Ch 11 Eval. Ortho

Description:	Chapter 11- The cervical spine
Category:	Sports Medicine
Created by:	gunrock on 2009-02-07

Question	Answer
What is the primary function of the atlas' two concave facet surfaces?	Supports the weight of the skull
What joint is formed by the atlas and the head?	Atlanto-occipital joint
What is the name of the superior projection of the axis?	The dens
What forms the atlanto-axial joint?	The articulation between the anterior arch of the atlas and the dens
What passes through the unique cervical transverse foramen?	The vertebral arteries
What are the five main ligaments of the cervical spine?	ant. and post. longitudinal ligaments(reinforce spinal column,run from cervical to the lumbar), ligamentum nuchae(triangular septum is broad area for muscle attachment),interspinous ligaments(occupy space between foramen), ligamentum flavum(connect lamina
What nerve roots form the brachial plexus?	C5-T1
What are the 3 trunks of the brachial plexus?	Upper (C5 and C6), Middle (C7), Lower (C8 and T1)
How many divisions are there in the brachial plexus?	6. One anterior and one posterior from each trunk
What are the 3 cords of the brachial plexus?	Lateral (anterior upper and middle), Posterior (posterior from all three divisions), and Medial (anterior lower)
What are the 4 major extrinsic muscles of the cervical spine?	Trapezius (upper one-third), Levator scapulae, Sternocleidomastoid, and Scalenes (anterior, middle, posterior)
What 4 things should be inspected when dealing with cervical injury?	Cervical curvature, Position of the head on the shoulders, Bilateral soft tissue comparison, and Level of the shoulders
What 7 structures should be palpated on the anterior cervical spine?	Hyoid bone, Thyroid cartilage, Cricoid cartilage, Sternocleidomastoid, Scalenes, Carotid artery, Lymph nodes
What 4 structures should be palpated on the posterior and lateral cervical spine?	Occiput and superior nuchal line, Transverse processes, Spinous processes, Trapezius
Define hyperreflexia.	Increased action of the reflexes
What is the name of the most superficial passage of the brachial plexus?	Erb's point
What three nerve roots of the brachial plexus have reflexes and where can they be tested?	C5 (biceps brachii), C6 (brachioradialis), C7 (triceps brachii)
What defines a positive Babinski test?	The great toe extends and the other toes splay.
What does a positive Babinski test implicate?	Upper motor leison, especially in the pyramidal tract, caused by brain or spinal cord trauma or pathology
What defines a positive Oppenheim test?	The great toe extends and the other toes splay or the patient reports hypersensitivity to the test.
What does a positive Oppenheim test implicate?	Upper motor neuron leison caused by brain or spinal cord trauma or pathology
What are the pain characteristics for a brachial plexus trauma?	Pain in the trapezius and deltoid, radiating into the arm.
What is the MOI for a Brachial plexus stretch?	Lateral bending of the cervical spine and depression of the opposite shoulder, resulting in tension on the brachial plexus; symptoms occur on the side opposite the lateral bend.
What is the MOI for a Brachial plexus compression?	Lateral bending of the cervical spine, resulting in the entrapment of the cervical nerve roots; symptoms occur on the side toward the lateral bend.
What are the pain characteristics for a cervical nerve root compression injury?	Commonly lower cervical vertebrate (C4 to C7); symptoms possibly radiating into the trapezius, scapula, shoulder, arm, wrist, and hand.
What is the MOI for a cervical nerve root compression injury?	Compression or irritation of the associated nerve root (or roots).
What defines a positive Brachial plexus traction test?	Pain radiating through the upper arm.
What does a positive Brachial plexus traction test implicate?	Radiating pain on the side of opposite the lateral bending: tension (stretching) of the brachial plexus. Radiating pain on the side toward the lateral bending: compression of the cervical nerve roots between two vertebrate.
Define herniation.	The protrusion of a tissue through the wall that normally contains it.
Define patency.	The state of being freely open.
Define nystagmus.	An uncontrolled side to side movement of the eyes.
What defines a positive shoulder abduction test?	Decrease in the patient's symptoms secondary to decreased tension on the involved nerve root.
What does a positive shoulder abduction test implicate?	Herniated disc or nerve root compression.
What defines a positive cervical compression test?	The patient experiences pain in the upper cervical spine, upper extremity, or both.
What does a positive cervical compression test implicate?	Compression of the facet joints and narrowing of the intevertebral foramen resulting in pain.
What defines a positive spurling test?	Pain radiating down the patient's arm.
What does a positive spurling test implicate?	Nerve root impingement by narrowing of the neural foramina.
What defines a positive cervical distraction test?	The patient's symptoms are relieved or reduced.
What does a positive cervical distraction test implicate?	Compression of the cervical facet joints and/or stenosis of the neural foramina.
What defines a positive vertebral artery test?	Dizziness, confusion, nystagmus, unilateral pupil changes, nausea.
What does a positive vertebral artery test implicate?	Occlusion of the cervical vertebral arteries.