Cervical Spine Injuries

Myotome and Dermatome Testing Nerve Root Level Sensory TestingMotor TestingReflex Testing C1-C2Front of faceNeck flexionN/A C3Lateral face and skullLateral flexionN/a C4SupraclavicularShoulder shrugN/A C5Lateral shoulder/upper armShoulder abductionBicipital (musculocutaneous) C6Lateral lower arm and hand (thumb and index finger) Elbow flexion and wrist extension Brachialradial (musculocutaneous) C7Palmar aspect of hand – middle 3 fingers Elbow extension and wrist flexion Triceps (radial) C8Medial lower arm and handFinger flexion and thumb extension N/A T1Medial elbow and upper armFinger abductionN/A

Cervical Spine Injuries Acute injuries typically occur in contact and collision sports or car accidents Chronic injuries develop from poor postural habits, faulty body mechanics, repetitive movements, decreased flexibility, and weak muscles Usually involved multiple structures so identifying one source is not possible

Cervical Strains Strain = injury to a muscle or tendon MOI – Muscles: S&S –

Acute Torticollis Commonly called stiffneck or wryneck MOI– S&S –

Cervical Sprain Commonly called whiplash Sprain – injury to a ligament or non-contractile tissue MOI – S&S –

Spinal Stenosis Narrowing of the spinal canal or intervertebral foramen Usually from degeneration associated with aging or can be congenital S&S: – can be asymptomatic – Neurological pain – Increased leg pain with standing that resolves by sitting (increases available space in spinal canal) – Can be ipsilateral (foramen) or bilateral (canal)

Cervical Disk Injuries Several types of disc injuries: Protrusion – Prolapse -

Cervical Disk Injuries (cont.) Several types of disc injuries: Extrusion – Sequestrated -

Cervical Disk Injuries (cont.) MOI – S&S –

Degenerative Disc Disease Called cervical spondylosis MOI – S&S –

Facet Joint Dysfunction Cervical instability MOI - from acute trauma (whiplash) or repetitive motions S&S – posterior neck pain in paraspinal region, pain with A and PROM during extension and rotation of the c-spine, clicking or catching; referred pain but no radicular pain

Brachial Plexus / Neuropraxia Commonly called burners, stingers, pinched nerves MOI – S&S -

Thoracic Outlet Syndrome Caused by pressure on the trunks and medial cord of the brachial plexus, the subclavian artery, or subclavian vein (neurovascular bundle) MOI – S&S -