M6 Test 1

Question 1

Cervicogenic headaches, TMJ dysfunction, and/or vertigo may arise from inter-segmental joint dysfunction in the ____ spine

Answer 1

Upper cervical

Question 2

Red flags of this condition include dizziness, facial or extremity paresthesia, visual disturbances, drop attacks, and difficulty swallowing, speaking or walking.

Answer 2

Vertebrobasilar artery insufficiency

Question 3

The most common and realistic complication of cervical SMT is ____

Answer 3

Local soreness

Question 4

__-__% of all headaches are referred from the cervical spine and are classified as _____

Answer 4

15-25%, cervicogenic

Question 5

The mean age for cervicogenic headache (CGH) is in the 40’s, and the condition affects women more often than men at a rate of __:__

Answer 5

4:1

Question 6

By definition, CGH is ____, but in some cases it may present ____ (unilateral/bilateral)

Answer 6

Unilateral, bilateral

Question 7

The American Headache Society endorses the acronym _____ to identify worrisome headache red flags

Answer 7

SNOOP

Question 8

Identify what the acronym SNOOP stands for:

Answer 8

Systemic symptoms (fever, weight loss)
Neurologic signs (confusion, impaired alertness)
Onset (sudden and abrupt HA that peak quickly)
Older (new HA in patients >50 - temporal arteritis)
Previous HA Hx (new HA that deviates significantly from prior pattern)

Question 9

The _____ (suboccipital muscle) shares a dense connective tissue bridge with the pain-sensitive dura at the level of the atlantooccipital junction

Answer 9

Rectus capitus posterior MINOR

Question 10

The most important clinical finding for the diagnosis of CGH is _____ restriction

Answer 10

Upper cervical spine

Question 11

Weak cervical flexors, rhomboids, and lower traps with hypertonic pecs, suboccipitals and upper traps suggests what common syndrome?

Answer 11

Upper crossed

Question 12

___ is the leading presenting complaint for seniors over age 75.

Answer 12

Dizziness

Question 13

The term _____, first described in 1955 by Ryan and Cope, describes dizziness or disequilibrium originating from abnormal proprioceptive activity in the cervical spine.

Answer 13

Cervicogenic vertigo

Question 14

____ is suggested by a history of dizziness associated with cervical movement and concurrent neck pain.

Answer 14

Cervicogenic vertigo

Question 15

The most common cause of vertigo is _____, which is responsible for between 17 and 42% of all cases.

Answer 15

BPPV

Question 16

____ function can be assessed with Romberg, finger to nose, heel to knee, and gait assessment.

Answer 16

Cerebellar

Question 17

The ____ test aims to isolate cervical mechanoreceptors without stimulating the vestibular apparatus. This test is used to differentiate cervicogenic vertigo from BPPV.

Answer 17

Rotating stool (or Neck torsion test)

Question 18

The ____ test is a classic assessment for BPPV, but may also provoke cervicogenic vertigo.

Answer 18

Dix-Hallpike

Question 19

____ is caused by involuntary, unilateral contraction of the neck muscles, particularly the SCM and trapezius. This protective measure results in lateral flexion and CONTRAlateral rotation

Answer 19

Torticollis

Question 20

List the four basic forms of torticollis:

Answer 20

1. Congenital (at birth)
2. Acquired (post-trauma or in response to inflammatory process)
3. Spasmodic (AKA cervical dystonia: unknown etiology-painful progressive involuntary contraction of SCM)
4. Acute (common-affecting younger and middle aged patients, onset sudden, often present upon rising. Generally self resolving in days to weeks)

Question 21

This type of torticollis is generally thought to be from sleeping in an awkward position, or a cold draft from a fan or window.

Answer 21

Acute torticollis

Question 22

____ injuries are the leading cause of acute cervical sprain/strains, followed by sporting injuries.

Answer 22

Whiplash

Question 23

Current literature suggests that up to __% of individuals involved in a MVA suffer a whiplash injury.

Answer 23

83%

Question 24

Initial opening of the TMJ is ____, while full opening requires _____

Answer 24

Rotational, forward translation

Question 25

A TMJ sprain is known as ____

Answer 25

Capsulitis

Question 26

Pain with protrusion, lateral movement of the jaw, and chewing on the opposite side would most likely indicate?

Answer 26

Capsulitis (sprain)

Question 27

A good ortho test for suspicion of capsulitis?

Answer 27

Condylar stretch test (mandible down and forward)

Question 28

Ipsilateral TMJ pain that is worse with full closure?

Answer 28

Synovitis

Question 29

The articular disc is ____ displaced in synovitis

Answer 29

Anteriorly

Question 30

Lateral deviation to the opposite side in the resting position might indicate what TMJ disorder?

Answer 30

Synovitis

Question 31

A good ortho for synovitis?

Answer 31

Condylar compression test (mandible posterosuperior)

Question 32

A person who has difficulty opening their jaw completely would have?

Answer 32

Closed lock (TMJ)

Question 33

Treatment for a “clicking disc” would be applying pressure anterosuperior on the mandible to get it to grab the disc and then?

Answer 33

Short thrusts posterosuperior to attempt to bring the disc back to it’s normal resting position

Question 34

Stretching the temporalis and masseter muscles would include opening the jaw as widely as possible and assisting further with the hand/finger

Answer 34

True