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211 exam 2
Cervical Spine
| Question | Answer |
|---|---|
| how many cervical vertebra are there? | 7 |
| Transverse processes contain foramen for ___ ____ | vertebral artery |
| how are facet joints aligned in the C spine? | frontal plane at 45 degree angle |
| movements of the cervical joints | FLEX / EXT Lateral side bending Rotation |
| what motions are available at the atlas? | nodding |
| what motions are available at the axis? | 50% of rotation |
| where are transverse processes found? | between angle of mandible and mastoid process |
| where is C2 spinous process found? | first bump inferior to skull |
| what level is C3 at? | level of hyoid bone |
| what level is C4/5 at? | level of thyroid cartilage |
| what level is C6 at? | level of cricoid cartilage |
| C7 | vertebra prominent |
| cervical muscles affected by shifting forward | Levator Semispinalis capitis |
| cervical muscles affected by shifting backward | longus colli and SCM |
| cervical muscles affected by shifting lateral | scalenes, splenius cervicis |
| transverse ligament function | functions to prevent anterior displacement of the atlanto-axial joint |
| transverse ligament characteristics | very strong ligament; in most cases the odontoid will fracture before the ligament tears. It is covered with articular cartilage to allow articulation with the odontoid process |
| alar ligament location | Attaches the dens of C2 to the occipital condyles. |
| what are the strongest ligaments that stabilize the craniocervical junction | alar ligament and transverse ligament |
| ligamentum nuchae location | Runs from the external occipital protuberance down to the spinous process of C7. |
| function of ligmentum nuchae | Limits flexion and provides an attachment for the Upper Trap and splenius capitis |
| important parts of pt history for C spine | Exact mechanism of injury [traumatic] Activities that may be contributing to overuse [non-traumatic] Questions on when pain occurs |
| tests for C spine | X-Ray CT Scan MRI |
| additional questions for C spine | Prior level of function Pain Level Level of function with ADL's Social/Home Situation Equipment needs |
| PROM/ AROM for C spine | FLEX / EXT Rotation Lateral Flex |
| MMT for cervical spine | FLEX / EXT, Rotation, Lateral Flex Rotator Cuff Scapular Stabilizers |
| myotomes | Group of muscles which are innervated by a single spinal nerve root |
| C5 myotome | Shoulder ABD, elbow flexion |
| C6 myotome | Wrist extension, elbow flexion |
| C7 myotome | elbow extension and wrist flexion |
| C8 mytome | finger flexion |
| T1 myotome | finger ABD and ADD |
| dermatomes | Areas of your skin that rely on nerves that connect to your spinal cord |
| C5 dermatome | lateral bicep and antecubital fossa |
| C6 dermatome | lateral forearm and thumb |
| C7 dermatome | middle of forearm and pointer, middle, and ring finger |
| C8 dermatome | lower medial forearm and pinky |
| T1 dermatome | medial bicep, antecubital fossa and forearm |
| C5 reflex testing | biceps |
| C6 reflex testing | brachioradialis |
| C7 reflex testing | triceps |
| alar ligament test | side bend and rotate rotation produces greater measurable affect than side bend |
| VA insufficiency test | Speak with your patient; positive signs include dizziness, dysarthria, drop attacks and nystagmus |
| purpose of spurling test | Used to provoke the patient’s symptoms of neck pain with radiating pain or paresthesis down the arm |
| how to perform spurling test | Done by narrowing the intervertebral foramen. Patient sitting with neck in extension, lateral bending to the affected side with axial compression (only if symptoms are not produced). |
| Adson's test purpose | for thoracic outlet syndrome |
| how to perform Adson's test | Shoulder ER, slight ABD and EXT. Palpate radial pulse. Then extend head and rotate towards affected sign. |
| positive Adon's test | Positive sign is reproduction of symptoms or decreased radial pulse |
| carpal tunnel tests | phalens and tinnels |
| dural mobility test | slump test |
| positive slump test | shooting pain, numbness or burning. Can indicate a herniated disc or nerve root impingement. |
| stages of disc injury | Herniation Protrusion Extrusion > Surgery Sequestration |
| are disc injuries common in C spine? | not as common |
| where do disc injuries most commonly occur? | C6-C7 |
| signs and symptoms of intervertebral disc lesions | Peripheral neuropathy Forward head posture Increase w/ flexion Decrease w/ extension |
| treatment for intervertebral disc lesions | Modalities, Massage Traction Cervical Retraction Patient Education Kinesthetic Training for Posture Correction Progression for endurance, strength in subacute phase Progression in intensity, function in chronic |
| traction parameters for disc | No longer than 10 min – sustained No longer than 15 min – intermittent |
| cervical retraction for disc | Supine, no pillow Gentle nod, neck flattens Neck positioned in midline (no rotation) |
| ___ pathology and ___ joint are linked | disc, facet |
| ____ can form at disc margins leading to facet joint pathology and pain | Osteophytes |
| treatment for facet joint dysfunction | Postural education Body mechanic education Traction Trunk stabilization Exercise Bracing, injections Manipulation/mobilization Surgical Intervention Discectomy, laminectomy, foraminectomy Fusions if unstable |
| tx in acute phase of acceleration injury | Pt education on posture to decrease stress on surrounding mms Massage Modalities Cervical traction Indirect motion Try to get them back to pre-injury activities as soon as possible without causing pain |
| tx in subacute phase of acceleration injury | PROM, AROM (light) Laser Manual Therapy Massage Postural strengthening: scapulothoracic Scap squeezes Shoulder shrugs |
| signs and symptoms of cervical and upper trap mm guarding | pain, stiffness, tightness; sudden onset |
| modalities for cervical and upper trap mm spasm/guarding | high volt, EMG/Biofeedback |
| pt education for cervical and upper trap mm guarding | ergonomic assessment, body mechanics |
| exercises for cervical and upper trap mm guarding | Relaxation techniques Shoulder shrug hold w/ overpressure General exercise and strength training beneficial for chronic issues |
Created by:
bdavis53102
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