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MS 2 Exam 1 > Lecture 5: Cervical Spine Whiplash > Flashcards

Lecture 5: Cervical Spine Whiplash Flashcards

1
Q

What happens to neck in rear end collision?

A

hyperextension followed by hyperextension

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2
Q

What happens to neck in frontal impact?

A

hyper flexion followed by hyperextension

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3
Q

What happens to the muscles involved during a whiplash injury?

A

fatty infiltrates will develop in neck muscles in pts with chronic whiplash

between 4 weeks and 3 months with severe pain levels

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4
Q

What is the timeline for whiplash classification?

A

acute- up to 2 weeks after injury
subacute- 2-12 weeks
chronic- more than 12

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5
Q

What is updated clinical classification of whiplash associated disorders?

A

0- neck neck complaint

1- neck complaint of stiffness, pain and merely tenderness

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6
Q

What is updated clinical classification of whiplash associated disorders level 2A?

A

neck pain, motor impairment, decreased ROM, altered muscle recruiting patterns, sensory impairment,

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7
Q

What is updated clinical classification of whiplash associated disorders level 2B?

A

same as 2 A plus psychological impairments, elevated psychological distress on GHQ 28, TAMPA

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8
Q

What is updated clinical classification of whiplash associated disorders level 2C?

A

same as A and B, plus generalized hypersensitivity, ULTT may show signs of SNS disturbances

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9
Q

What is updated clinical classification of whiplash associated disorders level 3?

A

neuro signs of conduction loss, decreased or absent DTR, muscle weakness, sensory deficits

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10
Q

What is updated clinical classification of whiplash associated disorders level 4?

A

neck complaint with fx or dislocation

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11
Q

What are some poor predictors of outcome after whiplash?

A

high baseline pain (over 5), HA, no seatbelt use, LBP, high NDI, female, WAD grade 2-3, cold sensitivity

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12
Q

What is important to ask during the evaluation?

A

speed of travel, seatbelt use, airbag, direction hit from, position of victim

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13
Q

What are components of cervical kinesthesia assessment?

A

used for sensorimotor impairment

joint position sense, balance assessment, oculomotor assessment

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14
Q

What will patients have in they have central sensitization after whiplash injury?

A

combination of cold hyperalgesia, reduced pain threshold

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15
Q

What are acute interventions for whiplash?

A

pt education, decrease pain, minimize ms spasm, posture re ed, body mechanics for ADL’s

ICE, estim, TENS, AROM exercises

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16
Q

What are subacute interventions for whiplash?

A

more emphasis on active exercises and ROM, strengthening, continued postural re-ed

STM, T spine mobs, AC, cervical kinesthetic training

17
Q

What are chronic interventions for whiplash?

A

segmental stabilization, joint mobs, scap stab, PNF, AC

18
Q

What are sign of sx of fibromyalgia syndrome?

A

widespread pain, tenderness to palpation of multiple joints, morning stiffness, fatigue, sleep disturbances, female, depression, STM loss

19
Q

What is American college of Rheumatology classification for FMS?

A

widespread ms pain, pain induced by palpation of tender points, which include occiput at subocciptal muscles, trap- midpoint of upper muscle border

20
Q

What is updated classification for FMS?

A

same as before plus 0-19 on widespread pain index, 0-3 on symptom severity score (sleep, fatigue, cog sx, somatic sx)

21
Q

What are exams findings for fibromyalgia?

A

allodynia- pain in response to non nociceptive stimulus like brushing of skin, may have trigger points, decreased ROM< decreased strength and endurance

22
Q

What is CMT?

A

congenital muscle torticollis

characterized by- head tilt to one side or lateral flexion due to shortening or fibrosis of SCM

23
Q

What else could accompany CMT?

A

cranial deformation, hip dysplasia, brachial plexus injury, distal extremity formation

24
Q

What are 3 types of CMT?

A
  1. postural- mildest, postural preference but but without muscle or passive ROM restrictions
  2. muscular- SCM tightness and passive ROM limitations
  3. SCM mass- most severe form presents with fibrotic thickening of SCM and passive ROM limitations
25
Q

What is key for CMT intervention?

A

early intervention

26
Q

What is plagiocephaly?

A

cranial asymmetry with flattening of 1 side of the head

27
Q

What are interventions for CMT?

A

passive stretching, use of prone position for 1 hour a day active movement away from the tightness, parent education, AROM to limited side asymmetrical handling

28
Q

When will a referal be need for PCP after PT for CMT?

A

4-6 week of intense tx not working, 6 months of tx with moderate resolution, side of CMT changes, mass develops if over 7 months

29
Q

When should a patient with CMT be discharged?

A

infant has full PROM with 5 degrees of non affected side, symmetrical active movement patterns throughout passive range, age appropriate motor development, no visible head tilt

MS 2 Exam 1 (9 decks)

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