Cervical Spine 2 Flashcards
When testing the cervcal spine, which side should you test first? Involved or uninvolved?
Test the uninvolved/ less involved side first
What are the Maitland SINSS?
Severity Irritability Nature Stage Stability
What is severity?
Intensity of the pain provoking activity (NPS). Can be min, mod, high
What is irritability?
How far into the movement is the pain provoked? Howling does it take to subside? Can be min, mid, high
What is nature?
Type of tissue that is causing sx (MSK, neural, inflamm…) Also consider fear avoidance
What is stage?
of healing… acute, sub-acute, chronic (3+ months)
What is stability?
If the problem is worsening, improving or stablized
Which is the most useful statistic clinically?
Likelihood ratios
strong evidence = + LR > 10 - LR < 0.1
What are the s/s of vertebral artery insufficiency?
Dizziness Diplopia (double vision) Dysarthria Dysphagia Drop attacks N/V Sensory changes
What is the sensitivity and specificity of the vertebral artery test?
Sensitivity 0% (A negative cannot be trusted); Specificity 67-90% a positive can be trusted)
T/F: Centralization and peripheralization with cervical ROM in transverse and frontal planes has good reliability.
False. It has no to poor reliability
What are the 4 elements in the cluster test for radiculopathy
- ULNT (Median)
- Cervical rotation <60
- Cervical distraction test
- Spurling’s
What is the sensitivity of plain film?
93%
What is special about the oblique view of C spine?
You can see the foramen
What are the ABCs of film
Alignment, Bones, Cartilage (and soft tissue)
Which imaging technique would you use to show the relationship between bone to neural canal in transverse plane?
CT
Which imaging technique would you use to visualize the spinal cord and soft tissues
MRI
Which imaging technique would you use to visualize spinal cord and nerve roots
Myelogram
Which imaging technique would you use to see a disc?
Discogram
What (2) tests would you use for neck pain with mobility deficits?
- Cervical AROM
2. Cervical/ thoracic segmental mobility
What (3) tests would you do for neck pain with HA
- Cervical AROM
- Cervical/ thoracic segmental mobility
- Cranial cervical flexion test
What (3) tests would you do for neck pain with movement coord impairments?
- Cranial cervical flexion test
- Deep flexor endurance test
- Flexibility deficits of upper quarter muscles
What (4) tests would you do for neck pain with radiating pain
- Cervical AROM
- Spurling’s
- ULNT
- Neck distraction
What are the 4 principles of classification into McKenzie’s syndromes?
- Pain behavior
- Loss of ROM
- Presence of referred pain
- Effect of repeated movement on pain
What are McKenzie’s 3 syndromes of mechanical pain?
- Postural
- Dysfunction
- Derangement
What causes postural syndrome?
Mechanical deformation or vascular insufficiency of normal tissue as result of sustained loading.
The following characteristics belong to which syndrome: gradual onset, dull symmetric pain, full cervical AROM, no referred pain, neck pain with sustained end range positions may take >15 mins
Postural
What causes dysfunction syndrome?
mechanical deformation or vascular insufficiency of abnormal tissue (shortened and fibroses or lengthened)
What syndrome has the following characteristics:intermittent neck pain, loss of cervical AROM, neck pain at end range, no arm pain
Dysfunction
What causes derangement syndrome?
internal disruption or displacement of tissues (thought to be disc related)
What syndrome has these characteristics: loss of cervical AROM, constant neck pain, pain radiates into shoulder/ arm, neck/ arm pain affected by repeated movement (peripheralization, centralization)
Derangement
How would McKenzie classify the following characteristics: constant pain, pain in all movement directions, pain is a result of inflammatory or infectious processes, intervention is rest and pharmacology
Non-mechanical pain
T/F: Forward head posture is the most common c-spine impairment
True
What effects does FHP have on c-spine and muscle activity?
Increased facet loading, slight extension of upper c spine, increased post cervical mm activity