Cervical Spine Continued Flashcards
What is a medical diagnosis
Made by physicians at a cellular level
True or False:
Derangements must have a directional preference
True
Which classification has a good prognosis
Dysfunction
Which classification has an ify prognosis
Derangement
True or False:
Dysfunctions are shortened tissue that need stretching overtime
True
When should you be suspicious of trauma (3)
- MVA
- Fall from 5 feet or more
- Fall down 5 or more stairs
What does the Canadian C-spine rules determine
If the patient needs imaging to ruleout fracture
What are the 5 positive tests for the Canadian C-spine rules
- Cognitively impaired or neurologic symptoms in limbs
- Age 65 or older
- Fearful of moving head
- Involved in a distraction based injury
- Midline pain
What is a distraction based injury
MVA
If you have one of these tests what should you do
Refer immediately
What constitutes a referral
One of the positive tests
Characteristics of cervicogenic HA (5)
- Originate from upper C-spine
- Symptoms in suboccipital region, temporal bone, frontal bone, and orbital region
- Symptoms change with motion
- Non life threatening
- Do very well in PT
Characteristics of ICAD (6)
- Life threatening
- Sudden intense HA in temporal region
- Neck pain of same side as HA
- Worst HA of life
- UMN signs
- Get to emergency room
True or False:
People with an ICAD will not be able to focus because pain is so bad
True
What does ICAD stand for
Internal Carotid Arterial Dissection
What is thoracic outlet syndrome
Collection of symptoms that don’t follow a typical pattern like a radiculopathy
Characteristics of TOS (6)
- Present with neck and shoulder pain
- Arm feels heavy
- Hands feel cold
- Difficulty with RM at or above shoulder level
- Not sure how injury occurred
- Usually no pain at rest
What are the 4 criteria of Wainner’s CPR for Cervical Radiculopathy
- Cervical spine rotation less than 60
- Spurling’s test
- Distraction test
- upper limb nerve tension test (Elvy’s test)
What is the LR with 2 out of 4 criteria
0.88
What is the LR with 3 out of 4 criteria
6.1
What is the LR with 4 out of 4 criteria
30.3
What does CPR stand for
Clinical Prediction Rule
What does LR stand for
Likelihood Ratio
What are things to consider when determining if neck or shoulder pain (3)
- Onset of symptoms
- Location of symptoms
- Examination how the neck changes shoulder pain/function
True or False:
Symptoms below the elbow are consistent with mechanical neck pain because the shoulder doesn’t refer to below elbow
True
What are the 5 basic managing principles
- Stage of recovery
- Exam findings
- Pt beliefs and goals
- Evidence to support what you are doing
- Test-tx-Retest-tx
What are the 5 broad intervention options for the C-spine
- Directional preference
- Hyper vs. Hypomobility
- Pain control
- Neuromobilization
- Traction
What are the mobility deficit classifications
Directional preference and hyper vs. hypomobile
What is the pain classification
Pain control
What is the radiculopathy classification
Neuromobilization
What is traction used for
Radiculopathy and stenosis
How many reps of directional preference motion do we need to do before we see change
Usually 30 reps
What are 6 interventions addressing hypomobility
- Education
- Thrust and non-thrust menipulation
- Soft tissue mobilization and stretching
- A/PROM in to restricted movements
- Postural education
- Muscle performance testing
What are 4 interventions addressing hypermobility
- Education
- Local modalities in acute/irritable conditions
- Stabilization activities
- Address postural muscle strength/endurance
5 ways to control pain/inflammation
- Local modalities
- Education
- Manual therapy
- A/PROM in pain free range
- Progress toward mobility classification
What are 6 things you should educate patients on
- Inform about prognosis and plan
- Limitations of stage of healing
- Learn how to manage symptoms
- Postural awareness
- Prevent future episodes
- HEP
What is HEP
What, why, how often, how long
