Cervical, Thoracic, and TMJ Musculoskeletal Physiotherapy Flashcards

Practice flashcards covering musculoskeletal clinical anatomy, conditions, and assessment procedures of the cervical spine, thoracic spine, and temporomandibular joint.

Atlas (C1)

The 1st cervical vertebra which supports the weight of the head through the atlanto-occipital joint ($C0-C1$) and lacks a true vertebral body or spinous process.

Axis (C2)

The 2nd cervical vertebra characterized by the Dens (odontoid process) which articulates with the Atlas to form a pivot joint for skull rotation.

Trigeminocervical Nucleus

The brain region where afferents of the $C1-C3$ nerve roots converge with afferents of the trigeminal nerve, forming the pathophysiological basis for cervicogenic headaches.

Cervical Myelopathy

Compression of the spinal cord resulting in bilateral neurological symptoms, ataxia, bladder/bowel dysfunction, and hyperreflexia.

Cervical Radiculopathy

Compression of a nerve root as it exits the cervical spine, leading to unilateral neurological loss in power, sensation, or reflexes (myotomes/dermatomes).

Cervical Arterial Dissection (CAD)

A tear in the wall of the vertebral or internal carotid artery, presenting with sudden, unfamiliar neck pain or headache and carrying high risk for stroke.

Vertebrobasilar Insufficiency (VBI)

A decrease in blood flow to the posterior portion of the brain typically caused by atherosclerosis or spondylosis, provoked by specific neck movements.

5 D's and 3 N's

The clinical mnemonic for screening VBI symptoms: Dizziness, Diplopia, Dysarthria, Dysphagia, Drop attacks, Nausea, Numbness (perioral), and Nystagmus.

Craniovertebral Instability (UCI)

Excessive movement at the $C1-C2$ vertebrae resulting from bony or ligamentous abnormality, often associated with Down syndrome (10-20% of individuals) or trauma.

Hangman's Fracture

A traumatic fracture involving both pedicles or the pars interarticularis of the Axis ($C2$).

Migraine with Aura

Recurrent attacks of unilateral, fully-reversible visual or sensory symptoms that develop gradually and are followed by a headache.

Cervicogenic Headache (CGH)

A secondary headache caused by non-traumatic disorders of the cervical spine, characterized by unilateral pain starting in the neck and spreading to the head.

Stomatognathic System

The functional system of bones, joints (TMJs), muscles, and tissues including the skull, mandible, hyoid, and teeth used for speech and mastication.

Retrodiscal Pad

A vascular, richly innervated bilaminar tissue behind the TMJ disc; its superior portion is elastic while its inferior portion is non-elastic.

Myalgia (TMD)

Masticatory muscle pain modified by jaw movement or function, confirmed by palpation of the temporalis or masseter muscles.

ADDwR (Anterior Disc Displacement with Reduction)

A TMJ disorder where the disc is displaced but returns to its normal position during opening, typically causing a click.

ADDwoR (Anterior Disc Displacement without Reduction)

Known as 'Closed Lock,' this TMJ condition presents with limited opening ($<25-30\,mm$) and absence of clicking.

Treatment Direction Technique (TDT)

A specific movement strategy chosen for treatment based on its immediate positive impact on a patient's symptoms during assessment.

Symptom Modification Procedure (SMP)

A test used during the physical examination to determine if specific movements or external supports can immediately change a patient's symptoms.

Rotator Cuff Related Shoulder Pain (RCRSP)

The most common clinical presentation of shoulder pain, encompassing rotator cuff tendinopathy and subacromial impingement symptoms.

External Subacromial Impingement

Mechanical encroachment of the soft tissue (bursa, RC tendons) in the subacromial space, typically causing a painful arc between $60-120^{\circ}$ of abduction.

Bankart Lesion

An injury involving damage to the labral attachment with the glenoid, often following a traumatic anterior shoulder dislocation.

AMBRI (Shoulder Instability)

An acronym for Atraumatic Multidirectional instability with Bilateral laxity, typically managed with Rehabilitation (exercise) and occasionally inferior capsule shift surgery.

SLAP Lesion

A Superior Labrum Anterior to Posterior tear of the labrum, affecting the primary attachment site of the long head of the biceps (LHBB).

Scheuermann's Disease

Juvenile osteochondrosis of the spine leading to structural thoracic kyphosis, defined by $>5^{\circ}$ of anterior vertebral wedging in three or more adjacent vertebrae.

Ankylosing Spondylitis (AS)

An inflammatory spondyloarthropathy hereditarily linked to HLA-B27, resulting in morning stiffness ($>1\,hour$) and potential spinal fusion ('bamboo spine').

T4 Syndrome

A clinical pattern involving upper extremity paraesthesia and pain, hypothesized to arise from autonomic nervous system pathways linked to upper thoracic hypomobility.

Thoracic Outlet Syndrome (TOS)

Neurovascular compression of the brachial plexus or subclavian vessels within the scalene triangle, subclavicular space, or subpectoral space.

Costochondritis

Inflammation of the costochondral junctions causing chest wall pain without local swelling, often systemic in nature.