Cervical Examination & Intervention Flashcards
neck pain is almost as prevalent as blank
low back pain
neck pain affects blank percent of individuals in their lifetime
70
neck pain makes up about blank percent of patients seen in pt
25
like low back pain, the origin of pain is often blank
indefinablee
some elements of subjective exam
nature of disorder, area of symptoms, behavior of symptoms, questionnaires
pain that is constant and high level… recent onset
chemical pain
pain that is intermittent, variable levels of pain, usually local, can be chronic
mechanical pain
mechanical pain can be reduced by blank
changes in position
some special questions for cervical pain
dizziness? trouble talking/swallowing? change in vision? change in gait? hard to hold onto small objects?
5 d special questions
double vision, dysarthria (difficulty speaking), dizziness, dysphagia (difficulty swallowing), drop attacks
10 item condition specific self report questionnaire
neck disability index (NDI)
ndi is on a scale of
0-50
minimal detectable change with ndi
5 points
blank scores on ndi are more desirable
lower
concordant sign is the patients blank
chief complaint
normal AROM of cervical flexion
45 degrees
normal arom cervical extension
45
normal lateral flexion cervical
45
normal arom rotation cervical
60
movements used for the purpose of assessment and management of pain
repeated movement testing
three types of repeated movement testing
postural, dysfunction, derangement
pain during movement is characteristic of blank
derangement
pain at end range is more characteristic of blank
dysfunciton
repeated movements have no effect on this syndrome
postural
PROM cervical is usually performed in the blank position for relaxation
supine
PROM examiner uses blank hold or blank hold to move patient’s head into desired ROM
chin cradle, cradle
during cervical PROM, examiner is looking for whether or not blank is present
gapping
this test provides clinician with information regarding tissue reactivity
resisted isometric testing
this test provides clinician with information regarding strength
MMT
most people with cervical pain have weakness in blank
neck flexors
special UMN lesion tests
babinski, hoffman, rhomberg, lhermitte
rhomberg is a blank test
balance
lhermittes sign is a blank pain down spine with blank cervical movement
lightning, retraction
ULNT is a special test that looks at the blank and physiologic ability of the blank system
mechanical, nervous
ULNT results that reproduce pain, alters pain, difference from side to side in ROM
positive results
three peripheral nerves tested by ULNT testing
median, radial, ulnar
alar ligament test, transverse ligament test, modified sharp pursers, aspinalls, tectorial membrane tests are provocative for blank
cervical instability
these tests test for vascular signs and consist of different movements of the neck to see if there is dizziness
vertebral artery tests
how many visits for appreciable change observation
6
following a MVA or a fall from a height or down stairs, the clinician should be suspicious of serious injury in the presence of blank sings
vague
canadian c spine rules are supposedly blank
100% sensitive
pt should determine if headaches are blank or blank
cervicogenic, icad
icad means
internal carotid artery dissection
pts can treat this headache
cervicogenic
cervicogenic headaches originate from cervical spine and symptoms change with blank testing, and symptoms in the suboccipital region, temporal, frontal, or orbital region
movement
icad is a sudden intense headache in the blank region unilaterally
temporal
icad also presents blank pain on the same side of headache
neck pain
icad may present with blank signs and as the worst headache of a patient’s life
upper motor neuron (check CN)
an icad is a medical blank
emergency
cervical radiculopathy is blank by pt but blank thoracic outlet syndrome
treatable, not
cervical radiculopathy is usually blank pain
referred
thoracic outlet syndrome have symptoms with blank and is characterized by blank arms or blank hands
activity, heavy, cold
four criteria to identify Wainners CPR for cervical radiculopathy
c spine rotation less than 60 degrees, spurlign’s test, distraction test, upper limb nerve tension test
three of five basic managing principles
stage of recovery, exam findings, patient beliefs, evidence to support what you’re doing, test then treat then retest then treat
intervention when patient responded favorably to repeated movement testing
directional preference
directional preference should use movements in the blank direction of pain
opposite?
directional preference should always exhaust movements in this plane
sagittal
directional preference should ideally be performed in this position
sitting
evidence for thoracic manipulation is blank
weak
manual therapy that controls inflammation/pain should be blank cervical traction for less than five mins
intermittent
this intervention is used in the presence of radicular symptoms or peripheral neurogenic symptoms
neuromobilization
neuromobilization, the test is the blank
treatment
passive neuromobilizations should be blank
graded
neuromobilizations can be done blank or blank depending on the nature of the disorder
active, manually
