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Spine Test 1 > Lecture 5 > Flashcards

Lecture 5 Flashcards

1
Q

What kind of pain is OA

A

Dull and achy

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2
Q

Where is cervical arthritis typically?

A

c5-c7

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3
Q

Why would cervical OA lead to decreased tolerance to a compressive load?

A

Because the articulating cartilage has essentailly been worn down and it hurts when compressed because its bone on bone / also the nerve roots exiting dont have as much room

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4
Q

What would OA do to spinal curvature?

A

Will change sagittal curvature (aka lordosis / kyphosis changes)

  • neck loses lordoic curve and becomes more neutral w/ OA
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5
Q

Will cervical OA increase or decrease ROM

A

Decrease

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6
Q

Will cervical OA increase or decrease C-spine height?

A

Decrease

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7
Q

Will cervical OA increase or decrease stiffness in the cervical spine?

A

Increase

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8
Q

What would we do for an acute OA pt

A

Isometric (decrease pain / increase function) - think when he came in w/ a painful neck

Eduction

Manipulation (etc..)

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9
Q

Know: facet joint referal pattern (its a reffered pain sensation - so deep and achy)

He’s proably going to pick on the extremes
C2-3 facet refferal = base of skull / ear
C6-7 = into the scapula

A
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10
Q

Which facet joint area referes into the scapula?

A

C6-C7

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11
Q

Which facet joint area referal refers to the shoulder?

A

C5-C6

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12
Q

Which facet joint area refers to the base of the skull / ear?

A

C2-C3

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13
Q

Which facet joint area refers to the upper neck?

What about lower neck?

A

C3-C4

C4-C5

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14
Q

Is mobilizing cervical vertebrae super specific?

A

No, you can mobilize one and it might not be the one you think you’re mobilizing / other ones around it also have benefit

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15
Q

is there specificity in manual therapy?

A

No

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16
Q

as disc heigh decreases what happens to load on facets?

A

It increases (essentially pinching together)

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17
Q

Does a closing down issue or an opening up issue cause facet referred pain?

A

Closing down on the facet joints is what causes the pain

18
Q

What two symptoms do facet issues cause

A

stiffness / pain

19
Q

Is facet pain unilatearl or bilatearl?

A

unilatearl

20
Q

A student heard a noise behind them and looked to see where it was (rotating their head). They felt a locking sensation and a dull aching pain in their right lower neck. What could be their issue?

A

right, c4-5 facet issue

21
Q

What is a key charcteristic of cervical facet issues after what 3 motions

A

locking after rotation, extension, or side bending (any motion that closes down those facet joints)

22
Q

Should you push into pain?

A

Yes

23
Q

A feeling of locking is common with what three movement when someone has facet issues. Why specifically do these movements cause an issue?

A

Rotation, side bending, extension

Because its closing down the facet joints

KNOW: the reason we have pain at all is because the facet joint is a synovial joint. When we close down a bit of that synovial membrane gets stuck and inflammed.

24
Q

A patient comes in reporting neck pain with extension. You figure out that its a facet joint issue. Would you want to open this patients facet joints up or push into pain? What does this depend on?

A

It all depends on how irritable the patient is

You would push into pain if it isnt that irritable in attempt to losen it up. However, if they are highly irritable you should work on opening that facet joint up by closing the contraltaeral facet joint down.

25
Q

Does imaging show facet joint issues?

A

Proably not

26
Q

KNOW: Sometimes a local steriod injection is done into the facet joint to calm it down if symptoms are lasting a long time

A
27
Q

A patient has shooting pain and numbness and tingling that starts in their neck and goes down their arm. Are we thinking this is a facet issue?

A

No.

Facet issues are typically nociceptive only (pain) and do not have numbness or shooting (nerves not involves here)

28
Q

KNOW: facet patients respond well to mobilization (loosen it up) ROM (loosen it up) and strenthening EX (and other pain modulation techniques - isometrices etc.)

A
29
Q

KNOW: you are upgliding from the left - which means i am going into right rotation

A
30
Q

If I want to open up the facet joint on the left between C4-C5 do i upglide on C4 or C5?

A

C4 - you’re essentially pulling the C4 up and off of C5

31
Q

If I wanted to close down C4 and C5 with an upglide what cervical verebra would I do it on?

A

I would upglide on C5 which will essentially push it up and into C4 (and will pull C5 and C6 apart)

So if they’re really tinder on C4 thats a way to close it down without actually touching it

32
Q

If I wanted to open the right C4-C5 facet joint what is the simplist way to do this?

A

lateral flexion to the left

33
Q

In an upglide which side opens?

A

ipsilatearl side (contralatearl side closes)

34
Q

in a cervical downglide which side closes down the vertebra

A

You’re essentailly laterally flexing them so the ipsilateral side closes and the contralateral side opens

35
Q

Patient reports pain on the right side when going into left side flexion. Is this a vertebral (facet) opening or closing issue? (on test)

A

Right opening issue (left side = closing right = opening)

36
Q

What are two things that cause opening issues between the vertebrae (might just be talking about between facet joints)

A

Muscles not wanting to be stretched (muscle tightness)

Synovial membrane not liking the stretch (I think specifically the synovial membrane around the facet joint)

37
Q

patient reports right pain when rotating right and side flexing right. Is this a opening or closing issue?

A

closing on right

38
Q

What 3 issues are associated w/ vertebral (facet) opening issues?

What two theraputic things do we do for this?

A

Flexion
contralteral rotation
Contralateral side bending

(anything that opens up)

We want to do anything that will further open up this side. Ipsilatearl upglide, contralatearl downglide (both facilitate opening of the same facet joint)

39
Q

Doesnt want to close is a closing issue or opening issue?

A

Closing issue

40
Q

What 3 motions are affected by closing dysfunction of the facet joint?

What two theraputic measures do we take?

A

Anything that closes it down. Extension, ipsilateral side bend, ipsilateral rotation

We want to do things that close down this joint. Ipsilateral downglide, contraltaeral upglide (things that close it down) - think stuck drawer we want to close it down and maybe get it unstuck

41
Q

A patient presents with extreme pain on the right side when right side flexing / extending / rotating to the right. We decide its a facet issue. What is the 1 and only best thing to do here and why? (test)

A

We know that it is a closing down issue because its on the same side were bending to. However, theres pain when on that side so we would want to mess with the other side. Our two options to close it down would be an ipsilateral down glide or contralateral upglide. We choose contralatearl upglide because its on the opposing side.

42
Q
A

Spine Test 1 (14 decks)

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