MSK 2 Flashcards

(40 cards)

1
Q

what are the most common levels of cervical impingement?

A

Joints: C5-C6 and C6-C7

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2
Q

Principles of MDT

A
  • primary uses symptom response
  • reproduce the symptoms they came in with
  • decrease patient reliance on therapist
  • utilize progression of forces and direction of prefrence
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3
Q

Centralizing

A

Describes the phenomenon by which distal pain originating from the spine is progressively abolished in a distal to proximal direction.

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4
Q

Peripheralization

A

Describes the phenomenon by which proximal symptoms originating from the spine are progressively produced in a proximal to distal direction.

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5
Q

Disc model flexion:

A

Flexion- Anterior disc compress , Posterior disc stretch

NP “squeezed” posterior

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6
Q

Disc model extension:

A

Extension- Posterior disc stretch , Anterior annulus compress

NP displaced anterior

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7
Q

Postural syndrome

A

Pain remains local only to cervical spine and is time-dependent

No UE pain or parasthesias

cervical ROM is full and pain-free

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8
Q

Dysfunction syndrome

A

Similar to tissue shortening, scar tissue, etc. Pain is local to cervical spine.

No UE pain and/or parasthesias

Pain present > 8 weeks
No pain at rest, only at end-range
ROM HALLMARK = consisten

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9
Q

Derangment syndrome

A

directional preference is an essential feature and centralizatoin is an important phenomenon observed in the spine

HALLMARK is RAPID CHANGE in symptom severity and location, as well as ROM, with repeated movements

Patient can have pain at rest, during movement, and at end-range of movement

Pain onset can be acute or chronic

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10
Q

Most important question on MDT form is knowing if it constant vs intermittent why?

A

intermittent means it can be more mechanical

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11
Q

Repeated motions are usually done how?

A

Seated

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12
Q

Tests for radiculopathy?

A

Spurling’s
Cervical distraction
Upper limb tension tests

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13
Q

when is Spurlings test positive

A

+) test is reproduction of pain or parasthesias into UE

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14
Q

What are the variations of Spurlings ?

A
  1. Head neutral
  2. Cervical spine extended
  3. Cervical spine extended and rotated
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15
Q

when is CERVICAL DISTRACTION TEST positive

A

(+) is decrease or relief of pain and parasthesias

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16
Q

What are the benefits of upper limb testing?

A

Excellent screen to rule out cervical radiculopathy

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17
Q

MDT cervical treatment principle: green light

A

decreased, abolished/ Better or Centralized

18
Q

MDT cervical treatment principle: yellow light

A

no effect, produce no worse, increase no worse, decrease or abolish no better

19
Q

MDT cervical treatment principle: red light

A

increase, pheralizing, remains worse, worse or pheripheralized

20
Q

Examine sagittal motions first

A

Retraction

Retraction & Extension

Protrusion

Flexion

21
Q

What is the progression of forces?

A

Repeated motions/sustained postures
 Repeated motions with patient-overpressure
Repeated Motions with clinician overpressure
Mobilization
Manipulation

22
Q

Dysfunction syndrome tx:

A

repeated end range loading in direction of movement loss

movement has to produce pain and discomfort to be effective

pain should be abolished after loading is removed

23
Q

Treatment of derangement step 1

A

reduce derangement

24
Q

Treatment of derangement step 2

A

maintain derangement

25
Treatment of derangement step 3
recovery of function
26
Treatment of derangement step 4
prevention of recurrence
27
Cervical MDT dosage:
initial pts require 10 reps every 2-3 hours
28
What are the 4 categories of neck pain?
1. Neck pain with mobility deficits 2. Neck pain with headaches 3. Neck pain with movement coordination impairments 4. Neck pain with radiating pain
29
Neck disability index out of 50 and what is the MDC and MDIC
– 0-4 = No disability – 5-14 = mild disability – 15-24 = moderate disability – 25-34 = severe disability – >34 = completely disabled ``` MDC = 5 MDIC = 5- 9.5 ```
30
Acute pain is
< 6 weeks
31
Sub acute pain is
6-12 weeks
32
Chronic pain is
> 12 weeks
33
What factors influence your interventions of neck pain?
``` – Classification – Identification of impairments – Stage of condition – Tissue irritability – Presence of psychosocial risk factors ```
34
What causes the tension type headache?
myofascial dysfunction and trigger point
35
what causes cervicogenic headache?
upper spine forward head posture
36
Neck pain with headache chacteristics?
Intermittent unilateral neck and suboccipital pain decreased Cervical ROm Decreased upper cervical segmental mobility
37
Cranial cervical flexion test
assess activation and endurance of deep neck flexors and how long they can be active for
38
Normal deep neck flexors can hold contraction for
26- 30 mmHg
39
Deep neck flexor test is positive when?
(+) = skin folds separate (loss of chin tuck) or occiput touches therapist’s hand >1 second
40
Neck pain with radiating pain symptoms
cervical rotation less than 60 degrees of involved side signs of nerve root compression success with reducing UE symptoms during exam and intervention