Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PHTH 623 - Differential Dx > Cx/Cx-Vr > Flashcards

Cx/Cx-Vr Flashcards

1
Q

whats C3-C7:
CP
CPP
RP

A

CP: SF/rot > ext > flex
CPP: full ext
RP: slight ext

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

whats the 2 Combined mvt? How to OP?

A

Flex+SF+rot
Ext+SF+rot
OP: stab c7 + OP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Indication for ULTN2m?

A

Scap depression
S/S to median n.
If shld prb and want to avoid shld abd

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Indications for ULNT2r

A

Radial n. distrib

  • post shld pain
  • lat elbow pain
  • dorsal FA pain (radial tunnel syndrom, de Quervain)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Indications for ULNT3

A

Ulnar nerve distrib
ant shld, axilla, medial arm/elbow, hypothenar eminence, 4-5th finger

C8 radiculo
TOS
CuTS
Guyons canal synd

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Clinical present WAD

A

Pain cx verry irritbale
P with shearing, compress/tract
No changes on RX (after 1y yes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

WAD tx?

A 
Rest, brace
 Posture
 Breathing pattern
Stab
Mobs below injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe WAD grade 0

A

No neck complaint

No phys sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

WAD grade 1

A

Neck: pain, stiffness or tenderness

No phys signs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

WAD grade 2

A

neck complaint + MSK sign (ROM, point tenderness)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

WAD grade 3

A

neck complaint + neuro sign (dec/abs td reflexes, weakness, sensory deficits)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

WAD grade 4

A

Neck complaint + fx/disloc (RX +ve)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

WAD grade 2A

A 
neck pain
motor impairment (ROM and altered recruitement pattern)
Sensory impair (local cx mechanical hyperalgesia)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

WAD 2B

A 
WAD 2A +
Psycho impairment (PTSD)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

WAD 2C

A

WAD 2B +
Motor impairm (jt position errors, gen sensory hypersensitivity, sympathetic NS disturb)
Psy ( acute PTSD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Whats the 2 different ax WAD pathway?

A

Acute (0-12w)

Chronic (post 12w, either popping out 12w later or 12+ weeks of tx)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

WAD yellow flags

A 
attitude, beliefs about pain
emotional response
behavior
family & work
compensation issues
dx & tx issues
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

C spine rule

A
  1. 65+ yo
    Dangerous MOI (fall 3ft/5stairs, axial load, MVA 100km/h;rolls, collision motorized recr, bicycle collision)
    Paresthesia extrem
2.
Simple reared MVA
Sitting/ambulatory at ER
Delayed onset of neck pain
Abs of midline c-spine TOP

3.
Cx rotation 45° L/R

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Poor prognosis factors of WAD

A 
Factors associated with
ongoing pain &/or ongoing disability after whiplash

High initial self reported pain intensity (VAS:7/10) & disability (NDI 40/100)

Low self efficacy = Pt’s low confidence in their ability to perform some ADL

Catastrophizing = negative thoughts

Increased sensitivity to cold

Anxiety = related to fear of pain (fear avoidance)

A large number of initial symptoms & self rated injury severity

Reduced Cx ROM

Symptoms of post traumatic stress

Negative expectation of recovery

Headache, Back pain, Dizziness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Factors NOT associated with poor prognosis for WAD?

A 
Factors
NOT associated with ongoing pain &/or disability after whiplash

Radiological findings OA/flattened Cx lordosis)

Kinesiophobia

Anxiety

Shoulder pain

Poor physical health

Previous Hx of neck pain

Crash related factors

Compensatory related factors (need more studies)

Age, living situation, work status
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Factors with inconsistent evidence for WAD

A

gender
educational evidence
self-perceived gen health
compensation related factors

22
Q

Concussion s/s (WAD)

A

HA
N/V
Dizziness/vertigo, balance
tinnitus

Memory impairment/reduced attn span
depression
fatiguability
insomnia
mood swings
23
Q

Observations (WAD)?

A 
Observation

Fatigue +++ often secondary to important pain

Nausea/vomiting
AROM as you do the subjective Ax

Important ↓↓ in ROM may be Fx or subluxation

Torticollis may be Fx

Ms wasting, especially SCM &/or trap (cranial supply) may be neuro deficit (brainstem lesion)
or Fx base of
skull
24
Q

Others ax WAD (after observ & concussions signs)

A

neuro exam
cx rom
altered ms recruit patterns (CCFT)

25
Q

WAD tx principles & education

A

 Adopt a supportive, patient centered approach
 Provide information & advice during initial visit EDUCATION
 Provide a clear explanation EDUCATION
 Ensure that a consistent message is conveyed
 Develop a management plan
 Use a stepped approach to care

 Encourage active forms of treatment
 Promote independence self management
 Review the effectiveness of treatment
 Take recommended action(s) where there is a lack of improvement

WAD IIC avoid Rx that are noxious & pain provoking for pts (gentle mobs & AROM exs)

26
Q

WAD multimodal thx

A 
 Modalities
 Pharmacotherapy
 Manual therapy
 Soft tissue techniques (massage, soft tissue stretch)
 Mobs
 HEP
 ROM & stretching exs; strengthening exs (DNF ms; DNE ms)
 Low load isometric
 Postural endurance
27
Q

WAD acute tx

A

Active exercise (ROM and mobilizing exercises, strengthening of the neck and scapula
muscles)
-
Advice to “act as usual”, reassurances, education

Rxs that may be undertaken
provided that there is ongoing evidence of benefit
-
Passive joint mobs/manipulation
-
Heat, ice and massage
-
Electrotherapies
-
Multimodal therapy
Rxs that should NOT be undertaken
-
Collar immobilization and/or prescribed rest
-
Surgery except in WAD IV
-
Cervical pillows
-
Intra articular injections
28
Q

wad chronic tx

A

Advice to “act as usual”, reassurances, education
-
Active exercise invoving functional exercise, ROM exercises, strengthening of the neck and
scapula muscles, specific strengthening exercises of the deep neck flexor muscles

Rxs that may be undertaken
provided that there is ongoing evidence of benefit
-
A coginitve behavioural approach to treatment
-
Passive joint mobilization/manipulation combined with active therapy
-
Multimodal therapy
-
Vestibular therapy

Rxs that should NOT be undertaken
-
Collar immobilization
-
prescribed rest
-
Surgery
-
Cervical pillows
-
Intra articular injections
-
electrotherapy
29
Q

larger superficial ms

  • name
  • movers/stabilizers
A

splenius capitis, SCM

movers

30
Q

T/F

deeper ms have a greater capacity to exert torque than the superficial muscles

A

F
Superf ms have a greater capacity to exert torque than the deeper muscles (multifidus,
longus colli and longus capitis)

31
Q

T/F

larger superf ms have larger lever arms and cross sectional areas

A

T

32
Q

T/F

Superficial ms are segmentally arranged with direct attachments to the cervical vertebrae

A

F

Deeper ms are segmentally arranged with direct attachments to the cervical vertebrae

33
Q

T/F

Superfic ms have larger spindle densities

A

F

Deeper ms are segmentally arranged with direct attachments to the cervical vertebrae

34
Q

T/F
Deep ms are characterized by a greater proportion of low threshold slow twitch
muscle fibres

A

T

35
Q

T/F

splenius capitis, sternocleidomastoid reflects their contribution to postural support

A

F

Deeper ms reflects their contribution to postural support

36
Q

????? can be seen when only the large superficial muscles of the neck were
stimulated to produce movement in the absence of deep muscle activation

A

regions of local segmental instability

37
Q

Superficial flexor muscles ?

A

 SCM muscle

 Anterior scalene muscle

38
Q

Superficial extensor muscles?

A

 Splenius capitis ms (Cr Vx extensor ms

 Levator scapula (when working bilaterally)

39
Q

Deep flexors ms?

A

Longus capitis

Longus colli

40
Q

Deep neck extensors ? What they do?

A 
Multifidus (stability via segmental attach)
Semispinalis cervicis (lower DNE, post stability)
41
Q

T/F

DNE are dynamic stabilizers and they tend to become activated but weak

A

F

Tend to become weak and inhibited (reduced activity)

42
Q

T/f
upper trap, levator scap and rhomboids may induce compressive loading on cervical motion segments
during upper limb function because of their attachments

A

F

IDK but rhomboids was not on the list

43
Q

people with neck pain will use superficial neck muscles for??

A 

craniovertebral flexion

isometric neck contractions

repeated upper limb movements
44
Q

Several biomechanical disturbances are noted in people with

neck pain. What are the motor output?

A 
•
reduced ROM
•
slower speed movements
•
reduced smoothness of movement
•
reduced neck muscle strength
•
Reduced endurance (observed indirectly as a reduced ability
to maintain an upright sitting posture)
•
Decreased force steadines s
45
Q

several biomechanical disturbances are noted in people with

neck pain. What are the ms behaviors?

A 

increased muscle coactivation

Reduced specificity of neck muscle activity

Decreased activation of deep muscle activity

Delayed muscle responses

Reduced muscle relaxation

Increased muscle fatiguability
46
Q

what is the neural subsystem responsible for?

A 

Responsible for:
timing of contraction
strength of contraction
recruitment pattern
47
Q

Provocative factor: Neck pain when looking down reading or using a device for prolonged periods

Possibilities?

A

Provocative factor: Neck pain when looking down reading or using a device for prolonged periods

Possibilities?
◦
Adverse strain on posterior elements, compression of anterior elements
◦
Neck extensor endurance inadequate for the task

48
Q

Provocative factor: Catching pain, suboccipital region on quick turning (driving)

Possibilities?

A

Provocative factor: Catching pain, suboccipital region on quick turning (driving)

Possibilities?
◦
C1 C2 dysfunction
◦
Poor movement sense
49
Q

Provocative factor:
Neck pain and later HA develops with prolonged computer use
Possibilities?

A 
Provocative factor:
Neck pain and later HA develops with prolonged computer use
Possibilities?
•
Adverse loading and dysfunction upper cervical joints
•
Poor control of posture
•
Poor endurance of deep neck flexors
•
Poor scapular muscle control
50
Q

Provocative factor:
•
looking up causes neck pain and light headedness, unsteadiness
Possibilities?

A

Provocative factor:
•
looking up causes neck pain and light headedness, unsteadiness

Possibilities?
•
Upper cervical joint dysfunction
•
Poor control and strength of neck flexors
•
Poor sensorimotor function proprioception, balance
•
Rule out Vertebrobasilar insufficiency (VBI)

51
Q

Provocative factor:
Carrying bags of groceries increase neck pain
Possibilities?

A 
Provocative factor:
Carrying bags of groceries increase neck pain
Possibilities?
•
Excessive compressive loads on cervical joints
•
Poor scapular muscle control
•
Poor neck flexor and extensor control
•
Adverse load on the brachial plexu s
52
Q

Provocative factor:
•
Neck and arm pain on reaching backwards

Possibilities?

A

Provocative factor:
•
Neck and arm pain on reaching backwards

Possibilities?
•
Adverse strain on neural tissues
•
Adverse loading on cervical joints
•
Adverse strain on glenohumeral join t

PHTH 623 - Differential Dx (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions