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PTRS 846 > Cervical Spine > Flashcards

Cervical Spine Flashcards

1
Q

first and second goal of PT/differential

A

diagnose

address dysfunctions

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2
Q

passive restraints

A

disc, ligaments

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3
Q

active restraints

A

muscle , tendons

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4
Q

if the structure has a contractile component it will be provoked most with

A

resisted motions

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5
Q

selective tissue tension testing for the joint

A

distend or load the joint (coupled/combined)

capsular pattern of limitation

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6
Q

selective tissue tension testing for the disc

A

motions that the disc restricts (saggital)

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7
Q

selective tissue tension testing for the nerve

A

neural tension test

local peripheral compression/tinnels

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8
Q

selective tissue tension testing for the nerve root

A

extremity provoked with spinal motions

foraminal compression tests/spurlings

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9
Q

pain with resisted motions
acute injuries
trauma
common secondary pain

A

muscles

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10
Q

primary pain for muscles

A

resisted motions most painful test

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11
Q

cervical spine

A

C1-C7

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12
Q

cervical spine disc segments

A

C2C3 to C6C7

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13
Q

cervical spine non disc segments

A

C0C1 and C1C2

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14
Q

coupling in C0 to C2

A

contra coupling

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15
Q

Coupling in C2 to T4

A

ipsi coupling

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16
Q

ZAJ orientation in the cervical spine

A

inclined 45 degrees

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17
Q

age 15-25

A

acute torticollis 2 degrees to internal dist disorder

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18
Q

Age 25-45

A

internal disc

facet synovitis

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19
Q

age 30-45

A

protrusion/prolapse/extrusion

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20
Q

age 45-55+

A

recurrent chronic IDD
facet arthrosis
NCRS/stenosis

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21
Q

irritation to the nerve causing tingling, radiculitis

A

parasthesia

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22
Q

lack of sensation, damage to the nerve and radiculopathy

A

numbness

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23
Q

Parasagittal structures do not cause

A

midline pain

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24
Q

midline structures can cause

A

parasagittal pain

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25
Q 
parasagittal neck pain
no arm pain
most pain with rotation 
no large limits of motion
no pain with extension with chin tuck
most pain with coupled 3D patterns
A

Cervical facet synovitis

26
Q

cervical facet synovitis most pain with

A

rotation
coupled 3D patterns
pain increases with each added motion

27
Q

extension pattern

A

rotation toward the painful side
worse with added SB toward the painful side
even worse with added extension

28
Q

flexion pattern

A

rotation away from pain
worse with added SB away from pain
even worse with added flexion

29
Q

diffuse occipital pain and headache
begins in the back and progresses to front
no change with ‘true migraine’ medication
history of trauma to the head
worse with protraction or retraction (even worse with added sidebend)

A

occipital-atlanto (C0-1) joint pain

30
Q

local sub occipital pain
can contribute to cervicogenic headaches that begin in the back and progresses to front
no change with ‘true migrane’ medication
history of trauma to the head or manipulation
worse with protraction or retraction (even worse with added rotation)

A

Atlanto-axial (C1-2) joint pain

31
Q

active flexion most painful think

A

disc

32
Q

active extension most painful think

A

loads the ZAJ: but rotation should be more painful for ZAJ

also loads the discs

33
Q

active rotation most painful

A

think ZAJ then confirm with 3D testing

ZAJ does not cause large limitation of motion

34
Q

active sidebend most painful think

A

uncovertebral joint

acute disc pain can cause large limits of sidebend

35
Q

large limits think

A

disc

36
Q

smaller limits then

A

look for the most painful motion

37
Q

pain with sagittal motion think

A

disc

38
Q

pain with increased 3D motion think

A

ZAJ vs UVJ

39
Q

rotation pain think

A

ZAJ

40
Q

SB pain think

A

UVJ

41
Q

most motion is controlled by the influence of the

A

disc

42
Q

large limits in cervical motions think

A

disc

43
Q

flexion greatly increases

A

ID pressure

44
Q

Extension slightly increases

A

ID pressure

45
Q

extension with chin tuck greatly increases

A

ID pressure

46
Q

Age 20-40
midline, parasagittal or band-form neck pain
can radiate diffusely to the upper extremity but cannot be provoded but no radicular pain
sagittal motions worst, especially extension with a chin-tuck
3D motions not most painful
can cause large limits of motion

A

Cerbical internal disc disruption

47
Q

age 25-55
midline, parasagittal or band-form neck pain
can radiate in complete or partial dermatomal pattern to the upper extremity but is mild or intermittent
sagittal motions most painful for cervical cervicothoracic pain
may have neurological changes
may have positive foraminal compression test
positive axial separation test

A

cervical protrusion

48
Q 
age 25-45
arm pain often worse than neck pain
radiate pain in complete or partial dermatomal pattern
sagittal motions worst
will likely have neurological changes
may have positive foraminal compression
positive axial separation test
A

cervical prolapse

49
Q

age 25-45
arm pain much worse than neck pain
severe broad ratiating pain pattern to the upper extremity
all motions often limited and painful
will have neurological changes
negative axial separation test (cannot completely alleviate with axial separation)

A

cervical extrusion

50
Q

Age 50+
arm pain > neck pain
pain/paresthesia radiate in complete or partial dermatomal pattern to the upper extremity but is mild or intermittent
provoked with extension, sidebend and/or rotation
May have neurological changes (numbness most common)
likely have positive foraminal compression test
positive axial separation test

A

cervical stenosis

51
Q

clinically, toation of the cervical spine with coupled ipsilateral sidebend is painful on the

A

convergent side with added extension (C2 to C4)

or when painful on the divergent side with added flexion (segments C3 to C7)

52
Q

combined loading test

A

rotate away and sidebend toward the side you are testing

53
Q

first thing you always do for treatment

A

patient education

54
Q

techniques for muscle
direct
indirect

A

soft tissue mobilization, modalities

soft tissue mobilization

55
Q

Direct techniques for Disc/NRCS

A

manual axial separation

Jenker mobilization

56
Q

Direct techniques for facet

A

joint-specific traction

joint specific glide

57
Q

indirect technique for Disc/facet

A

mobilize hypomobile segments

Disc hydration program

58
Q

techniques for costotransverse joint
direct
indirect

A

joint mobilization

joint mobilization, soft tissue mobilization (transverse friction over costotransverse joint)

59
Q

PT for discogenic pain

A

manual axial separation

60
Q

ZAJ coupling for ZAJ synovitis

A

Rotation (toward painful side) + ipsilateral SB + extension

Rotation (away from painful side) + ipsilateral SB + flexion

61
Q

coupling for ZAJ arthrosis

A

Rotation away from painful side + SB toward

PTRS 846 (10 decks)

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