CT exam and patient history Flashcards

1
Q

What are descriptors of a musculoskeletal problem?

A
  • sharp
  • dull
    -aching
  • numbness
  • tingling
    -weakness
  • burning
  • shooting
  • stabbing
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2
Q

What are descriptors of a non-musculoskeletal issue?

A
  • deep
  • boring
  • tearing
  • pulsating
  • itchy
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3
Q

Definition: pain evoked from a dorsal nerve root/ganglion which extends down a limb (inflammation of a nerve)

A

Radicular pain

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4
Q

What type of pain has a burning/lancinating quality and can be severe/debilitating?

A

Radicular pain

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5
Q

Pain from an acute disc herniation is an example of ___ pain.

A

radicular

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6
Q

Definition: pain evoked by a noxious stimulation of structures in the cervical spine that DOES NOT radiate and is very local to the site of irritation

A

Nociceptive pain

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7
Q

Irritation of the anterior scalene muscle at its insertion site (1st rib) is an example of ___ pain.

A

nociceptive

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8
Q

Definition: Noxious stimulation to structures in the cervical spine can produce referred pain into the UE/mid-back in addition to pain localized in the neck

A

Somatic referred pain

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9
Q

C5 referring pain to the lateral deltoid is an example of ___ pain.

A

Somatic referred pain

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10
Q

Somatic referred pain has a _____ feeling.

A

dull/aching

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11
Q

Definition: noxious stimulation of an organ that produces referred pain into the low back or neck

A

visceral referred pain

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12
Q

What is the feeling of visceral referred pain?

A
  • dull/aching
  • gnawing
  • expanding pressure feeling
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13
Q

Definition: left shoulder pain from the spleen

A

Kehr’s sign

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14
Q

Low back pain can be caused by noxious stimulation of the ___ (visceral referred pain).

A

kidney

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15
Q

Noxious stimulation of the ___ can result in right scapular pain (Visceral referred pain).

A

gallbladder

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16
Q

Definition:
- Involves pressure on a nerve or nerve root
- pins and needles, tingling feeling

A

paresthesia

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17
Q

Lesions of the _____ causes paresthesia.

A

nervous system

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18
Q

Lesions of the _____ system produces pain.

A

musculoskeletal

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19
Q

Definition: rounded shoulders and forward head posture

A

kyphosis

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20
Q

Normative value for cervical FLX

A

60-80 degrees

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21
Q

Normative value for cervical EXT

A

60 degrees

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22
Q

Normative value for side bending

A

45 degrees

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23
Q

Normative value for cervical ROT

A

90 degrees

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24
Q

What should you assess if a patient’s primary restriction is cervical ROT?

A

Assess Upper C-spine

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25
Q

___% of cervical rotation comes from the AO and AA joints of the neck

A

50%

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26
Q

What should you assess if a patient’s primary restriction is in cervical side bending?

A

Assess mid-lower C-spine and upper ribs

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27
Q

The C2-C3 segments are often limited in ____ which can mimic trigeminal symptoms and cause headaches

A

extension

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28
Q

What are the possible findings of the cervical compression test?

A
  1. acute lesion (disc herniation)
  2. pressure on a sensitive structure (formainal stenosis)
  3. Fracture w/ elicit pain
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29
Q

What is considered as a (+) test for cervical compression test and Spurling’s compression test?

A

Reproduction of neck or UE symptoms

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30
Q

What does it mean if a Spurling’s compression test produces neck pain?

A

The pain can be from joint tissue

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31
Q

What does it mean if there is reproduction of UE symptoms when performing a Spurling’s compression test?

A
  1. referred pain from the joint
  2. disc herniation
  3. foraminal stenosis
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32
Q

What are you looking for when performing a cervical distraction test?

A

Decrease in neck and UE symptoms

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33
Q

What is a quick and very effective screening test to help determine if the UE symptoms are coming from the C-Spine?

A

Cervical Distraction test with UE activity

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34
Q

When performing DTR tests, you want to see ___ stretch reflexes that are involuntary and give information about the health of a particular spinal segment

A

monosynaptic

35
Q

With a LMN lesion, the issue is somewhere between the ___ and ____.

A

spinal nerve root, innervated muscle

36
Q

What is the most common site of a LMN lesion?

A

spinal nerve root (Formainal stenosis, disc herniation, etc)

37
Q

Myotomal testing should consist of at least __ trials with a minimum of ___ second holds.

A

3, 5

38
Q

With myotomal testing, you (should/should not) gradually increase resistance with each trial.

A

should

39
Q

If fatigable weakness is present during myotomal testing, that means ___% of the motor unit is affected.

A

80

40
Q

The C5 myotome can be tested via what muscles?

A

deltoid, biceps, RTC muscles

41
Q

The C6 myotome can be tested via what muscles?

A

brachioradialis (wrist EXT)

42
Q

The C7 myotome can be tested via what muscles?

A

triceps, FCR (elbow extension, wrist flexion)

43
Q

The C8 myotome can be tested via what muscles?

A

EPL, PIP joint FLX

44
Q

During Upper limb tension tests, you should (gradually, rapidly) increase the tension on the nerve roots and nerves by passively moving the UE.

A

gradually

45
Q

Describe the ULTT1 (Median).

A

Shoulder: stabilized superiorly, ABD 90-120 degrees, ER
Elbow: EXT
Forearm: SUP
wrist, fingers, and thumb: EXT

46
Q

Describe the ULTT2 (Median).

A

Shoulder: depressed, ABD 10 degrees, ER
Elbow: EXT
Forearm: SUP
wrist, fingers, and thumb: EXT

47
Q

Describe the ULTT3 (radial).

A

Shoulder: depressed and ABD 10 degrees, IR
Elbow: EXT
Forearm: PRON
wrist: FLX and UD
fingers, and thumb: FLX

48
Q

Describe the ULTT4 (ulnar).

A

Shoulder: depressed and ABD 10-90 degrees, ER
Elbow: FLX
Forearm: PRON
wrist: EXT and RD
fingers, and thumb: EXT

49
Q

What is a (+) response for upper limb tension tests?

A

reproduction of pain, numbness, tingling, or burning sensation in the UE

50
Q

definition: When he tip of the odontoid becomes separated from the remainder of the vertebra, which can lead to spinal instability.

A

os odontoideum

51
Q

What are the primary movements that occur at the AO joint?

A

FLX/EXT

52
Q

What is the primary movement at the AA joint?

A

ROT

53
Q

What ligament attaches C2 to the occiput?

A

tectorial membrane

54
Q

What ligament is an important restraint to excessive craniovertebral FLX?

A

tectorial membrane

55
Q

definition: connects the superior part of the dens to the occipital condyles (can also attach to the lateral messes of the atlas.

A

Alar ligaments

56
Q

What ligament resists excessive Craniovertebral FLX, contralateral SB, and contralateral ROT?

A

alar ligaments

57
Q

The major role of the transverse ligament is to counteract ____ translation of the atlas relative to the axis, thus maintaining the correct position of the dens on the anterior arch of the atlas.

A

Anterior

58
Q

What is the action of the sub-occipital musculature?

A

EXT and ROT of the head

59
Q

What artery and nerve are found in the sub-occipital triangle?

A

vertebral artery
sub-occipital nerve

60
Q

The Rectus capitis posterior major runs from the ___ to the ___.

A

C2 spinous process, inferior nuchal line

61
Q

What is the action of the rectus capitus posterior major?

A

EXT, ipsilateral ROT

62
Q

The rectus capitus posterior minor runs from the ____ to the ____.

A

posterior tubercle of C1, inferior nuchal line

63
Q

What is the action of the rectus capitis posterior minor?

A

EXT of the head

64
Q

The superior oblique muscle runs from the ___ to the __.

A

C1 transverse process, medial portion of the occiput

65
Q

What are the actions of the superior oblique muscle?

A

EXT and contralateral ROT

66
Q

The inferior oblique runs from the ___ to the ____.

A

C2 SP, C1 TP

67
Q

What is the action of the inferior oblique muscle?

A

ipsilateral ROT

68
Q

definition/test: Assesses the integrity of passive ligamentous structures and look for cardinal signs or symptoms (5 D’s And 3 N’s)

A

Upper C-spine ligamentous assessment

69
Q

What are the 5 D’s?

A

dizziness
diplopia
dysphagia
dysarthria
drop attacks

70
Q

What are the 3 N’s?

A

numbness
nystagmus
nausea

71
Q

definition: seeing two images due to an ocular misalignment

A

diplopia

72
Q

definition: difficulty swallowing

A

dysphagia

73
Q

definition: difficulty speaking

A

dysarthria

74
Q

What are the 3 tests of the upper cervical spine ligamentous assessment?

A
  1. tectorial membrane stress test
  2. transverse ligament stress test
  3. alar ligament stress test
75
Q

Side bending and ROT in the UPPER C-spine occur in (opposite/same) directions when they are combined.

A

opposite

76
Q

Side bending and ROT in the MID to LOWER C-spine occur in (opposite/same) directions when they are combined.

A

same

77
Q

If cervical ROT is limited to one side, SB to the the contralateral side and rotate once more… if there is still a limitation, what part of the spine is most likely affected?

A

Upper C-spine

78
Q

If cervical ROT is limited to one side, SB to the the contralateral side and rotate once more… if there is no longer a limitation, what part of the spine is most likely affected?

A

middle/lower C-spine

79
Q

The upper C-spine movement assessment involves testing neck ____, ___, and ___.

A

neutral ROT, FLX w/ ROT, and EXT w/ ROT

80
Q

If rotation in the Upper C-spine is equally limited in the neutral, flexion, and extension positions, that means that the ___ joint is most likely the cause of the limitation.

A

AA joint

81
Q

If rotation in the Upper C-spine is more restricted in EITHER FLX or EXT, that means that the ___ joint is most likely the cause of the limitation.

A

AO joint

82
Q

(true/false) After the Upper C-spine movement assessment, intervention will be performed on both sides of the neck

A

true

83
Q

What are the common symptoms of upper C-spine dysfunction?

A

headaches, local muscle soreness and spasm, trigeminal nerve symptoms (tongue sensitivity, paresthesia of face/hand/tongue)