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Musculoskeletal II > Midterm > Flashcards

Midterm Flashcards

1
Q

What are the effects of joint mobilization?

A

Neurphysiological
Biomechanical
Psychological

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2
Q

What are the three sub-systems that contribute to stability in the spine?

A

passive
active
central nervous system

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3
Q

Passive system:

A

anatomical structures contributing to stability

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4
Q

Active system:

A

muscles, source of active stiffness

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5
Q

Central nervous system:

A

feedforward and feedback

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6
Q

Neutral zone:

A

region of laxity around the neutral resting position of a spinal segment
position of the segment in which minimal loading is occurring in the passive structure and active structures

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7
Q

Total vertebrae:

A

29 total
5 sacral
4 coccygeal and 3 joints and 2 facets

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8
Q

Alignment of upper cervical spine?

A

horizontal and 45 degrees in lower

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9
Q

Fryette’s First Law

A

when any part of the spine is in neutral position the side bending of the vertebrae will be to the opposite side as the rotation of the spine

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10
Q

Fryette’s Second Law

A

when any part of the spine is in a position of flexion or hyperextension the side bending of the vertebrae will be to the same side as the rotation of the spine

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11
Q

Fryette’s Third Law

A

If motion in one plane is introduced to the spine any motion occurring in another direction is thereby restricted

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12
Q

Can’t open restriction:

A

restriction of Flex/SB/Rot to the opposite side of pain

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13
Q

Can’t close restriction:

A

restriction of Ext/Sb/Rot to the same side of pain

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14
Q

Where does the majority of cervical rotation occur?

A

occipital atlanto region

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15
Q

Occipital atlanto flexion

A

15-20 degrees

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16
Q

Occipital atlanto side flexion

A

10 degrees

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17
Q

Atlanto-axial flexion/extension:

A

10 degrees

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18
Q

Atlanto-axial side flexion

A

5 degrees

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19
Q

Atlanto-axial rotation

A

50 degrees (primary motion)

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20
Q

4 parts of vertebral artery:

A

proximal
transverse
suboccipital
intracranial

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21
Q

4 parts of suboccipital portion of vertebral artery:

A

within transverse foramen of C2
between C2 and C1
in the transverse foramen of C1
between the posterior arch of atlas and its entry into the foramen magnum

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22
Q

5 D’s And 3 N’s

A 
dysarthria
Dysphagia
Drop attacks
Dizziness
Double Vision
Ataxia
Nausea
Numbness
Nystagmus
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23
Q

Clinical prediction rule for patients with neck pain likely to benefit from TJM to Cspine:

A

symptom duration less than 38 days
positive expectation that manipulation will help
side to side difference in cervical rotation ROM of 10 degrees or greater
pain with posteroanterior spring testing of the middle cervical spine

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24
Q

Trauma patient order:

A 
VBI and trauma hx
C-spine rules and AROM screen
Progress to eval if clear
AROM, ROM, MRS
functional movement screen
special test
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25
No hx of trauma order:
``` VBI screen AROM, PROM, MRS hypermobile vs. hypomobile functional movement screening special test treatment ```
26
C-spine:
``` Cognitively intact? Under 65? 45 d of rotation? injury circumstances? pain at rest in midline? paresthesia in arms? ```
27
Positive findings for cervical instability clearing tests:
movement felt during passive translation clunk symptoms that were present during forward flexion are relieved
28
Priority tests for cervical instability:
sharp purser membrane test alar ligament test
29
Where does nodding occur?
upper C-spine C0-C1 during flexion
30
What muscles are commonly implicated with headaches?
SCM Upper trap superior obliqus capitus
31
Shoulder abduction relief test
C4-C5 or C5-C6 | Bakody sign
32
ULTT 1
median nerve, anterior interosseous C5-C7
33
ULTT 2
median nerve, axillary musculocutaneous
34
ULTT 3
radial
35
UlTT 4
ulnar C8-T1
36
Radiculopathy cervical prediction rule:
+ spurlings + ULTT median nerve (1) + cervical distraction less than 60 degrees rotation in c-spine
37
Clinical prediction rule for radiculopathy:
``` spurlings jackson's MFCT distraction ULTT assymetrical ```
38
Clinical prediction rule for neck pain and cervical traction:
``` peripherlization with lower c-spine mobility +shoulder abduction test age older than 54 + ULTT A +distraction ```
39
Cervical Facet syndrome:
mild/moderate neck pain that is often long standing neuro symptoms into arm not dermatomal
40
Treatment of cervical facet syndrome:
Joint mobs, HVLA traction core strengthening with balance exercises thoracic mobility
41
Clinical prediction rile for cervical spine manipulation
inital scores on NDI less 11.50 presence of bilateral pattern of involvement not performing sedentary work for more than 5 hours each day feeling better when moving neck not worse when extending neck spondylosis without radiculopathy
42
Alternative CPR for cervical manipulation:
symptoms for less than 38 days positive attitude side to side difference 10 degree or more cervical rotation pain with PA spring test of mid cervical spine
43
Cervical myelopathy, cervical stenosis, severe cervical arthritis
muscle weakness, possible muscle wasting at end stages decreases reflexes or possible hypertonic reflexes walking difficulity
44
Cervical myelopathy, cervical stenosis, severe cervical arthritis treatment:
``` nerve glides thoracic spine mobility segmental mobs for decreased mobility postural re-ed soft tissue/core strengthening for logus coli ```
45
WAD
hyperflexion/hyperextension injury stiffness/loss ROM in all planes guarding
46
WAD grade 1:
mild strain
47
WAD grade 2:
neck pain and decreased ROM
48
WAD grade 3:
neurological + msk
49
WAD grade 4:
fracture/dislocation
50
WAD treatment:
neuro exercises gentle mobs soft tissue/core strengthening and balance
51
Myofascial disorders/Fibromyositis
hypermobility lack of neuro symptoms trigger points repetitive trauma
52
Myofascial disorders/Fibromyositis treatment:
trigger point joint mobs postural re-ed thoracic spine mobility
53
Adult torticolis:
painful SCM spasm with movement restricted in one plane worse than other
54
Pseudotorticolis:
limited in all ROM, typically seen upon waking (no trauma)
55
Treatment torticolis:
``` strain-counterstrain gentle mobs trigger points modalities HVLA ```
56
Cervicogenic HA:
worse with movement, cervical flexion/rotation test positive C1-C2 segment
57
HA treatment:
``` soft tissue Joint mobs trigger point postural re-ed stability ```
58
CPR for patients who will respond to thoracic manipulation:
``` duration of symptoms less than 30 days no symptoms distal to shoulder looking up does not aggravate symptoms FABQ less than 12 diminshed upp t-spine kyphosis at T3-5 cervical extension ROM less than 30 d excluded stenosis pts, red flags, WAD less than 6 weeks, CNS disorder, nerve root compression ```
59
T-spine flexion/extension
20-45 degrees
60
T-spine rotation:
35-50 degrees
61
T-spine lateral flexion
20-40 degrees
62
Wells Criteria:
``` clinical S/S DVT PE is as likely or more than alternative pulse greater than 100 previous hx of DVT or PE immobilization or major surgeries in past 4 weeks hemophysis active cancer within last 6 months less than 2 =low, 2-6 moderate, greater than 3=high ```
63
Compression or spinal fracture:
``` more common in those osteoporosis age greater than 70 steroid use trauma common in T11-L1 increased kyphosis supine sign and percussion test ```
64
Scoliosis rehab:
stretch concavity strengthen convexity strengthen rotation to opposite side of rib hump
65
Sites of compression for thoracic outlet:
interscalene triangle costoclavicular space thoraco-coraco-pectoral space
66
Onset for thoracic outlet:
repetitive trauma insidious unilateral or bilateral
67
Thoracic outlet intervention:
``` cyriax release 1st rib mobilization mobility for scalene/1st rib mobilize AC and GH joints pec stretching scap muscle strengthening ```

Musculoskeletal II (14 decks)

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