Ortho 2
Terms
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- Most neck rotation occurs
- - at the atlas and axis
- C3-7 have how many joints each?
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- 3
- disc in the front and paired facet joints in the back - Spurling test
- Applying downward pressure while the subject laterally flexes the head. Pain into the extremity toward the same side during compression is a positive sign for nerve root compression. Pain felt in the opposite side is called a REVERSE SPURLING’S SIGN
- Distraction test
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- distract (pull up) the subjects' head from the trunk
- positive = existing complaints disappear - Oblique views of the neck woudl be taken if ...
- suspected foraminal narrowing in degenerative diseases
- Acute Disc herniation
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- neck pain, headache, dermatome pain and referred pain to shoulder and medial scap
- BABINSKI SIGN
- fasciculations
- loss of deep tendon reflexes
- MRI needed for DX
- Tx= foam collar, pain meds, surgery last resort - Cervical Spondylosis
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- stabbing pain in border of arm, neck pain/stiffness
- CHRONIC SUBOCCIPITAL HEADACHE
- loss of cervical flexibility, myelopathy
- Xray shows ostophytes, disc space narrowing, facet disease
- neck collar may halt progression
- if very serious = decompressive laminectomy - Osteoarthritis
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- asymtomatic but may cause diffuse neck pain, complainst of unsteady walking, urinary frequency and urgency, ELECTRICAL SHOCK SENSATIONS
- Xray shows ostephyte formation anteriorly
- cervical collar, rest, analgesics, or PT - Thoracic outlet syndrome
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- pain, numbness, and or swelling depending on stucture that is compromised
- pain radiates
- paresthesias are common and distributed to the volar aspect of the FOURTH AND FIFTH digits
- sensory symptoms may be aggrevated at night
- Xray - may show CERVICAL RIB PATHOLOGY
- MRI may show impaired blood flow
- Tx = local heat, analgesics, muscle relaxants and exercise
- surgery only if vascular or neural pathways are severely impaired - Torticalis
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- may follow URI or trauma in children
- mass may be felt in SCM
- head rotated to one side
- TX= active ROM exercises - Erbs palsy
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- upper trunk nerve injury of brachial plexus
- MOST COMMON BIRTH RELATED NEUROPRAXIA
- lesion of C5 and 6 roots, often from difficult birth
- arm hangs at side internally rotated and extenteded at the elbow
- may also becaused by a cervical rib
- therapy can help if not severe
- if no improvement by 6 mon, should have surgery and nerve grafting - Dermatomes
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C5 – shoulder & lat. arm
C6 – lat. forearm & thumb
C7 – middle finger
C8 – little finger
T1 – medial forearm & elbow - Myotomes
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C5 – elbow flexors
C6 – wrist extensors
C7 – elbow extension
C8 – finger flexors
T1 – finger abductors -
Spondylosis
Spondylolysis
Spondylolithesis -
Spondylosis – degenerative change, osteophytes, disc space changes
Spondylolysis – pars interarticularis defect
Spondylolithesis – slipping of one vertebra on another