EXAM 2: set 2 Flashcards
stage 1
get sym under-control
stage 2
sym under control
nor working on functional impairments
stage 3
sym resolved
impairments are slight
function endurance remains the issue - return to sport activities
what is the capsular pattern representing
degenerative/arthritic changes
what is the capsular pattern movement diagram
sym restriction of SB and rot
restricted ext
normal flexion
is a capuslar pattern seen at one segment or multible segments
multiple segments involved
normal presentation of capsular pattern
restrict movement
soreness, stiffness, and ahcing
boney or firm end feel
Traumatic event neck presentation
something happened to the pt they are now restricted in all directions
o Fracture or dislocation
Acute synovitis neck presentation
o This is a rapid alternation of the pt condition due to some mechanical probation
o This can be a pain-inflammatory reaction
o This pt needs active rest -72 hours
o This could be an adverse reaction to treatment of neck pain
slept on it wrong pattern
- The neck got held in a certain position of sometime and the facet joints/capsules are now holding you in that position
- This person is very inflamed – we do not want to mobilize these pt
- Active rest with palliative measures
Arthritis def
umbrella term
used to describe several conditions that cause inflammation in your joints
OA and RA
Arthrosis def
another name for OA
is OA sym
no one sided
athrosis presentation in the neck
Not acute, older individuals, have a history of prolonged neck issues
Old man in the park with his hand on his back with forward flexion
Hands on back – to preserve balance
stuck in flexion
what movement is effected with arthrosis
rot is preserved normally - AA is not effected
suck in flexion
treatment of arthosis neck
not malleable
Aggressively working on restoring motion will not typically work
reasons for restricted flexion
o Acute trauma synovitis
o Painful discogenic structure
o Mechanical dysfunction in the CT upper thoracic spine
what tells you that the issues is Mechanical dysfunction in the CT upper thoracic spine
restricted flexion
Pain in the axial skeleton – middle of neck
what do you do if you have a mech dysfunction of the CT
manual therapy
Seated thoracic distraction
seated CT distraction
mid thoracic thrust
Seated CT distraction segments
Believed to be more specific: C7 - T2
contradictions for seated CT distraction
shoulder issues
seated thoracic distraction segments
More general: T1-T4
Mid-thoracic thrust
mid thorax – T4 -T8
Painful discogenic structure presentation
Pain will peri (scapula) – high level of pain
Does not respond to manual therapy
follow up after cervial resitricted flexion interventions
cervical protraction and retraction
anything that promotes thoracic extension - laying on pillow/foam
winged arm breathing
follow up for extension pattern
Retraction cervical
three finger sweep
hand collar
towel mobilization
what is cervical radioulopathy
UE sym that have their origin in the cervical spine
- head movements reproduce radiating sym
- sharp intense sever pain
- associated parathesis
does any cervical radio follow dermatonal patterns
yes
C5, C6, C7 are the most common
do you need imaging for radiculopathy
no it is a clinical diagnosis
what is wainner’s cluster used for
ruling in cervical radiculopathy
what is included in wainners cluster
distraction
spurling
cervical rotation - less then 60-degrees
ULTTA - median nerve tension testing
what is the treatment of choice for radiculopathy
traction
what kind of herniation do we see in the lumbar spine
disc protrusion, rearrangement, the disc change
The structure at the disc is most likely to contact the nerve root
Cervical herniation
We can get degenerative change in the foramen over time
spurling pt position
SB and ext head in sitting
Positive shoulder ABD test: C7
better when hand is on opposit should
this is taking away the tension on the nerve root
Positive shoulder ABD test: C6
better when arm in on head
Positive shoulder ABD test: C5
better when arm in on abdomen
Upper limb tension test (ULTT) – focus on the median nerve arm movements
90 abd
arm ER
supination
ext of tumb, pointer, and wrist
then ext the elbow from this position
what kind of pain is seen with a flexion patterns
stretch pain
when I lean to my left my right side hurts
what are the intervention of r flexion pattern
- Upper ribs (1st and 2nd) – look at the 2nd one first
- Breathing pattern: do not use their diaphragm, contributes to hypertonicity
- CT/upper thoracic spine
- Mid C-spine flexion mobility
- Anterior neck flex activation: motor control, retraction
- Shoulder/shoulder girdle
- Soft tissue mobilization
- Stretching
Upper cervical presentation/symptoms
- Suboccipital pain/tenderness (AO)
- Headaches (cervicogenic)
- Dizziness
- Nausea
- Fatigue and lethargy
movement pattern for AA
rot and contralleral SB are restricted and pain ful
movement patteren for AO
ext and SB are restricted and painful
Painful discogenic structure
nerve receptors located in the outer part of the annulus are irritated by inflammation or other conditions
