FINAL EXAM Flashcards
T/F - nodding of the cervical spine occurs in the lower cervical spine, whereas flexion occurs in the upper C spine
FALSE
during flexion, nodding occurs in upper C-spine, flexion occurs in lower C-spine
T/F - rotation in the atlanto-occipital joint is negligible
TRUE
-principle motion of these two joints is flexion-extension (15°-20°) or nodding of head
-side flexion is ~10°
T/F - the atlas has a vertebral body
FALSE
T/F - the odontoid process of C2 has evolved from the vertebral body of C1
TRUE
T/F - the atlanto-axial joint is the least mobile articulation of the spine
FALSE
= MOST mobile articulations of the spine, they are ellipsoid & act in unison
T/F - rotation is the primary movement of the joints between C1-C2
TRUE
rotation is the primary movement of atlanto-axial joints (C1-C2)
T/F - the atlanto-axial joint is the articulation between C1 and C2
TRUE
T/F - the first palpable spinous process below the external occipital protuberance is the spinous process of C1
FALSE
first palpable vertebra descending from the EOP = SP of C2
what are the joints of Luschka? (costal/ uncovertebral processes/ uncinate joints)
-uncovertebral processes of inferior vertebrae
-pseudo - joint formed by weakness in annulus fibrosus
greatest stresses placed on the vertebral artery
-where it enters TVP of C6
-within bony canals of vertebral TVPs
-between C1 & C2
-between C1 & occiput
in shoulder/upper crossed syndrome, which muscles would be short & tight?
pectorals, upper traps, suboccipitals, levator scapula
in shoulder/upper crossed syndrome, which muscles would be long & taut?
deep neck flexors, rhomboids, serratus anterior, lower traps
a group of inherited disorders characterized by joint hypermobility, skin hyper-extensibility and increased bruising is called…
Ehler’s Danlos Syndrome
an autoimmune disorder characterized by inflammation and destruction of connective tissue resulting in hypermobility of the affected joints is called…
Rheumatoid Arthritis
inherited disorder with fragmentation of elastin, leading to joint hypermobility, elongated bones, aortal widening, mitral valve prolapse and changes in the eye is called…
Marfan’s Syndrome
to test for nerve root compression in the C spine, what would be the best special test to perform?
Spurling’s
to differentiate dizziness or vertigo, what would be the best special test to perform?
Hautant’s
which special test is to assess for nerve root compression in C spine by alleviating symptoms?
distraction
what trigger point referral pattern refers pain around the ear?
suboccipitals
which trigger point referral pattern refers pain to the top of the head?
splenius capitis
which trigger point referral pattern refers pain to the temple?
splenius cervicis
temporalis
semispinalis capitis
T/F - tension headaches are a muscle contraction type headache
TRUE
T/F - tension headaches cannot be the condition or secondary because of an underlying pathology
FALSE
primary: headache is the condition
secondary: result of an underlying pathology, such as hypertension or head trauma
T/F - predisposing factors of tension headaches can be TP stimuli or TMJ dysfunction
TRUE
trauma, acute mm overload, infection, fatigue, chilling of mm, referred pain, emotional stress, sleep disturbance, postural imbalances (hyperkyphosis, head-forward posture)
T/F - a ‘common migraine’ is a migraine with an aura
FALSE
T/F - a ‘classic’ migraine is a migraine with an aura
TRUE
T/F - a migraine without aura is more common than a migraine with aura
TRUE
(85%)
T/F - auditory stimuli and weather changes are not considered trigger factors for migraine
FALSE
stress, foodstuffs & food additives, hunger, meds, visual stimuli, olfactory stimuli, sleeping, hormonal shifts, allergies
T/F - ’Postdrome’ is when the person may feel fatigued and drained 24 - 48 hours post migraine
TRUE
T/F - the frequency of migraines is usually weekly
FALSE
= daily
Pseudo-torticollis is which type of torticollis?
acute acquired
trauma may be a predisposing factor, head & NK in typical torticollis position, aggravated by stress, C-spine bent toward & rotated away from affected side
torticollis
acute acquired
congenital
spasmodic
results from localized dystonia, idiopathic, painful movements, spasmodic mm, CNS lesion, malformation C0-C1, caused by postural dysfunction
spasmodic torticollis
idiopathic, tissue ischemia & cranial bone/ memebrane dysfunction may be predisposing factor, lifetime unless corrected, increase possibility of degenerative disc disease, present from infancy, contracture ipsilateral SCM, SCM thick, pain-free contracture
congenital torticollis
painful movements, spasmodic mm, suddent onset, may have tinnitus/ nausea/ tearing of eye, increase possibility of degenerative disc disease, woke up with it, caused by postural dysfunction, activation of latent TPs, subluxation C1/C2, facet joint irritation, infection, disc related P
acute acquired torticollis
what other conditions could lead to a patient presenting with TOS?
-carpal tunnel syndrome
-common flexor tendonitis
-compression of Guyon’s canal
-C-spine spondylosis, cervical radiculopathy, cervical tumors
-Raynaud’s disease (phenomenon)
-ulnar nerve compression
-osteoarthritis (OA)
Adson’s maneuver tests for what?
TOS
Tx for TOS
-main goal is to reduce cause of compression
-when treating subclavius, address pec major first
-when addressing anterior TVP for scalenes, SCM treated first
-when addressing pec minor, pec major treated first
-for all syndromes, address fascia of anterior NK, chest & SH
if a patient comes in presenting with TOS symptoms and they tell you they sleep with their arm above their head, what type of TOS would you suspect?
pectoralis minor
if a patient comes in presenting with TOS symptoms and they tell you the pain is activated by heavy lifting, what type of TOS would you suspect?
anterior scalene
if a patient comes in presenting with TOS symptoms and they tell you the pain is activated by carrying a heavy bag over their shoulder, what type of TOS would you suspect?
costoclavicular, pectoralis minor
anterior scalene syndrome can be caused by what?
-extra wide insertion of anterior scalene
-HT in anterior scalenes that is activated by heavy lifting
-anatomical anomalies such as a cervical rib
CIs for treating TOS
-avoid aggressive mobilizations if a cervical rib is present
-moist heat over neck if clt has hypertension
what factors might affect a rear-impact whiplash?
head position, air bags, seat belts, headrest position
whiplash can result in…
facet joint irritation
nerve root compression
ligamentous injury
mm injury
vertebral injury
intervertebral disc injury
joint capsule injury
blood vessel injury
fascial injury
full peak acceleration occurs at what phase of whiplash?
phase II
(vehicle & torso)
head & neck are now at their peak forward acceleration while the vehicle and torso are slowing down
phase III
head & torso are now at full deceleration
phase IV
T/F - grade 1 classification of whiplash indicates no physical neck/upper back signs
TRUE
T/F - grade 2 classification of whiplash indicates neck/upper back musculoskeletal signs
TRUE
T/F - grade 3 classification of whiplash indicates neck/upper back neurological signs
TRUE
T/F - grade 4 classification of whiplash indicates neck/ upper back fracture or dislocation
TRUE
recommended self-care for a patient with acute or early subacute whiplash includes…
P-free active range of motion of cervical spine
rib springing should be performed bilaterally at all times to…
hypomobile ribs
a localized, sharp posterior angulation from vertebral wedging is called…
Gibbus deformity
(Pott’s disease)
to eliminate compensation during AROM of the thoracic spine, the examiner can…
ask the patient to sit
the primary muscles of inspiration is/are…
diaphragm
subclavius
levator costorum
external & internal intercostals
T/F - if a rib stops moving relative to the other ribs on exhalation, it is classified as a(n) elevated rib
TRUE
T/F - if a rib stops moving relative to the other ribs on inhalation, it is classified as a(n) deranged rib
FALSE
= depressed rib
what direction does the pump handle action of ribs 1-6 move the ribs most?
superior-inferiorly
increase the anteroposterior dimension
what direction does the bucket handle action of ribs 7-10 move?
upward, backward, medially
downward, forward, laterally
= bucket-handle action
to locate the TVP of T9, what SP would be at the same level to landmark?
T8
an increase in thoracic kyphosis can cause…
int.R GH joint
restricted rib mobility
TOS
inefficient breathing
the purpose of using the passive scapular approximation test is to assess for what nerve root problem?
T1-T2
when performing the slump test, what would be the next step in the test after getting the patient to “slump” or flex the spine forward?
- patient seated
- patient flexes spine & shoulders sag forward
- patient moves neck into flexion
- patient extends one knee
- patient dorsiflexes their foot
which pathology leads to hyperkyphosis in juvenile males?
Scheuermann’s disease
T/F - your patient presents with a hyperkyphotic posture, with AROM testing for the thoracic spine, the movement you would expect to see the most limited would be flexion
FALSE
= extension
resisted muscle testing for someone with hyperkyphosis would reveal taut, weak muscles…
middle trapezius & rhomboid major
infrahyoids & suprahyoids
what is CI’d for hyperkyphosis?
-mm stripping techniques to lengthened tissues
-fascial techniques to overstretched tissues
T/F - lateral flexion of the spine towards the convexity is increased
FALSE
= decreased
T/F - the ribs on the convex side are more posterior in scoliosis
TRUE
T/F - the vertebral bodies are rotated toward the concavity
FALSE
= toward convexity
T/F - the paraspinals are lengthened on the convex side
TRUE
when charting information about scoliosis, you should list…
span of scoliosis
apex of the curve
direction of concavity
S or C shaped curve
transitional vertebra
how can the therapist evaluate/confirm a structural scoliosis from a functional scoliosis?
-determine whether a small hemi-pelvis exists
-have them flex forward to see if spine straightens
-test to see if there is a leg length discrepancy
what is the best way to locate the lateral pterygoids internally?
place finger against last upper molars & slide superiorly and posteriorly between maxilla & coronoid process of mandible
what is the best way to locate the medial pterygoids internally?
place finger on last lower molar, then slide around to medial surface of molar & inferiorly past gum towards floor of mouth
which muscle bilaterally depresses and retracts the mandible and unilaterally moves the mandible to the same side?
lateral pterygoid, digastric ??
T/F - the resting position for the TMJs is the mouth slightly open, the lips together and the teeth not in contact
TRUE
T/F - on mandibular depression, normally gliding occurs before rotation
FALSE
rotation = first
T/F - the temporomandibular ligament restrains movement of the lower part of the jaw
TRUE
T/F - the TMJ is a synovial, condylar, modified ovoid hinge joint
TRUE
which muscles close the jaw?
masseter
medial pterygoid
temporalis
lateral pterygoid = opens jaw
