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MS II > Exam 5: Cervical Spine (9-12) > Flashcards

Exam 5: Cervical Spine (9-12) Flashcards

1
Q

True or False:

It is appropriate to shift my patient schedule around in order to fit in a WAD patient

A

true, they need to be seen ASA(

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2
Q

True or False:

What a patient does at home, is just if not more, important than what they do in the clinic

A

True, we should encourage self management

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3
Q

True or False:

After the first session with a WAD patient, we should consider a period of no therapy to allow tissues to heal and the inflammatory process to slow down

A

True

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4
Q

When should a WAD patient start weaning off their cervical collar

A

the second day

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5
Q

True or False:

The wearing of a cervical collar should be pain dependent

A

False, it should be function or time dependent

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6
Q

True or False:

A WAD patient should only wear a cervical collar when their symptoms are exacerbated to allow optimal healing

A

False, it should be functional or time dependent

Ex: Only wearing the collar while doing chores or wear the collar for a few hours at work and take it off when your back home

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7
Q

Patients want to know what is wrong with them post injury, so a lot of education about pain science is necessary. What type of patient friendly terms should we use

A

Stay away from torn or ruptured
Use sprain or strain
Use an ankle sprain as a metaphor
Introduce the graphic of a sensitive alarm/nervous system

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8
Q

If a WAD patient asks how long will it take to heal, how should we respond

A

Reassure them that they get better every day and will heal overtime

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9
Q

What can the patient do to ensure a better recovery following a whiplash injury

A

Ice, gentle movements, breathing exercises, move the rest of the body, relax, and keep working

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10
Q

What can the PT do to ensure a better recovery in WAD patients

A

lay out a plan of care
thorough eval
encourage and constantly educate

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11
Q

True or False:

If a patient wakes up in the middle of the night, they should perform exercises before going back to bed

A

True

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12
Q

What modalities will reduce nociception in the acute and sub-acute stages of WAD

A

Heat, ice, NSAID, TENS

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13
Q

Initial neck exercises should be done in (supine/prone/side lying)

A

supine

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14
Q

True or False:

We want WAD patients to return to work as soon as possible

A

True, as long as it is light work

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15
Q

True or False:

It is important to keep the homunculus well defined in WAD patients

A

true

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16
Q

In treating the acute and sub acute WAD patient, we need to keep the maps alive, how can we do this

A

sensory discrimination
motor imagery
imagined movement

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17
Q

True or False:

Although there is a high incidence of WAD, it usually doesn’t last long enough to be chronic

A

False, there are high rates of chronic pain

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18
Q

Patients who damage tissue is stressful environments have a __-__ times higher chance of developing chronic pain

A

7-8

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19
Q

In a study with demolition derby drivers, what was the average car collisions per event and what mean speed? How many drivers had chronic pain?

A

52 collisions at 26 mph
Only 2 drivers had neck pain greater than 3 months and only 1 driver had neck pain more than a year. The rest had pain that went away under 21 days

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20
Q

Explain why the study with demolition derby drivers didn’t have chronic neck pain after an event

A

It probably has something to do with their environment since they are doing something they enjoy. They may also brace for impact if they see it coming

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21
Q

True or False:

An MRI or CT scan are better than x-rays in diagnosing fx in WAD patients

A

true

22
Q

True or False:

MRI’s or CT scan have many false-positives

A

true

23
Q

True or False:

Although there are many false positive, MRI’s or CT scans are the standard of care for chronic WAD patients

A

False, it is not the standard of care

24
Q

A “shock” to the nervous system in WAD patients, relates to (tissues/environment/sample)

A

sample

25
Q

Central processing usually takes a (short/long) amount of time to produce sx, however in whiplash, central processing takes a (short/long) amount of time

A

long; short`

26
Q

WAD patients who do not recover in ___ months are unique that they demonstrate ____ ___ ____ which is suggestive of altered central processing mechanisms.

A

6 months

widespread sensory hypersensitivity

27
Q

Which motions during the slump test produces significant increase in the intensity of cervical sx in whiplash patients.

A

Knee extension and ankle DF

28
Q

WAD patients showed a greater limitation in knee (flexion/extension)

A

extension - this produces an increase in sx during slump test

29
Q

There is a ___ time more likely to have a peripheral neurogenic pain

A

150x

30
Q

Explain why direct trauma to the DRG in whiplash injuries can become a real problem

A

Sympathetic basket weaving occurs around the DRG. The sympathetic system contains adrenaline, and the DRG is super sensitive to adrenaline which causes pain

31
Q

If it is a central sensitization problem, where will the primary lesion be located

A

the spinal cord, brainstem, and cerebral hemisphere

32
Q

How many pain centers are within the brain

A

11

33
Q

A smudged brain is a ___ brain

A

painful

34
Q

True or False:

We need to be extremely careful when doing manual therapy in chronic WAD patients

A

true

35
Q

What are the three types of headache discussed in the powerpoints

A

Cervicogenic, tension type, migraine

36
Q

What is the most common type of headache

A

tension type

37
Q

What percentage of the population has a cervicogenic headache

A

3-14%

38
Q

True or False:

Headaches are one of the top five leading disabling disorders in men

A

False, this is true in women

39
Q

True or False:

Headaches have more functional limitations than chronic diabetes, HT, OA, and LBP

A

True

40
Q

What percentage of the population has a chronic daily headache

A

3-5%

41
Q

The trigeminal cranial nerve is a ___ ___

A

relay center

42
Q

The spinal nucleus of the trigeminal nerve extends (cephalically/caudally) to the (ventral/dorsal) horn of the upper three cervical spinal segments

A

caudally, dorsal

43
Q

Trigger points are related to (cervicogenic/tension/migraine) type headache

A

tension

44
Q

How long can a tension headache last

A

30 minutes to 7 days

45
Q

Tension type headaches have to have at least two of the four of what criteria?

A

Bilateral pain
Pressing/tightening pain
Mild to moderate intensity
Not aggravated by walking/stairs

46
Q

Tension type headaches must of what two criteria?

A

No nausea or vomiting

No more than one of photophobia or phonophobia

47
Q

A patient with a tension type headache can have either infrequent episodes, frequent episodes or chronic tension type headaches. What does an infrequent episode look like

A

At least 10 episodes that occur once a month

48
Q

A patient with a tension type headache can have either infrequent episodes, frequent episodes or chronic tension type headaches. What does a frequent episode look like

A

At least 10 episodes that occur 15 days per month for at least 3 months

49
Q

A patient with a tension type headache can have either infrequent episodes, frequent episodes or chronic tension type headaches. What does chronic tension type headaches look like

A

greater than 15 days a month for three months or more

50
Q

What type of head is caused mostly by myofascial input

A

tension type

think trigger point with myofascial

51
Q

True or False:

Central sensitization to the trigeminal nerve can cause a tension type headache

A

False, headaches cause central sensitization

central sensitization does not cause headache

MS II (14 decks)

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