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PCM II Exam 1 > Cervical Spine: Neck Pain, Whiplash and Toricollis > Flashcards

Cervical Spine: Neck Pain, Whiplash and Toricollis Flashcards

1
Q

What are the mechanics for C1 (OA Joint)?

A

Modified Type 1: Can contain a flexion/extension component

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2
Q

What are the major motions of the OA joint?

A

Flexion and Extension

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3
Q

What is the primary motion of the Atlantoaxial Joint?

A

Rotation (Atlas rotates about the dens)

Almost NO SB or flexion/extension

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4
Q

What are the mechanics for the Typical C-Spine segments (C2-C7)?

A

Type II - Like Mechanics

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5
Q

What are some contraindications to HVLA of the C-Spine?

A
  • Rheumatoid Arthritis
  • Down Syndrome (Might not have a full Dens)
  • Peripheral Vascular Disease
  • Osteoporosis of risks thereof
  • Patients on Anticoagulants
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6
Q

Define Whiplash injuries.

A

Generic term for acute hyperflexion-hyperextension injuries in the c-spine

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7
Q

Which motion within Whiplash injuries is going to cause greater injury?

A

Hyperextension

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8
Q

Explain the pathophysiology of superficial soft tissue damage in whiplash injuries.

A

Abrupt elongation initiates acute stretch reflex

If stretch is severe, tearing can occur in EXTRAfusal fibers (contractile elements of muscles)

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9
Q

What is the 1st muscle to get injured on the anterior aspect of the neck?

A

Sternocleidomastoid M.

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10
Q

What are the muscles that can be injured on the posterior aspect of the neck?

A

Suboccipital Ms.

Intrinsic Ms. (Multifidus)

Should girdle Ms. (Levator Scapulae, rhomboid, and trapezius)

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11
Q

Which ligaments can be messed up with Hyperextension and Hyperflexion?

A

Hyperextension: Anterior Longitudinal L.

Hyperflexion: Posterior Longitudinal L. (Rare Disc herniation)

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12
Q

Which nerve is going to be giving you the headaches after a whiplash event? What is a treatment that can relieve that pain?

A

Greater and Lesser Occipital N. irritation

Suboccipital Release

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13
Q

What should you check for if a patient describes a blinding or exploding sensation in head at the time of Whiplash Injury?

A

Concussion

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14
Q

How can you prevent a hyperextension injury?

A

Adjust the head rest to the correct height!

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15
Q

You should immobilize the C-Spine until which event?

A

Immobilize C-Spine until cleared by X-Ray

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16
Q

What other injuries might occur with Whiplash?

A
  • Pelvic Injury: Ilial Rotations and Pubic Shears
  • Thoracic and Lumbar Injuries
  • Cranial Injury
  • Upper Extremity Injury
17
Q

Will patients feel better or worse the next day after a whiplash injury? Why?

A

Worse!

Swelling is going to get worse overnight, tell them to use Ice Packs and Anti-Inflammatories

18
Q

Describe Treatment during the Acute Stage for Whiplash Injuries.

A
  • Start off with gentle INDIRECT techniques

- Ice Packs and NSAIDs

19
Q

Describe Treatment during the Early Chronic Stage for Whiplash Injuries.

A

(1 Week to 1 Month)

  • More Aggressive Tx
  • ME and HVLA in Thoracic and Lumbar areas
  • ME to C-Spine and lymphatic drainage, suboccipital and fascial release, and counterstrain
  • Moist heat
  • NSAIDs
  • Tricyclic antidepressants (TCAs): Low dose at night (sedative)
20
Q

Describe Treatment during the Late Chronic Stage for Whiplash Injuries.

A

(1 to 3 Months or Longer)

  • More OMT similar to Early Chronic Stage
  • Electrical stimulation to avoid atrophy of muscles
  • Emotional Support
21
Q

What are the two important predictors of pain 1 year after an accident (according to UK study)?

A
  1. Pain severity at time of rear-end collision

2. Presence of a compensation claim (Sometimes when the money is gone, then the pain goes with it!)

22
Q

What are the different muscles involved with Torticollis?

A

Toricollis: SCM spasm (rotation of head)

Laterocollis: Trap spasm (lateral tilt)

Anterocollis: Spasm anterior neck Ms. (flexion)

Retrocollis: Poster neck Ms. spasm (Extension of head)

23
Q

If you notice Congenital Torticollis, what else should you consider? How might this have been caused? What do you need to do if you suspect congenital Torticollis?

A
  • Clubfeet, Congenital Hip Dysplasia
  • Cause: Difficult Delivery, One SCM is shorter than the other
  • C-Spine x ray to rule out any other abnormalities
24
Q

What is the best treatment for a child that is over 1 year of age? What if they are younger than 1 year?

A

Surgical release of SCM (Send to ortho)

You can try and fix it with OMT!

25
Q

Describe the Treatment for Torticollis on an Adult.

A

Indirect Tx and then Progress to M. Energy

26
Q

At what level of the spinal cord is the vertebral artery likely to become compressed and spasm?

A

C1-C2

PCM II Exam 1 (9 decks)

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