C spine additional syndromes Flashcards
MPS signs and symptoms
Excessive muscle tone/tension
muscle activity that can be transient or chronic
muscle will have short/ hard feel
What is the mc MPS of the neck
scalenes
Clinical presentation of MPS of scalenes (refer zone)
Can be tender w palpation
Active TP can refer to arm,chest, interscap area
pt. may present w jump sign
Clinical presentation of MPS of lev scap
May be refered to as stiff neck muscles
will have decreased active ROM
painful passive ROM
tender TPs
Jump sign
Pts with whiplash have MPS mc in this muslce
Semispinalis capitis (85%)
What is vertigo caused by
Disturbance in semicircular canals due to imbalance of firing rate of vestibular n or vestibular nuclei bw 2 sides of head
what common dizziness symptoms are not synptoms of BPPV
symptoms of imbalance, light headiness or syncope are not suggestive
Natural history of BPPV
benign, with spontaneous recovery in weeks to months
what percentage of pop has BPPV
10% of pop
Symptoms of vestibular system dysfunction
vertigo (spinning)
Oscillopsia (blurred vis)
Postural imbalance
Pathological nystagmus
80% of cases of BPPV are becuase of this mechanism
Canalithiasis (80%)
Cupulolithiasis (20%)
How to assess diziness in BPPV
- Steadiness in Rhomberg + gait
- head shaking test
- Rotary chair test
- Dix Hallpike test
MC distribution (location) of BPPV
- Unilateral PC BPPV 65%
questions+ tests to determine if someone has BPPV
provoked by head positional moveemnts
Dix hallpike maneuver (will observe nystagmus + may reproduce symptoms)
Rotary chair test
BPPV txs
Epleys (mc)- best for PC
Semont- best for AC
log roll- best for LC
what is some important points after completing the dix hallpike maneuver
-maintain upright pos or next 48 hrs (keep head in smae pos)
BPPV prevention tips
- sleep on uninvolved side
- refrainn from rapid head mvmts
- refrain from cervical pillows
What is cervical spondylotic myelopathy and most common segents
Involves stenosis of the apinal column in cervical spine usually in older individuals
usually in C4-7
Is acute myelopathy a contraindication of manip
yes
how many mm is considered myelopathy
<11mm
Signs + symptoms of CSM
hnad numbness, weakness, decreased light touch
can also affect lower limb if in posterior column
what is the gold standard for diagnosing CSM
MRI
What can dynamic hoffmans sign and babinski sign show u for CSM
dynamic for early/mild CSM
Babinski for later stage CSM
tx for CSM
imboalization (limit mvmts)
myofascial releases
education
surgery
If a nerve is compressed in the spinal cord what is it considered and what does it causes
Upper motor neuron lesion
Causes pathological hyperreflexxia
If a nerve is compressed in the nerve root what is it considered and what does it cause
Lower motor neuron lesion
Causes pathological hyporeflexia at same level and hyoreflecxia below
what is the primary risk with cervical hypermobility
vertebral artery tear during cervical SMT
Cervical spine Red Flags
- Acutre Cervical Myelopathy
- Neoplastic conditions + metastasis
- cervical fxs/ dislocations
- Cervical intability
- Vertibrobasillar insuffiency or stroke
- Deterorating neuro signs
