increased thoracic (lordosis/kyphosis) is a mechanism of injury for thoracic disc pathology.

Answer 14

Kyphosis

Question 15

If there is pain in thoracic disc pathology, how does it present?

Answer 15

Nonspecific, sensory changes, motor changes, bladder involvement

Question 16

Stiffness & pain in thoracic disc pathology lasts for >___ min.

Answer 16

20

Question 17

What are some neural tension tests that would have positive results in thoracic disc pathology?

Answer 17

Straight leg raise, slump test, femoral nerve stretch, scapular retraction

Question 18

What are some neurological signs seen in thoracic disc pathology?

Answer 18

Nerve root palsy, decreased dermatomic sensation, altered DTRs, upper motor neuron signs

Question 19

What are the 2 surgical options for thoracic disc pathology?

Answer 19

Costotransversectomy, laminectomy

Question 20

Cervical facet dysfunction involves pain-generating source located toward which elements of spine?

Answer 20

Posterior

Question 21

True or False: Primary facet pathology is seen more in younger adults while secondary is seen more in older populations.

Answer 21

False

Question 22

How does stiffness/pain present for someone with cervical facet dysfunction daily?

Answer 22

Morning stiffness –> improve throughout day –> end of day increase stiffness & pain returns

Question 23

True or False: Facet pathology usually has an absence of neurological clinical findings.

Answer 23

True

Question 24

What evidence can be found in radiograph of someone with facet pathology?

Answer 24

Cervical spondylosis, narrowing of IV foramina

Question 25

What condition is characterized by spinal nerve root dysfunction that is from foraminal impingement or inflammatory condition around nerve?

Answer 25

Cervical radiculopathy/radiculitis

Question 26

In population younger than 40 y/o, cervical radiculopathy is hypothesized to occur via what 2 pathologies?

Answer 26

Disc herniation, acute injury

Question 27

What are some common signs & symptoms of cervical radiculopathy besides pain & limited ROM?

Answer 27

Numbness and/or tingling in arm or hand, weakness of hand musculature

Question 28

If the cause is foraminal impingement, which side would the limitations be on?

Answer 28

Towards side of discomfort & pain

Question 29

If it was related to disc or decreased mobility of peripheral nerve trunk and/or brachial plexus, which side would the limitations be on?

Answer 29

Away from side

Question 30

What condition is the breakdown of cervical spine facet articular surfaces with resultant loss of cartilage?

Answer 30

Degenerative joint disease

Question 31

In DJD, there's breakdown of _________ cartilage & thickening & sclerosis of subchondral bone & development of osteophytes/bone spurs.

Answer 31

Hyaline

Question 32

DJD has (uni/bi)lateral pain.

Answer 32

Uni

Question 33

DJD has morning stiffness for the first ___-___ mins.

Answer 33

10-15

Question 34

What can be observed with movement with DJD?

Answer 34

Cracking, crunching, crepitus

Question 35

Forced (flexion/extension) with whiplash makes cervical region vulnerable to anterior muscle strains, anterior disc tears, & posterior compressive injuries.

Answer 35

Extension

Question 36

What are some common signs & symptoms of whiplash?

Answer 36

Neck pain, headache, shoulder pain, anxiety & more

Question 37

True or False: ROM is limited initially in all directions with whiplash.

Answer 37

True

Question 38

There will be guarding & tenderness in _________ posteriorly & the scalenes & SCM anteriorly with whiplash.

Answer 38

Trap

Question 39

Scoliosis is a lateral curvature of spine >___ degrees as measured with Cobb method.

Answer 39

10

Question 40

What is the classification of scoliosis if it occurred before 3 y/o?

Answer 40

Infantile idiopathic

Question 41

What is the classification of scoliosis if it occurred between 3-10 y/o?

Answer 41

Juvenile

Question 42

What is the classification of scoliosis if it occurred after 10 y/o?

Answer 42

Adolescent

Question 43

_________ scoliosis is a result of abnormalities in body that secondarily impact the spine.

Answer 43

Functional

Question 44

_________ scoliosis develops secondary to problems during development of spine.

Answer 44

Neuromuscular

Question 45

_________ scoliosis occurs as body ages because of changes in spinal vertebrae or discs.

Answer 45

Degenerative

Question 46

Which age group is scoliosis most seen in?

Answer 46

Adolescent (2-4% of children)

Question 47

True or False: Girls have a higher ratio than boys for having a 10 degree curve.

Answer 47

False

Question 48

__________ is used for functional scoliosis, mild idiopathic scoliosis, & degenerative scoliosis.

Answer 48

Observation

Question 49

Which type of scoliosis can be corrected?

Answer 49

Functional

Question 50

Which type of scoliosis is only addressed if symptoms are present in structures adjacent to scoliosis?

Answer 50

Degenerative

Question 51

Which type of scoliosis has the greatest chance for poor outcomes?

Answer 51

Neuromuscular

Question 52

Which type of scoliosis will get better without any intervention?

Answer 52

Infantile

Question 53

Which type of idiopathic scoliosis has the highest risk for poor outcomes? What is the first course of action?

Answer 53

Juvenile, bracing

Question 54

Which type of scoliosis is the most common form?

Answer 54

Adolescent idiopathic

Question 55

Describe the treatment for scoliosis curves: <25 degrees, 25-40 degrees, >40 degrees.

Answer 55

<25: no treatment, 25-40: brace, >40: surgery