Cervical Spine CPG Flashcards
MDC for NDI
10 points
MCID for NDI
10-19%
canadian c-spine rules high risk factors
- > 65
- dangerous mechanism
- parasthesias in extremities
*if any of these are present, get an xray
Canadian c-spine rules low risk factors
-simple rear end collision
-sits in ER
-ambulatory at any time
-delayed onset neck pain
-absence of midline c-spine tenderness
*if any of these are present you can assess ROM
if a pt cannot actively rotate neck ________ degrees both ways they need an xray
45
the PT subjective exam has what rating? (ABCD)
A
The PT objective exam has what rating
B
what are the 4 ICF impairment based classifications for neck pain
1 - neck pain with mobility deficits
2 - neck pain with headaches
3 - neck pain with movement coordination impairments
4 - neck pain with radiating pain
what is the rating for ICF impairment based classifications
C
what are some clinical findings with neck pain w/ mobility deficits
1) >50y/o
2) - acute
3) symptoms isolated to neck
4) restricted cervical ROM
with neck pain w/ mobility patients typically have pain at __________. are passive accessories painful?
end range
yes
what are some objective measures you want to do with neck pain with mobility (5)
1 - rule out instability
2 - VBI
3 - AROM
4 - PAs
5 - muscle lengths
how to test muscle length of ant/middle scalenes
side bend away, rotate towards, stabilize clavicle and first rib
how to test muscle length of levator scap and posterior scalenes
depress scapula, side bend away, rotate away
how to test muscle length of upper traps
depress scapula, side bend away, rotate towards
what are some treatments for neck pain with mobility deficits in acute/subacute phase
- thoracic/cervical manipulations/mobilizations
- neck ROM exercises
- scapular and UE strengthening
If your pt is in the chronic phase of neck pain with mobility deficits, you can do all of the treatments for acute, but what other treatments may be needed?
-endurance training/aerobic conditioning
-cognitive affective elements
-traction
-counseling
T or F: effects of spinal thrust manipulation may be neurophysiological in origin
T: act over central pain control by stimulating descending inhibitory pain mechanisms, particularly the periaqueductal grey area
what are some clinical findings with neck pain with headaches
1 - unilateral headache associated with neck symptoms that are aggravated my neck movement or palpation of myofascial and joints
2 - restricted cervical ROM
3 - restricted cervical segmental mobility
4 - substandard performance on neck flexor endurance test
what are some objective measures you want to take for neck pain with headache (5)
1 - AROM
2 - PROM
3 - PAs
4 - muscle lengths
5 - muscle strength and endurance
T or F: mobilizations/manipulations are a good treatment for neck pain with headaches
T
clinical findings with neck pain with movement coordination
- long standing neck pain
- substandard neck flexor endurance
- strength/flexibility deficits of neck and UE
- ergonomic insufficiencies
what objective measures should you do for neck pain with movement impairments (6)
1 - rule out instability
2 - VBI
3 - AROM
4 - PAs
5 - muscle lengths
6 - muscle strength/muscle endurance
Clinical findings with neck pain w/ radiating pain
1) UE symptoms produced or aggravated with Spurling and ULTT and reduced with neck distraction
2) decreased cervical rotation toward involved side
3) signs of nerve root compression
4) success with reducing UE symptoms with initial intervention
What objective measures should you do for neck pain with radiating pain? (7)
1) neuro screen
2) AROM
3) PAs
4) Muscle length testing
5) ULTT
6) Spurlings
7) Distraction
What are some treatments for neck pain with radiating pain?
1) mobilization and stabilization exercises
2) traction
3) education
