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Cervical spine, Cervical spine Practical - Coggle Diagram
Cervical spine
Cervical problems
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Cervical discal irritation, disruption, damage
Spain-strain, musculoligamentous damage
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Description of TOS
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- Describe a group of disorders that occur when there is a compression, injury, or irritation of the nerves and/or blood vessels in the lower neck and upper chest area
- Named for the space between your lower neck and upper chest area where there is a group of nerves and blood vessels
- The pain os TOS is sometimes confused with the pain of angina
We can differentiate these two because pain of TOS does not occur or increase when walking. Or pain by raising the affecting arm = TOS
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Cervical Problems
Causes not to miss
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Tumours, cervical spine is rare region but not unseen site of mets from lungs, breast, thyoid
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Cervical
Inspection
- Spinal curve -> smooth lordosis
- Head carriage
- Shoulder position
- Muscle atrophy
- Scapular winging
- Swelling
Palpation
- Interspinous pain
- Facet joints
- Trigger points
- Intervertebral joint play
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Cervical spine Practical
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Nerve damage
III- Axonotmesis
- Axonal degeneration wtth endometrium disruption
IV- Axonotmesis
- Axonal degeneration with endoneurium and perineurium disruption
II- Axonotmesis
- Axonal degeneration without endometrium disruption
V- Neurotmesis
- Complete axonal degeneration
I- Neuropraxia
- Focal demyelination, nerve conduction loss without axonal degeneration
Axon regeneration:
- 1mm per day
- 1cm per week
- 2,5 to 3 cm per month
Mononeuropathies
Tunnel syndromes
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Chronic nerve compression = symptoms of pain, numbness, paraesthesia, and paresis
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In mixed nerve, sensory symptoms and signs usually appear before motor signs
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Most common neuropathy
Median nerve (C5-C8)
Motor:
- Abd pollicis brevis
- Opponens policis
- Pronator
- Flexor carpi radialis
O:
- Phalen's
- Reverse phalen's
- Tinel's (carpal tunnel)
- ULTT (median)
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Ulnar nerve (C8-T1)
Motor:
- Add pollicis
- Finger add-abd
- Flexor carpi ulnaris
O:
- Froment's
- Tinel's (cubital tunnel, Guyon's canal)
- ULTT (ulnar)
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Radial nerve (C5-T1)
Motor:
- Triceps
- Brachioradialis
- Wrist extensor
- Finger extensor
- Supinator
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O:
- Tinel's (supinator: fronde arcade)
- ULTT (radial)
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Less common neuropathies
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Dorsal scapular nerve
Innervate rhomboids, levator scapula
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Musculocutaneous nerve
Innervates biceps, brachial, coracobrachialis
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Plexopathies
Orthopaedic tests:
- Adson's
- Modified adson's
- Hyperabduction test
- Shoulder depression
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