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Mincer - Spine Exam 2 > Manip/mob Contraindications (absolute and relative) > Flashcards

Manip/mob Contraindications (absolute and relative) Flashcards

1
Q

vertebrobasilar insufficiency

Absolute Manip/Mob

Absolute Manip (probably relative mob)

Relative Manip/Mob

A

Absolute Manip/Mob

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2
Q

acute nerve root irritation or irritability

Absolute Manip/Mob

Absolute Manip (probably relative mob)

Relative Manip/Mob

A

Relative Manip/Mob

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3
Q

spinal fusion

Absolute Manip/Mob

Absolute Manip (probably relative mob)

Relative Manip/Mob

A

Absolute Manip/Mob

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4
Q

significant segmental stiffness

Absolute Manip/Mob

Absolute Manip (probably relative mob)

Relative Manip/Mob

A

Relative Manip/Mob

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5
Q

advanced degenerative changes such as severe foraminal encroachment

Absolute Manip/Mob

Absolute Manip (probably relative mob)

Relative Manip/Mob

A

Absolute Manip (probably relative mob)

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6
Q

systemic disease

Absolute Manip/Mob

Absolute Manip (probably relative mob)

Relative Manip/Mob

A

Relative Manip/Mob

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7
Q

immediate post-partum for lumbar, t-spine, and pelvic girdle

Absolute Manip/Mob

Absolute Manip (probably relative mob)

Relative Manip/Mob

A

Relative Manip/Mob

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8
Q

osteoporosis depending on intent and direction of movement

Absolute Manip/Mob

Absolute Manip (probably relative mob)

Relative Manip/Mob

A

Relative Manip/Mob

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9
Q

What is frank spinal deformity?

A

Don’t know. We should ask. I think Dr. Mincer said it in class, but I don’t remember. - Sara

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10
Q

condition is worsening with present treatment

Absolute Manip/Mob

Absolute Manip (probably relative mob)

Relative Manip/Mob

A

Relative Manip/Mob

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11
Q

radiculopathy involving more than one nerve root ipsilaterally

Absolute Manip/Mob

Absolute Manip (probably relative mob)

Relative Manip/Mob

A

Absolute Manip/Mob

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12
Q

oral contraceptives if c-spine is area of interest

Absolute Manip/Mob

Absolute Manip (probably relative mob)

Relative Manip/Mob

A

Relative Manip/Mob

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13
Q

person presenting with red flags such as cancer, fracture, systemic dz

Absolute Manip/Mob

Absolute Manip (probably relative mob)

Relative Manip/Mob

A

Absolute Manip/Mob

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14
Q

neurological deterioration

Absolute Manip/Mob

Absolute Manip (probably relative mob)

Relative Manip/Mob

A

Relative Manip/Mob

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15
Q

severe nerve root pain, acute radiculopathy

Absolute Manip/Mob

Absolute Manip (probably relative mob)

Relative Manip/Mob

A

Absolute Manip (probably relative mob)

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16
Q

children/teenagers

Absolute Manip/Mob

Absolute Manip (probably relative mob)

Relative Manip/Mob

A

Absolute Manip (probably relative mob)

17
Q

What are 4 examples of bone diseaase, when bone disease is listed as an absolute contraindication for manips and mobs?

A

Osteoporosis

osteomyelitis

tuberculosis

Paget’s disease

18
Q

bone disease such as osteoporosis, osteomyelitis, TB, paget’s disease

Absolute Manip/Mob

Absolute Manip (probably relative mob)

Relative Manip/Mob

A

Absolute Manip/Mob

19
Q

rheumatoid collagen necrosis

Absolute Manip/Mob

Absolute Manip (probably relative mob)

Relative Manip/Mob

A

Absolute Manip/Mob

20
Q

active acute inflammatory condition

Absolute Manip/Mob

Absolute Manip (probably relative mob)

Relative Manip/Mob

A

Relative Manip/Mob

21
Q

congenital hypomobility

Absolute Manip/Mob

Absolute Manip (probably relative mob)

Relative Manip/Mob

A

Absolute Manip (probably relative mob)

22
Q

malignancy of region of interest- rule out metastasis

Absolute Manip/Mob

Absolute Manip (probably relative mob)

Relative Manip/Mob

A

Absolute Manip/Mob

23
Q

irritable disorder and protective guarding

Absolute Manip/Mob

Absolute Manip (probably relative mob)

Relative Manip/Mob

A

Absolute Manip (probably relative mob)

24
Q

long term corticosteroid use if c-sine is area of interest

Absolute Manip/Mob

Absolute Manip (probably relative mob)

Relative Manip/Mob

A

Relative Manip/Mob

25
Q

irritable disorder

Absolute Manip/Mob

Absolute Manip (probably relative mob)

Relative Manip/Mob

A

Relative Manip/Mob

26
Q

pregnancy and immediate post-partum

Absolute Manip/Mob

Absolute Manip (probably relative mob)

Relative Manip/Mob

A

Absolute Manip (probably relative mob)

27
Q

What may indicate VBI? (15)

What is another way we preveiously learned to ID VBI?

A

5 D’s

  • Dizziness (vertigo, light headedness)
  • Driop Attacks (sudden numbness/weakness)
  • Diploplia (double vision or other vision problems)
  • Disarthria (difficulty speaking)
  • Dysphagia (difficulty swallowing)

Or the book:

  1. drop attacks
  2. blackouts
  3. loss of consciousness,
  4. nausea
  5. vomiting
  6. poor general health
  7. dizziness
  8. vertigo
  9. disturbance of vision including diplopia
  10. unstady gait
  11. general feeling of weakness
  12. dysarthria or swallowing difficulty
  13. hearing disturbances,
  14. headache of undetermined origin
  15. facial numbness or tingling

VBI = vertebrobasilar insufficency

Commentary from Journal of Manual and Manipulative Therapy article: Manual Therapy and Cervical Arterial Dysfunction, Directions for the Future: A Clinical Perspective: “Traditionally, VBI was said to result in transient episodes of hindbrain ischemia manifesting in a number of cardinal signs conventionally referred to as Coman’s 5 Ds19. However, clinical presentations of transient hindbrain ischemia are more diverse than these classically quoted cardinal signs.” http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2565074/

28
Q

unstable upper c-spine

Absolute Manip/Mob

Absolute Manip (probably relative mob)

Relative Manip/Mob

A

Absolute Manip/Mob

29
Q

spondylolisthesis or other segmental instability

Absolute Manip/Mob

Absolute Manip (probably relative mob)

Relative Manip/Mob

A

Absolute Manip/Mob

30
Q

advance diabetes

Absolute Manip/Mob

Absolute Manip (probably relative mob)

Relative Manip/Mob

A

Absolute Manip (probably relative mob)

31
Q

myelopathy with s/s of SC involvement

Absolute Manip/Mob

Absolute Manip (probably relative mob)

Relative Manip/Mob

A

Absolute Manip/Mob

32
Q

RA w/ no acute inflammation (C-spine is an absolute contraindication)

Absolute Manip/Mob

Absolute Manip (probably relative mob)

Relative Manip/Mob

A

Relative Manip/Mob

33
Q

CES, transverse myelitis, demyelinating conditions

Absolute Manip/Mob

Absolute Manip (probably relative mob)

Relative Manip/Mob

A

Absolute Manip/Mob

34
Q

frank spinal deformity due to old pathology such as adolescent osteochondros

Absolute Manip/Mob

Absolute Manip (probably relative mob)

Relative Manip/Mob

A

Absolute Manip (probably relative mob)

35
Q

inflammatory arthritis such as RA, gout, AS

Absolute Manip/Mob

Absolute Manip (probably relative mob)

Relative Manip/Mob

A

Absolute Manip/Mob

36
Q

when history and exam finding don’t make sense

Absolute Manip/Mob

Absolute Manip (probably relative mob)

Relative Manip/Mob

A

Relative Manip/Mob

37
Q

List the 8 things that are Absolute Contraindications for Manips NOT Mobs (probably relative contraindications for mobs?)

A
  1. frank spinal deformity due to old pathology such as adolescent osteochondrosis
  2. congenital hypomobility
  3. advance diabetes
  4. advanced degenerative changes such as severe foraminal encroachment
  5. severe nerve root pain, acute radiculopathy
  6. irritable disorder and protective guarding
  7. pregnancy and immediate post-partum
  8. children/teenagers
38
Q

List the 17 things that are Absolute Contraindications for Manips AND Mobs

A
  1. malignancy of region of interest- rule out metastasis
  2. person presenting with red flags such as cancer, fracture, systemic dz
  3. rheumatoid collagen necrosis
  4. unstable upper c-spine
  5. vertebrobasilar insufficiency
  6. bone disease such as osteoporosis, osteomyelitis, TB, paget’s disease
  7. inflammatory arthritis such as RA, gout, AS
  8. CES, transverse myelitis, demyelinating conditions
  9. myelopathy with s/s of SC involvement
  10. radiculopathy involving more than one nerve root ipsilaterally
  11. spinal fusion
  12. spondylolisthesis or other segmental instability
  13. medically unstable
  14. deteriorating CNS pathology
  15. undiagnosed pain
  16. anticoagulant meds, vascular disorders in the region, blood clotting disorders*
  17. clinician lack of ability
39
Q

List the 13 things that are Relative Contraindications for Manips AND Mobs

A
  1. active acute inflammatory condition
  2. significant segmental stiffness
  3. systemic disease
  4. RA w/ no acute inflammation (C-spine is an absolute contraindication)
  5. neurological deterioration
  6. irritable disorder (I think my kids have this)
  7. osteoporosis depending on intent and direction of movement
  8. condition is worsening with present treatment
  9. acute nerve root irritation or irritability
  10. when history and exam finding don’t make sense
  11. oral contraceptives if c-spine is area of interest
  12. long term corticosteroid use if c-sine is area of interest
  13. immediate post-partum for lumbar, t-spine, and pelvic girdle

Mincer - Spine Exam 2 (6 decks)

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