C and T Spine - 1 Flashcards
what percent of the adult general public suffer from persistent neck pain of at least 3 months duration?
16-23%
which type of work environment has the greatest risk of neck pain
static postures: typists, people whom work on computers all day, and sweing machine operators
T/F: research shows that it does not matter what kind of passive treatment one offers, it is what the patient does that really matters
TRUE
often called a “pinched nerve,” occurs when a nerve in your neck is compressed or irritated where it branches away from your spinal cord. This can cause pain that radiates into your shoulder, as well as muscle weakness and numbness that travels down your arm and into your hand.
cervical radiculopathy
is a loss of function in your upper and lower extremities because of compression of the spinal cord within your neck
can involve your arms, hands, legs, and bowel and bladder function
cervical myelopathy
commonly known as double vision
diplopia
muscles you use for speech are weak or you have difficulty controlling them
characterized by slurred or slow speech that can be difficult to understand
dysarthria
difficulty swallowing
dysphagia
vision condition in which the eyes make repetitive, uncontrolled movements. These movements often result in reduced vision and depth perception and can affect balance and coordination.
Nystagmus
an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage
pain
fear of pain and re-injury may lead to
avoidance of activities that it is thought will do more harm
what can lead into a perpetual circle of dz, depression, disability, and persistent pain
exaggerate fear of pain coupled with a hyper-vigilance to every minor discomfort
posterior structures receive innervation from the _________ of the cervical spine nerves
dorsal rami
tral rami and the sinuvertebral nerves innervate the ________ of the cervical spine
anterior structures
pain: msk tissue
somatic
pain: nerve root/dorsal root ganglion
radiuclar
pain: equals both somatic and radicular pain
combined states
pain: CNS
central pain
pain: visceral organs
visceral
the quality of ______ pain is dep and aching in quality, vague and hard to localise
somatic
upper and mid cervical segements tend to refer to
occiput, neck, and upper shoulder
lower cervical segments refer to the
shoulder, scapula, and upper arm
______ pain is sever, lancinating, or shooting in quality, felt along a narrow strip
radicular
c spine level: refers to lateral neck and top of shoulder
C4
c spine level: refers more distally to the lateral arm
C5
c spine level: refer down the lateral arm and into the thumb and index finger
C6
c spine level: refer to the more posterior and extends into the middle and ring fingers
C7
______ pain is most commonly felt in the shoulder girdle and upper arm
somatic referred
if pain is felt in the distal part of the limb, which type of pain is it most likely to be?
radicular or somatic
radicular
and most commonly paired with neurological signs and symptoms
______ pain is phantom limb pain, post-herpetic neuralgia and the pain from a brachial plexus lesion
central
90% of individuals with coronary heart dz experience angina, a large proportion of these peoples with chest pain _______ have any underlying cardiac problem
DO NOT
clinical syndrome due to myocardial ischemia characterized by episodes of precordial discomfort or pressure, typically precipated by exertion and relieved by rest
chest pain
in primary care pt’s, ______ % of two large cohorts of pt’s attending with chest pain were diagnosed with a msk problem
30
it is highly ______ that mobilisation of spinal structures, whether through exercise or therapist techniques, would actually affect symptoms that were genuinely visceral in origin
UNLIKELY
what 3 mechanisms are known to activate nociceptors
thermal
mechanical
chemical
deformation of collagen networks so that nerve endings are squeezed between the collagen fibres, with the excessive pressure perceived as pain
mechanical nociception
bending your right index finger back is an example of
mechanical nociception
T/F: when intermittent mechanical pain is the main presenting symptom, drugs should never be the treatment of choice
TRUE
produced by the irritation of free nerve endings in the presence of certain chemicals, such as histamine, serotonin, hydrogen ions, substance p and bradykinin
chemical nociception
constant pain: mechanical or chemical
most always chemical
constant pain
shortly after onset
cardinal signs may be present - swelling, redness, heat, tenderness
lasting aggravation of pain by all repeated movement testing
no movement foudn that reduces, abolishes, or centralises pain
inflammatory (chemical) pain
certain repeated movemetns cause a lasting reduction, abolition, or centralisation of pain
movements in one direction may worsen symptoms, whereas movements in the other direction improves them
improves with the symptoms
mechanical pain
timeframe:
inflammation
tissue repair
remodeling
inflammation < 5 days
tissue repair < 7 weeks
remodeling > 7 weeks
intermittent pain is almost certainly ______ in origin, and is generally easier to treat than constant pain
mechanical
in normal msk problems, inflammatory problems are only a consideration in the ________
first few days
in inflammatory irritants sensitise the local pain receptor system and lower the threshold at which the system is triggered, creating a state of ________
peripheral sensitisation
only during the ______ period are rest and relative rest required; this must be followed by early mobilisation to optimise tissue healing
inflammatory
fibroplastic or repair stage commences as the acute inflammatory stage subsides and lasts about three weeks
collagen and glycosaminoglycans that replace the dead and damaged tissue are laid down
tissue repair stage
about what day after injury is the most optimal to apply gentle natural tension to encourage good quality repair with collagen fibres
5th day
