L10 CT Exam Flashcards
Neck Pain Epidemiology
- 10-20% of population will experience neck pain at any given time
- 2nd only to LBP in workers’ compensation costs in the US
- 25% of patients seeking out-patient PT care
Neck pain risk factors
- age > 40 yrs
- coexisting LBP
- previous hx of neck pain
- females > males
- high job demands
- low social/work support
Neck Disability Index
*10 Qs, ranked 0-5 each
*50 pts total
* higher score is more disability
* MDC is 5 pts
Prognostic Factors for Neck pain
- natural hx of neck pain is favorable, rates of recurrence and chronicity is high
- > 6/10 initial visit has increased likelihood of persistent s/s at 12 mo
- higher perceived disability (>30%) is poorer prognosis
- WAD is easier to gauge, cold hyperalgesia has poorer prognosis
Complete recovery after recurrent episodes is
the exception, not the rule
Most recovery from neck pain will occur in the first
6-12 weeks
Things to know for MVA
- where in the car was the pt
- was the pt belted and did it engage
- which direction did the impact come from
- did the pt see it coming
- did the pt have s/s that were immediate or delayed
Thoracic and Shoulder Screening Exams
seated thoracic rotation
lumbar locked thoracic rot
apley scratch test
thoracic shoulder test
Myotomes for Neck
- neck flexion = c1-c2
- neck lateral flex = c3
- shoulder elevation = c4
- shoulder abd = c5
- elbow flex = c6
- wrist ext = c6
- elbow ext = c7
- wrist flex = c7
- thumb ext = c8
- finger abd = t1
Upper Limb Reflexes
Brachioradialis = c5/6
Biceps = c5/c6
Triceps = C7/c8
Dermatomes
Clinical Instability of cervical spine
can be due to trauma, hypermobility syndromes, degenerative processes, congenital conditions
tests for eval look specifically at passive constraints
Patients with clinical instability may report
- head feels heavy, fatigued
- may seek external support
- feeling of instability
- neck gets stuck
- frequent episodes
- past history of trauma
- fear/unwillingness to move
- 5ds and 3 ns
5 Ds and 3 Ns
Dizziness
Diplopia
Drop attacks
Dysphagia
Dysarthria
Nausea
Nystagmus
Numbness
OA Joint
flexion and extension of occiput on condyles of C1