cervical Flashcards
learn the cervical region
do men or women more commonly have neck pain?
women
what is the purpose of the neck and shoulder screening questionnaire?
screen for ligamentous instability, cervical fx, cord lesions, pancoast tumors
what are the three major risk factors at the beginning of the canadian C-spine rules?
> 65 y/o, paresthesia in the limbs, dangerous MOI
if someone clears that initial canadian c-spine rules, what are the 5 criteria to be cleared to check ROM?
can sit up in ER, can walk at any time, pain does not start immediately, no midline cervical tenderness, the MVA did not involve a big bus or truck
if ROM can be assess for the canadian c-spine rules, how far must they be able to rotate to clear the test?
45 degrees rotation each way.
what ligament are you testing with the sharp purser test?
cruciform ligament
how do you perform the alar ligament test?
fingers on C2, sidebend and should feel C2 pop into finger opposite the side of the sidebend, delay equals a ligamentous instability
what is the most common presenting symptom suggestive of a VBA dissection?
pain in head and neck, often unilateral and suboccipital. onset is usually acute
what are the 6 predictors of a positive outcome to cervical manipulation?
NDI <11.5, having bilateral involvement, performing sedentary work <5 hours/day, feel better moving the neck, symptoms don’t increase with extension, a dx of spondylosis without radic
what four things predict a good response to thrust manip to the cervical region?
symptoms less than 38 days, positive expectation it will help, side to side difference in rotation >10 degrees, pain with PA spring testing mid cervical
what nerve root levels are tested with the biceps brachii and brachioradialis reflex?
C5-C6
what nerve root level is tested with the triceps reflex?
C7
describe the babinski test and what is positive
hammer on foot, positive test is toes splay out
describe the Hoffman test and what is positive
flick middle finger, look for clonus
what is the cluster for cervical radiculopathy (4 things)?
positive spurlings, positive distraction test, rotation less than 60 degrees to involved side, positive median ULTT
what 4 variables predict a successful outcome in a cervical radiculopathy with PT?
age <54, dominant arm not affected, symptoms not worse looking down, multimodal approach
what indicates a patient will benefit from traction (5 things)?
peripheralization with lower cervical spine mobility testing, + shoulder abd sign, age >55, + median ULTT, symptom relief with manual distraction test
on the NDI does a higher score indicate more or less disability?
more
what characteristics does someone in the neck pain with mobility deficits category have? (4 things)
age <50, acute neck pain (<12 weeks), symptoms isolated to the neck, restricted cervical ROM
what six factors predict a positive response to thoracic manip for neck pain?
symptoms <30 days, no symptoms distal to shoulder, looking up does not aggravate, FABQ-PA <12, diminished upper thoracic kyphosis, cervical extension <30 degrees
how many factors do you need on the thoracic manip predictors to likely have a good outcome?
3
what 5 factors help classify someone as neck pain with headaches?
unilateral headaches in subocc region aggravated by neck movements, headache reproduced with posterior muscle palpation, limited cervical ROM, limited segmental mobility, substandard CCFT
what is average time patients without neck pain get on the neck flexor endurance test?
39 seconds
how do you do the CCFT?
chin tuck onto biofeedback unit, holds pressure levels for ten seconds at 22,24,26,28,30 mmHg, rest 10 seconds between each level
what denotes failure on the CCFT?
less than 26, compensation
what 6 things classify someone into the neck pain with movement coordination impairments category?
chronic neck pain (>12 weeks), substandard CCFT, substandard DFET, coordination and strength issues of UE muscles, flexibility issues of the UE muscles, ergonomic inefficiencies with repetitive activities
what 4 things put someone into the neck pain with radiating pain category?
decreased cervical rotation (>60), signs of nerve root compression, success with reducing UE symptoms with initial eval and interventions, UE radicalizing symptoms
what do you see for location, intensity, and duration for migraines?
4-72 hours, one sided, throbbing
what do you see for location, intensity, and duration for sinus headaches?
widespread, last until treated, dull
what do you see for location, intensity, and duration with tension headaches?
widespread, last hours, dull
what do you see for location, duration, and intensity of cluster headaches?
one sided, 15 mins to 3 hours, sharp intense pain
what do you see with cervicogenic headaches?
trigger point referral, are usually recurrent
