Exam 2: Whiplash Flashcards

1
Q

Whiplash describes a mechanism in which

A

Neck is whipped in one direction and recoils in opp direction

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2
Q

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

A

25-33%

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3
Q

Most likely group to be injured by whiplash

A

Females, 20-24

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4
Q

1 month post accident, __% had residual neck pain

A

6%

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5
Q

2 years post accident, ___% had residual neck pain

A

66%

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6
Q

Identifying the mechanism of injury is crucial:

A
  1. Direction of force
  2. Patients position
  3. Relationship of head/spine
  4. State of tension in neck muscles
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7
Q

Most important factor in mechanism of whiplash injury

A

Patient’s position

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8
Q

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

A

Greater velocity

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9
Q

The more segments, the ____ of the distal end

A

Greater the velocity

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10
Q

Likely sites of injury from whiplash

A
Facet joints/capsules
Vertebral endplates
Spinal ligs
IVDs
Neck muscles
Vertebral arteries
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11
Q

Facet joints mechanisms of injury

A

Pinching of synovial fluid

Strain of capsule

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12
Q

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

A

Endplate

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13
Q

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

A

50%

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14
Q

Ligaments more vulnerable during rear impacts

A

ALL (C3/4-C7/T1)

Alar and transverse ligs

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15
Q

Alar and transverse lig injuries are more severe when

A

Head is turned

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16
Q

Disc more vulnerable in rear impacts

A

C5-6 disc

Vulnerable at lower speeds

17
Q

Ligaments more vulnerable to front impacts

A

Supraspinous
Ligamentum nuchae
Interspinous
Lig flavum

18
Q

Discs vulnerable during front impacts

A

C2/3 — C7/T1

C5/6 = most vulnerable

19
Q

Superficial muscles damaged w/ whiplash injury

A

SCM

Trapezius

20
Q

SCM damaged during

A

Hyperextension

21
Q

Trapezius damaged during

A

Hyperflexion

22
Q

Deeper muscles damaged during whiplash injuries

A
Splenius
Semispinalis
Longissimus
Scalenes
Longus
23
Q

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

A

Insufficiency

24
Q

Abnormal pressure or tractional stresses may impede

A

Circulation

25
Vertebral arteries are most susceptible to injury at
Posterior AO membrane Space btw occ and posterior arch Btw lateral mass and TP of C2
26
Space between occiput and posterior arch most susceptible during
Extension
27
Between lateral mass and TP of C2 most susceptible during
Rotation and extension
28
Grading system of whiplash injury
5 point grading system
29
WAD-0
No signs/symptoms
30
WAD-1
Complaints of: -pain -stiffness/tenderness No physical signs noted
31
WAD-2
Complaints Dec ROM Point tenderness
32
WAD-3
Complaints + neuro signs - dec deep tendon reflexes - weakness/sensory deficits
33
WAD-4
Fracture/dislocation | Cord injury
34
Imaging guidelines
Candian C-Spine rules | NEXUS C-Spine Criteria
35
Concussion and subdural hematoma can occur with or without
Head strike