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MM III > C-Spine lecture1 > Flashcards

C-Spine lecture1 Flashcards

1
Q

Why is the c-spine more mobile than other regions of the spine?

A

positioning of head (vision, balance), need for rapid motion at times

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2
Q

which joints comprise upper c spine

A

C0-2

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3
Q

which jts comprise lower c spine

A

C3-C7, C7 transitional segment

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4
Q

neck pain is ___ greatest contibutor of global disability

A

4th

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5
Q

Chronic neck pain ___ to chronic LBP as most common MSK disorder associated with injury and disability claims in workplace and MVA

A

2nd

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6
Q

Lifetime prevalence of neck pain

A

66%

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7
Q

prevalence ___ with age, peaking in ____ year group

A

increases, 35-49

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8
Q

C-spine risk factors (health, psychological)

A

cycling, smoking, previous neck pain, depression, job stress, low co-worker social support

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9
Q

demographic risk factors

A

female, 45-59 years, better prognosis in younger pts.

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10
Q

occupation risk factors

A

heavy labor, office jobs, healthcare workers, unemployed

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11
Q

physical work risk factors

A

sedentary, repetitive work, working with neck flexed, working with arms above or at shoulder height, head carrying

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12
Q

T/F most patients with neck pain:specific pathoanatomic cause is not known

A

T

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13
Q

Non-MSK causes of neck pain

A

infection, tumor, cardiac, endocrine, gastrointestinal, neurological, pulmonary, systemic disease

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14
Q

MSK causes of neck pain

A

soft tissue injury, degenerative changes in facet joints, joint pain, fracture, dislocation

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15
Q

Onset exam questions

A

insidious or acute

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16
Q

trauma exam questions

A

incident details, loss of consciousness, immediate treatment

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17
Q

neuro exam questions

A

pain pattern, sensory changes, muscle weakness, gait changes, loss of balance/coordination

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18
Q

Other exam questions (a lot)

A

bowel and bladder, weight loss, night pain, fever, dizzines, fainting episodes, headache-location, TMJ symptoms, facial pain, pulmonary symptoms-SOB, coughing, blood in sputum, effect of cough/sneeze on neck/arm pain, cardiac symptoms-palpitations, angina, sleeping habits, postural stressors, litigation

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19
Q

Score summary of NDI

A 
0-4 - no disability
5-14- mild
14-24- moderate
25-34- severe
>35- complete disability
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20
Q

T/F elevated fear-avidance beliefs do not contribute to muscle guarding and the persistence of pain and disabiltiy

A

F - these beliefs will result in altered movement patterns and reduced physical activity

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21
Q

Nerve roots exit

A

above the named level

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22
Q

which neurological sequelae of impingement will you get with sensory/motor changes

A

radiculopathy: nerve root

23
Q

which neurological sequelae of impingement will you get with UMN signs

A

Myelopathy

24
Q

Which nerve keeps us alive

A

phrenic (C345) to the diaphragm

25
Q

Tracheobronchial conditions

A

inflammation, infection (viral, bacterial), tumor

26
Q

Potential symptoms of tracheobronchial conditions

A

referred neck pain, dyspnea, dysphagia, persistent cough, fever, chills, hemoptysis

27
Q

Conditions referring to the neck

A

tumors, infection, cardiovascular pain, gastrointestinal, Lyme disease, RA, ankylosing spondylitis, fibromyalgia,Klippel-Feil syndrome, Hypo/hyperthyroidism

28
Q

This syndrome is a congenital fusion of cervical vertebrae. Mutation in genes GDF6 and GDF3

A

Klippel-Feil Syndrome

29
Q

Briefly look over conditions referring to the neck

A

yaaa

30
Q

____ of patients with neck pain will go on to develop chronic symptoms

A

44%

31
Q

_____ of general pop who experience neck pain at some time will report neck pain 1-5 years later

A

50-85%

32
Q

Age and male were _____associated with PT use

A

negatively

33
Q

Lower ed level, having workers comp and litigation were ____ associated with PT use

A

positively

34
Q

compared to centralization exercicises, traction, and neural mobilizations; cervical manual therapy with exercise has ____ evidence of success

A

stronger

35
Q

classification for recent onset of symptoms and no radic

A

Mobility (manual therapy and exercise)

36
Q

classification for radic, symptoms below elbow

A

centralization

37
Q

classification for no radic, chronic symptoms

A

Exercise and condtioning

38
Q

classification for primary complaint of headache, specifically cervicogenic

A

Headaches (manual therapy and neck flexor/scapular strengthening)

39
Q

classification for acute and traumatic mechanism

A

pain control (gentle ROM and activity)

40
Q

staging the patient is based on the level of

A

acuity

41
Q

acuteness is determined by

A

the nature of the presenting symptoms and the goals for treatment

42
Q

Goal of stage 1 acuity

A

decrease severity

43
Q

goal of stage 2 acuity

A

address relative impairments

44
Q

goal of stage 3 acuity

A

return to work/sport

45
Q

Decision rule developed for radiographs of the c spine following trauma

A

canadian cervical spine rule

46
Q

what is the canadian cervical spine rule looking to detect

A

any fracture, dislocation, or ligamentous instability demonstrated by dx imaging

47
Q

Pt is older than 65 or dangerous mechanism or paresthesias in extremities after a traumatic incident (MVA, fall, collision). Do we send for Radiography according to Canadian C-spine rule

A

YES

48
Q

According to the CCS rule, after establishing that there is no high risk factor that mandates radiographs, what are the low-risk factors that allow for a safe assessment of ROM?

A

Simple rear-end MVC, sitting position in the emergency department, ambulatory at any time, delayed onset of neck pain, absence of midline cervical spine tenderness

49
Q

If the patient passes the low risk factor that allows safe assessment of ROM in the CCS rule, how many degrees to the left and right are required to not get radiography

A

45 in each direction

50
Q

Signs/symptoms of upper cervical instability

A

suboccipital (C2) pain, bilateral UE/LE paresthesias, clumsiness/loss of balance, nystagmus, headaches, blurred vision

51
Q

UMN signs

A

Hyperreflexia, spasticity, abnormal gait, clumsiness, babinski’s sign.

52
Q

Causes of atlantoaxial instability

A

congenital bony malformation, downs, inflammatory conditions, trauma, chronic coritcosteroid use

53
Q

_____ of patients with RA have cervical involvement

A

50% (destruction of dens, transverse lig, or both

54
Q

which inflammatory conditions do we worry about for atlantoaxial instability

A

RA, psoriatic arthritis, anklyosing spondylitis, osteomyelitis

MM III (7 decks)

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