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Questions and Answers
Which vertebra in the cervical spine is also known as the Atlas?
Which vertebra in the cervical spine is also known as the Atlas?
Which cervical vertebra is directly below the Axis?
Which cervical vertebra is directly below the Axis?
How many cervical vertebrae are labeled in the diagram?
How many cervical vertebrae are labeled in the diagram?
What is the main function of the cervical spine?
What is the main function of the cervical spine?
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Which of the following is the second cervical vertebra called?
Which of the following is the second cervical vertebra called?
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Which of the following is a cause of nerve root entrapment due to narrowing of the intervertebral foramina?
Which of the following is a cause of nerve root entrapment due to narrowing of the intervertebral foramina?
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What is a potential outcome of degenerative disc disease (DDD) with respect to nerve roots?
What is a potential outcome of degenerative disc disease (DDD) with respect to nerve roots?
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Which condition is not involved in causing nerve root entrapment?
Which condition is not involved in causing nerve root entrapment?
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How can osteophytes contribute to nerve root entrapment?
How can osteophytes contribute to nerve root entrapment?
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Which pathology is characterized by the protrusion or extrusion of the intervertebral disc that may lead to nerve root entrapment?
Which pathology is characterized by the protrusion or extrusion of the intervertebral disc that may lead to nerve root entrapment?
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Which spinal cord segments are likely involved in a patient presenting with radiating pain, numbness, and tingling in the upper extremity?
Which spinal cord segments are likely involved in a patient presenting with radiating pain, numbness, and tingling in the upper extremity?
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Muscle weakness and atrophy are common in which spinal cord segment injuries related to the upper extremity?
Muscle weakness and atrophy are common in which spinal cord segment injuries related to the upper extremity?
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Patients with cervical spinal cord segment impairments may experience difficulty in which of the following activities?
Patients with cervical spinal cord segment impairments may experience difficulty in which of the following activities?
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Which of the following is NOT a common symptom associated with upper extremity involvement in cervical spinal cord impairments?
Which of the following is NOT a common symptom associated with upper extremity involvement in cervical spinal cord impairments?
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What types of activities would be most challenging for someone with impairments in the C5-C8 spinal cord segments?
What types of activities would be most challenging for someone with impairments in the C5-C8 spinal cord segments?
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What is a major limitation of epidural steroid injections for managing radicular symptoms?
What is a major limitation of epidural steroid injections for managing radicular symptoms?
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Which surgical procedure involves removing part of the vertebra to relieve pressure on the spinal cord?
Which surgical procedure involves removing part of the vertebra to relieve pressure on the spinal cord?
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What is the primary goal of physical therapy (PT) in conservative management?
What is the primary goal of physical therapy (PT) in conservative management?
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How long do the effects of an epidural steroid injection typically last?
How long do the effects of an epidural steroid injection typically last?
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Which of the following is NOT listed as a pain management technique in conservative management?
Which of the following is NOT listed as a pain management technique in conservative management?
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What should postural education and training aim to address in conservative management?
What should postural education and training aim to address in conservative management?
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Which option is not considered a pharmacological intervention for medical management?
Which option is not considered a pharmacological intervention for medical management?
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Which of the following treatments is aimed at addressing the patient's impairments in conservative management?
Which of the following treatments is aimed at addressing the patient's impairments in conservative management?
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Which surgical procedure specifically targets the removal of a herniated disc?
Which surgical procedure specifically targets the removal of a herniated disc?
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Which modality is included in the pain management techniques that involve mechanical intervention?
Which modality is included in the pain management techniques that involve mechanical intervention?
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Which part of the spine does Cervical Degenerative Disc Disease affect?
Which part of the spine does Cervical Degenerative Disc Disease affect?
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What does the highlighted area in the image represent?
What does the highlighted area in the image represent?
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Which vertebrae are typically involved in Cervical Degenerative Disc Disease?
Which vertebrae are typically involved in Cervical Degenerative Disc Disease?
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What condition is indicated by the degeneration of discs in the cervical spine?
What condition is indicated by the degeneration of discs in the cervical spine?
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Which symptom is common for individuals suffering from Cervical Degenerative Disc Disease?
Which symptom is common for individuals suffering from Cervical Degenerative Disc Disease?
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At which stage of disc degeneration is the disc entirely outside of its original position without fragments migrating away from it?
At which stage of disc degeneration is the disc entirely outside of its original position without fragments migrating away from it?
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Which stage of disc degeneration is best characterized by the disc still being intact and starting to bulge outward?
Which stage of disc degeneration is best characterized by the disc still being intact and starting to bulge outward?
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In which depiction (A, B, C, or D) is the disc bulging but not pressing on the spinal cord?
In which depiction (A, B, C, or D) is the disc bulging but not pressing on the spinal cord?
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What differentiates the extrusion stage from the sequestration stage in terms of disc position?
What differentiates the extrusion stage from the sequestration stage in terms of disc position?
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Which image depicts a disc that is completely out of its position and pressing on the spinal cord?
Which image depicts a disc that is completely out of its position and pressing on the spinal cord?
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What primarily contributes to the loss of disc height during the normal aging process?
What primarily contributes to the loss of disc height during the normal aging process?
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Which of the following best describes an extruded disc herniation?
Which of the following best describes an extruded disc herniation?
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What condition is associated with an increased risk for tears on the annulus during the degeneration of a disc?
What condition is associated with an increased risk for tears on the annulus during the degeneration of a disc?
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How is a disc condition classified when the nucleus pulposus herniates through the annulus?
How is a disc condition classified when the nucleus pulposus herniates through the annulus?
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What happens to the disc during a sequstrated herniated disc?
What happens to the disc during a sequstrated herniated disc?
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Which of the following disc conditions is likely to result in both impaired motor function and sensation if severe enough?
Which of the following disc conditions is likely to result in both impaired motor function and sensation if severe enough?
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Which movement are patients most likely to avoid to minimize pain due to cervical disc disease?
Which movement are patients most likely to avoid to minimize pain due to cervical disc disease?
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Which position is most preferred by patients with cervical disc disease to reduce discomfort?
Which position is most preferred by patients with cervical disc disease to reduce discomfort?
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Which type of disc degeneration involves the protrusion of the disc material without rupture?
Which type of disc degeneration involves the protrusion of the disc material without rupture?
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In the context of cervical disc disease, which of the following statements accurately describes the preferred movements or positions of patients?
In the context of cervical disc disease, which of the following statements accurately describes the preferred movements or positions of patients?
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What is the primary difference between a discectomy and a spinal fusion?
What is the primary difference between a discectomy and a spinal fusion?
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Which surgical procedure would most likely be recommended to permanently stabilize the spine in severe scoliosis?
Which surgical procedure would most likely be recommended to permanently stabilize the spine in severe scoliosis?
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Which of the following symptoms is most directly addressed through a discectomy surgery?
Which of the following symptoms is most directly addressed through a discectomy surgery?
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What is a potential risk associated specifically with spinal fusion surgery?
What is a potential risk associated specifically with spinal fusion surgery?
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What is typically used during a spinal fusion to promote bone growth between the fused vertebrae?
What is typically used during a spinal fusion to promote bone growth between the fused vertebrae?
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Study Notes
Cervical Radiculopathy
- The cervical spine consists of vertebrae C1-C8, with C1 labeled as the "Atlas" and C2 as the "Axis".
- Nerve root entrapment occurs due to narrowing of intervertebral foramina and/or the spinal canal, caused by:
- Disc pathology (extrusion and/or protrusion)
- Degenerative disc disease (DDD)
- Osteoarthritis (OA)
- Osteophytes
- Facet joint degeneration or hypertrophy
Clinical Presentation
- Impairments:
- Radiating pain, numbness, and tingling
- Muscle weakness and atrophy
- Activity limitations and participation restrictions:
- Difficulty with ADLs involving the upper extremity (UE)
- Impaired bathing, dressing, and toileting abilities
- Difficulty with writing, grasping, feeding, and driving
Medical Management
- Pharmacological interventions:
- NSAIDs
- Epidural steroid injection (reduces inflammation, provides temporary relief for 3-6 months)
- Surgical procedures:
- Decompression surgery (laminectomy, discectomy, fusion)
Conservative Management
- Goals of physical therapy:
- Centralize symptoms
- Manage pain using heat, cold, ultrasound, electrical stimulation, and mechanical traction
- Postural education and training
- Stretching and resistance training to address patient impairments
Cervical Degenerative Disc Disease
- Pathophysiology:
- Degeneration of the disc as part of the normal aging process
- Loss of disc height due to nucleus pulposus (NP) dehydration
- Disc becomes stiffer, and the annulus becomes weaker (increasing the risk of tears)
- Types of disc degeneration:
- Protrusion (aka prolapse)
- Herniated:
- Extruded: NP outside the annulus, limited by the posterior longitudinal ligament
- Sequestrated: NP outside the posterior longitudinal ligament and into the central canal
Disc Degeneration Stages
- Healthy disc
- Prolapse: disc starts to bulge out
- Extrusion: disc is entirely outside its original position
- Sequestration: disc is completely broken, and some of its content has migrated
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Description
Identify the different components of the cervical spine, including the vertebrae and spinal nerves. This quiz is based on a labeled diagram of the cervical spine, from C1 to C8.
