E4: Cervical Sprain and Strain

Question 1

All patients with whiplash should undergo what type of imaging?

Answer 1

X-Ray

Cervical Spine: AP, Lateral, Oblique, Open Mouth views

Question 2

Which whiplash patients should undergo an MRI?

Answer 2

Those with symptoms of nerve root injury and those with pain persisting without significant recovery beyond 6 weeks

Question 3

When are flexion/extension x-rays utilized and what do they diagnose?

Answer 3

6-12 weeks after injury

Diagnose segmental instability

Question 4

Grade 0 Whiplash Disorders

Answer 4

No neck pain, stiffness, tenderness

Question 5

Grade I Whiplash Disorders

Answer 5

Neck pain, stiffness, tenderness

Question 6

Grade II Whiplash Disorders

Answer 6

Neck pain, stiffness, tenderness, physical signs, musculoskeletal signs

Question 7

Grade III Whiplash Disorders

Answer 7

Neck pain, stiffness, tenderness, physical signs, musculoskeletal signs, neurological signs

Question 8

Grade IV Whiplash Disorders

Answer 8

Neck pain, stiffness, tenderness, physical signs, neurological signs, fracture/dislocation

Question 9

Where should OMT be administered to whiplash injuries?

Answer 9

Areas adjacent to most severely injured, especially cranium and sacrum

Question 10

HVLA should be administered to tissues with what characterization?

Answer 10

Soft tissues that are not boggy/warm

Question 11

When do most whiplash patients improve?

Answer 11

4-6 weeks

Question 12

What is the first stage of treatment for patients?

Answer 12

Neuro exam, AP & lat x-rays

Question 13

What is the second stage of treatment?

Answer 13

If neuro deficit OR abnormal films, then brace and immediate referral for further imaging

If normal neuro exam and films, then rest, ice, NSAIDs

Question 14

What is the incidence of whiplash injury?

Answer 14

80-131 per 100,000 (Australia)

175 per 100,000 (Canada)

Question 15

What is the prevalence of whiplash injury?

Answer 15

2800 per 100,000 of police-reported MVAs

Question 16

What happens during a whiplash injury?

Answer 16

Initially, all parts of the body move toward point of impact, then recoil away from point of impact.

Question 17

Which bones are especially vulnerable to forces transmitted through SCM?

Answer 17

Temporal bones