C spine additional syndromes

Question 1

MPS signs and symptoms

Answer 1

Excessive muscle tone/tension
muscle activity that can be transient or chronic
muscle will have short/ hard feel

Question 2

What is the mc MPS of the neck

Answer 2

scalenes

Question 3

Clinical presentation of MPS of scalenes (refer zone)

Answer 3

Can be tender w palpation
Active TP can refer to arm,chest, interscap area
pt. may present w jump sign

Question 4

Clinical presentation of MPS of lev scap

Answer 4

May be refered to as stiff neck muscles

will have decreased active ROM
painful passive ROM
tender TPs
Jump sign

Question 5

Pts with whiplash have MPS mc in this muslce

Answer 5

Semispinalis capitis (85%)

Question 6

What is vertigo caused by

Answer 6

Disturbance in semicircular canals due to imbalance of firing rate of vestibular n or vestibular nuclei bw 2 sides of head

Question 7

what common dizziness symptoms are not synptoms of BPPV

Answer 7

symptoms of imbalance, light headiness or syncope are not suggestive

Question 8

Natural history of BPPV

Answer 8

benign, with spontaneous recovery in weeks to months

Question 9

what percentage of pop has BPPV

Answer 9

10% of pop

Question 10

Symptoms of vestibular system dysfunction

Answer 10

vertigo (spinning)
Oscillopsia (blurred vis)
Postural imbalance
Pathological nystagmus

Question 11

80% of cases of BPPV are becuase of this mechanism

Answer 11

Canalithiasis (80%)

Cupulolithiasis (20%)

Question 12

How to assess diziness in BPPV

Answer 12

1. Steadiness in Rhomberg + gait
2. head shaking test
3. Rotary chair test
4. Dix Hallpike test

Question 13

MC distribution (location) of BPPV

Answer 13

1. Unilateral PC BPPV 65%

Question 14

questions+ tests to determine if someone has BPPV

Answer 14

provoked by head positional moveemnts

Dix hallpike maneuver (will observe nystagmus + may reproduce symptoms)

Rotary chair test

Question 15

BPPV txs

Answer 15

Epleys (mc)- best for PC
Semont- best for AC
log roll- best for LC

Question 16

what is some important points after completing the dix hallpike maneuver

Answer 16

-maintain upright pos or next 48 hrs (keep head in smae pos)

Question 17

BPPV prevention tips

Answer 17

• sleep on uninvolved side
• refrainn from rapid head mvmts
• refrain from cervical pillows

Question 18

What is cervical spondylotic myelopathy and most common segents

Answer 18

Involves stenosis of the apinal column in cervical spine usually in older individuals

usually in C4-7

Question 19

Is acute myelopathy a contraindication of manip

Answer 19

yes

Question 20

how many mm is considered myelopathy

Answer 20

<11mm

Question 21

Signs + symptoms of CSM

Answer 21

hnad numbness, weakness, decreased light touch

can also affect lower limb if in posterior column

Question 22

what is the gold standard for diagnosing CSM

Answer 22

MRI

Question 23

What can dynamic hoffmans sign and babinski sign show u for CSM

Answer 23

dynamic for early/mild CSM

Babinski for later stage CSM

Question 24

tx for CSM

Answer 24

imboalization (limit mvmts)
myofascial releases
education
surgery

Question 25

If a nerve is compressed in the spinal cord what is it considered and what does it causes

Answer 25

Upper motor neuron lesion

Causes pathological hyperreflexxia

Question 26

If a nerve is compressed in the nerve root what is it considered and what does it cause

Answer 26

Lower motor neuron lesion

Causes pathological hyporeflexia at same level and hyoreflecxia below

Question 27

what is the primary risk with cervical hypermobility

Answer 27

vertebral artery tear during cervical SMT

Question 28

Cervical spine Red Flags

Answer 28

• Acutre Cervical Myelopathy
• Neoplastic conditions + metastasis
• cervical fxs/ dislocations
• Cervical intability
• Vertibrobasillar insuffiency or stroke
• Deterorating neuro signs