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WVSOM -- opp1
WVSOM -- OPP1 -- Cervical Spine Dysfunction
| Question | Answer |
|---|---|
| What is the function of cervical vertebrae (3)? | serve to stabilize and support the head. Permit motion of the head and neck. Provide protection and housing for the cervical spinal cord and nerve roots and vertebral artery. |
| What kind of symptoms occur with cervical spine dysfunction? | head, neck and upper extremity |
| What is the most common mechanism of injury for neck pain? | MVA |
| What does optimum pain management require for neck pain? | requires identification and appropriate treatment of somatic dysfunction |
| What kind of curve is the cervical spine? | lordotic curve |
| What do uncinate processes do and where are they? | C3-7. Add support to cervcial spine and helps prevent herination |
| What is the Occiptal antlantal segment? | C0-C1 |
| What is the antantal-axial segment? | c1-2 |
| What is the 2 functions of the cervical muscles? | stabilize spine and control effects of gravity. Integrate and C-Spine movement with thoracic rib, and upper extremity motions. |
| What are the two major muscular groups of the cervical spine? | Flexors and extensors |
| Where do the cervical nerves exit? | above corresponding cervical vertrae until C8 where the nerve exits below the 7th vertebrae. |
| What is the most common herniation in cervical spine? | C5-C6 disc (C6 root) |
| What is the Foramen transversaruim? | vertebral artery found in C1-7 |
| Where are bifid spinous processes found? | C2-C6 |
| What enables flexion and extension? | bilaterally muscle activity |
| What enables sidebendinga nd rotation? | muscles acting unilaterally |
| Do Fryette’s mechanics apply to the cervical spine? | no |
| What is the primary roation of the Antlantal Axial segment? | rotation |
| What is the primary movement of the Occipital-antlantal segment? | flexion and extension |
| What happens to rotation in the OA joint when it is sidebent? | rotation in the OPPOSITE direction |
| What is the degree of articulation of facets on the oblique plane? | 45degrees |
| How is rotation affected when it is sidebent for typical cercvical vertebrae? | same side |
| Where does most cervical sidebending occur? | lower cervical |
| What do facets do during typical flexion? | open |
| What do facets do during typical extension? | close |
| What kind of dysfunction is seen in AA joint? | entirely rotation |
| How much flexion and extension is at OA joint? | 50% |
| How much rotation is at AA joint? | 50% |
| How much rotation and flexion/extension is found in the typical cervical? | 50% |
| What are the 4 things done during examination of the neck? | 1. Posture and movement. 2. Rotation, lateral bending, flexion and extension. 3. Palpation. 4. Assess for radiculopathy |
| What is dorsokyphosis? | depression, upper-crossed postural abnormality. Seen with advanced age |
| What may sluggish movement indicate? | sfibromyalgia, OA, cervical strain |
| What is torticolis? | acute muscle spasm, possible HNP |
| What is normal rotation? | 80 degrees |
| What is normal sidebending? | greater than 45 degrees |
| What is normal flexion? | greater than 50 degrees |
| What is normal extension? | greater than 60 degrees |
| What is first movement to show defecit? | rotation |
| What is the most sensitive indicator to pathology intrinsic to the neck? | loss of rotation |
| What should you do if angle of rotation is less than 90 degrees? | neurological exam of upper extremities as well as x-rays. |
| What is tested with passive range of motion? | rotation, sidebending, flexion, and extension |
| What should you consider if countour is malaligned? | rotation, facet dislocation and fracture |
| Where is osteoarthritis usually seen? | C5-C6 |
| What may be seen if there is osteoarthritis? | tenderness, stiff and possibly enlarged. |
| What do you palpate with bone? | bony tenderness, spinous processes and facet joint |
| What do you palpate with muscle? | paraspinous muscle, trapezius muscle |
| What is the most commonly irritated neck muscle? | trapezius |
| What does the trapezius muscle do in respects to the neck? | attaches to all 7 spinous processes to distal acromion process |
| What is spurling maneuver? | tap or press on top of head in with extension and sidebending |
| What innervates the deltoid m.? | c5 |
| What innervates wrist extensors? | c6 |
| What innervates finger flexors? | c8 |
| What innervates interossei mm. | T1 |
| What innervates biceps? | c5 |
| What innervates brachioradialis? | c6 |
| What innervates triceps? | c7 |
| What is VAD? | vertbral artery dissection. Unpredictable, rare complication of neck thrusts. 1/20,000 |
| How do vertebral arteries angulate? | angulates 3 times at 90 degrees around the atlas as it ascends into the cranium thru the foramen magnum |
| What is Wallenberg’s Test? | patient is supine and flexion, extension, etension with rotation right and extension with rotation left are held for 10 seconds |
| What is a positive Wallenberg’s Test indicate? | nystagmus, dizziness, light headedness, visual disturbance |
| What is contraindicated with a positive wallenberg’s test? | HVLA |
| What does Wallenberg’s Test test? | vertebral aretery problems |
| What are the symptoms of cervical radiculopathy? | paracervical tenderness with abnormal upper extremity exam. Loss of full ROM especially in rotation with positive spurling sign. Vertical traction will provide relief. |
| 90% of radicular symptoms are due to ? | cervical OA |
| You evaluate a patient who has limited sidebending to left which is worse in extension at C5. What is the diagnosis? | FRS (r) |
| On physical examination you not mild noss of sensation in the region of the thumg, +1/+2 reflexes at brachioradialsi and 4/5 strentth in wrist extension. The affected nerve root exits the C-spine? | below C5 |
Created by:
tjamrose
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