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PHTY APPB > Advanced Motor Control: Cervical Spine > Flashcards

Advanced Motor Control: Cervical Spine Flashcards

1
Q

What positions to consider when assessing neck?

A

Standing
Sitting
Supine
Prone

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2
Q

What makes up your physical assessment?

A 
Posture: dynamic and static
Balance
Other joint screen 
AROM: repeated/sustained, motor control
Articular movement: Mobes 
Special test: VBI, CVI 
Sensorimotor/vestibular: JPE, oculomotor, SPNT
Neurological: cranial, UL reflex, power, sensation 
Sensory: ULTT, CCFT 
Motor

Review table and reproduce

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3
Q

What is the aim of assessment in C/sp?

A
  • Triage classification
  • Source of pain
  • Sub-classification
  • Impairment identification
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4
Q

Where could pain originate from if it is primary nociceptive?

A

Any pain sensitive somatic structure (e.g. ligament, nerve, muscle, facet joint, disc)

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5
Q

What can NSNP consist of?

A
  • Movement/ articular impairment: ROM, PAIVM, PPIVM
  • Motor control impairment
  • Sensori-motor
  • Sensory/pain: PPT, CPT, NTPT
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6
Q

What are the roles of the deep and superficial muscles?

A

Deep muscles used for segmental motion control

Superficial muscles provide torque while deep muscles prevent buckling

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7
Q

Proprioception: Describe the propriceptive qualities of neck compared to rest of the body

A

High density of muscle spindles in the neck

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8
Q

How do neck reflexes act?

A
  • Receive afferent input: vision, proprioception, posture
  • Sensorimotor control to and from CNS
  • Cervico-collic reflex (CCR), Cervico-ocular reflex (COR), tonic neck reflex (TNR)
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9
Q

How do neck reflexes act?

A
  • Receive afferent input: vision, proprioception, posture
  • Sensorimotor control to and from CNS
  • Cervico-collic reflex (CCR), Cervico-ocular reflex (COR), tonic neck reflex (TNR)
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10
Q

Describe Axio-scapula functional anatomy

A

Trapezius and lev scap dissipate loads from shoulder girdle to pain sensitive c/sp structures
LS & LT, UT & SA force couples

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11
Q

What are performance changes to muscles in cervical disorders

A
  • changes to timing and amplitude
  • increased neuromuscular fatiguability
  • increased co-activation
  • delayed relaxation
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12
Q

What are the structural changes to muscles?

A
  • Changes in fibre type
  • Muscle atrophy
  • Fatty infiltration
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13
Q

What are the functional changes to muscles?

A
  • Reduced strength and endurance
  • Reduced postural control and movement
  • Altered sensori-motor function
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14
Q

What to assess of motor system?

A

Posture
Axioscapula control
Cervical flexors
Cervical extensors

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15
Q

What are the two theories for change in muscle behavior in neck pain?

A
  • Pain alters kinematics and alters muscle compositon
  • Inadequacies in axioskeletal muscles, and subsequent composition by other muscles such as traps can lead to problems in c/sp
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16
Q

What are the behaviour changes to scapular control with cervical pain?

A
  • Increased activity in superficial muscles (SCM, ant scalenes, UT with UL activities)
  • Increased residual activity in UT
  • altered trap control pattern
  • downward rotation of scap to reduce neck pain, ROM and propriception
17
Q

What are the changes to cervical flexors in cervical pain states?

A
  • Deep neck flexors (longus colli/longus capitus) - reduced activation and range
  • Increase co-activation of SCM and SC
  • Reduced deep neck F activity, increased sup neck F activity
18
Q

What are changes in deep cervical extensors?

A
  • Differential activation of cervical extensors altered
  • CCE more likely to recruit semispinalis capitus
  • CCN more likely to recruit multifidus and SSC at lower segmental levels
  • Atrophy of extensors
19
Q

What are the changes in superficial c/sp extensors?

A
  • Increased activation

- Delayed offset

20
Q

What are the functional changes in muscle?

e.g. strength

A
  • reduced isometric strength 22%-32%
  • lower strength ratio
  • lower endurance ratio
21
Q

What are other functional changes that can occur with neck pain

A
  • JPE
  • Reduced occulomotor control (gaze stability, velocity of tasks)
  • Reduced balance
22
Q

Describe the structural changes of c/sp muscle?

A
  • Reduced CSA under RTUS

- Fatty infiltrate

23
Q

What are rehabilitation strategies?

A
  • CCF exercises

- Multimodal management superior

PHTY APPB (10 decks)

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