Exam 2: Whiplash

Question 1

Whiplash describes a mechanism in which

Answer 1

Neck is whipped in one direction and recoils in opp direction

Question 2

____% of those involved in rear-end accidents experience neck injury

Answer 2

25-33%

Question 3

Most likely group to be injured by whiplash

Answer 3

Females, 20-24

Question 4

1 month post accident, __% had residual neck pain

Answer 4

6%

Question 5

2 years post accident, ___% had residual neck pain

Answer 5

66%

Question 6

Identifying the mechanism of injury is crucial:

Answer 6

1. Direction of force
2. Patients position
3. Relationship of head/spine
4. State of tension in neck muscles

Question 7

Most important factor in mechanism of whiplash injury

Answer 7

Patient’s position

Question 8

For an object w/ multiple segments, distal end moves at _____ than prox end

Answer 8

Greater velocity

Question 9

The more segments, the ____ of the distal end

Answer 9

Greater the velocity

Question 10

Likely sites of injury from whiplash

Answer 10

Facet joints/capsules
Vertebral endplates
Spinal ligs
IVDs
Neck muscles
Vertebral arteries

Question 11

Facet joints mechanisms of injury

Answer 11

Pinching of synovial fluid

Strain of capsule

Question 12

When subject to compressive load, first structure to fail is the

Answer 12

Endplate

Question 13

25% reduction in bone mass causes ___% decrease in strength in vertebral endplate

Answer 13

50%

Question 14

Ligaments more vulnerable during rear impacts

Answer 14

ALL (C3/4-C7/T1)

Alar and transverse ligs

Question 15

Alar and transverse lig injuries are more severe when

Answer 15

Head is turned

Question 16

Disc more vulnerable in rear impacts

Answer 16

C5-6 disc

Vulnerable at lower speeds

Question 17

Ligaments more vulnerable to front impacts

Answer 17

Supraspinous
Ligamentum nuchae
Interspinous
Lig flavum

Question 18

Discs vulnerable during front impacts

Answer 18

C2/3 — C7/T1

C5/6 = most vulnerable

Question 19

Superficial muscles damaged w/ whiplash injury

Answer 19

SCM

Trapezius

Question 20

SCM damaged during

Answer 20

Hyperextension

Question 21

Trapezius damaged during

Answer 21

Hyperflexion

Question 22

Deeper muscles damaged during whiplash injuries

Answer 22

Splenius
Semispinalis
Longissimus
Scalenes
Longus

Question 23

Vertebral artery _____ is one explanation for some of the CAD injury symptoms

Answer 23

Insufficiency

Question 24

Abnormal pressure or tractional stresses may impede

Answer 24

Circulation

Question 25

Vertebral arteries are most susceptible to injury at

Answer 25

Posterior AO membrane
Space btw occ and posterior arch
Btw lateral mass and TP of C2

Question 26

Space between occiput and posterior arch most susceptible during

Answer 26

Extension

Question 27

Between lateral mass and TP of C2 most susceptible during

Answer 27

Rotation and extension

Question 28

Grading system of whiplash injury

Answer 28

5 point grading system

Question 29

WAD-0

Answer 29

No signs/symptoms

Question 30

WAD-1

Answer 30

Complaints of:
-pain
-stiffness/tenderness
No physical signs noted

Question 31

WAD-2

Answer 31

Complaints
Dec ROM
Point tenderness

Question 32

WAD-3

Answer 32

Complaints + neuro signs

• dec deep tendon reflexes
• weakness/sensory deficits

Question 33

WAD-4

Answer 33

Fracture/dislocation

Cord injury

Question 34

Imaging guidelines

Answer 34

Candian C-Spine rules

NEXUS C-Spine Criteria

Question 35

Concussion and subdural hematoma can occur with or without

Answer 35

Head strike