NMS 2-Exam #1

Question 1

When should a cervical brace be used

Answer 1

Acute phase, where there is still benefit

Question 2

Contained vs. Non-Contained Disc Herniation

Answer 2

-Contained (Protrusion/Bulging): Damage to the nucleus of the disc, causing outward pressure of annulus
-Non-contained disc herniation (Extrusion): Involves the nucleus breaking or rupturing of the annulus

Question 3

Common manifestation of TMJ

Answer 3

-Bruxism
-Others: TMJ synovitis or disc derangement, hyper/hypomobile TMJ, muscle spasms, trauma, poor fitting dentures, dental conditions, OA, or RA

Question 4

Kirkaldy-Willis Stages of Spinal Degeneration

Answer 4

-Dysfunction Phase, Destabilization Phase, Restabilization Phase

Question 5

Dysfunction Phase

Answer 5

Synovial reaction, cartilage degeneration, circumferential and radial tears, disc herniation, facet syndrome

Question 6

Destabilization Phase

Answer 6

Capular laxity, subluxation, disc narrowing, internal disruption, stenosis, degenerative spondylolisthesis

Question 7

Restabilization Phase

Answer 7

Osteophyte Formation, facet and Lamina hypertrophy, vertebral body hypertrophy, stenosis, spondylitis

Question 8

Rheumatoid Arthritis observations

Answer 8

-Observations: Swelling, deformity of the hand and wrist, rheumatoid nodules

Question 9

Condition associated w/ Blood Glucose >100

Answer 9

DISH

Question 10

Congenital vs. Acquired Torticollis

Answer 10

-Congenital: Newborns;Associated with Klippel Feil
-Acquired: Caused by sustained head torsion and/or tilt, no associated ataxia, weakness or reflex changes. Transitent (<6 months)/Idiopathic(>6 months)

Question 11

Lab factors of rheumatoid arthritis

Answer 11

RH Factor, ESR, CRP, ANA

Question 12

Disc Injuries

Answer 12

-Osteophytes
-DJD

Question 13

Common Level of Cervical Radiculopathy

Answer 13

C6/7

Question 14

Grade 1 Sprain/Strain

Answer 14

-Mild swelling/tenderness, no bruising, <10% fiber damage, mild stretch/no instability, (-) stretch tests, no instability
-Recovery: 2-14 days

Question 15

Grade 2 Sprain/Strain

Answer 15

-Mild to moderate swelling, can include partial tearing, 11-90% fiber damage, mild to moderate instability
-Recovery is 14 days-2 months

Question 16

Grade 3 Sprain/Strain

Answer 16

-Severe deep bruising and swelling, complete tearing of multiple ligaments, muscles and joint capsules, marked instability, almost complete loss of ROM
-Recovery is 1-3 months

Question 17

Proliferative Phase (Scar Tissue Formation)

Answer 17

-Usually lasts 2 days-6 weeks
-Removal of cellular debris/fibrin clot by macrophages
-Regeneration of myofbrils/neurons
-Hemotoma replaced by type 3 collagen then type 1

Question 18

C5

Answer 18

-Motor: Deltoid
-Sensory: Lateral upper arm to elbow
-Reflex: Biceps

Question 19

C6

Answer 19

-Motor: Biceps/Wrist extensors
-Sensory: Lateral lower arm to thumb and web
-Reflex: Brachioradialis

Question 20

C7

Answer 20

-Motor: Triceps/Wrist flexors
-Sensory: Middle wrist to middle digit (palmar)
-Reflex: Triceps

Question 21

C8

Answer 21

-Motor: Finger Flexors
-Sensory: Medial lower arm from elbow to 5th digit
-Reflex: Finger flexors

Question 22

T1

Answer 22

-Motor: Interossei
-Sensory: Medial upper arm from elbow to axilla
-Reflex: None

Question 23

Cervical Ortho’s

Answer 23

Compression, distraction, shoulder depression

Question 24

TOS Orthos

Answer 24

Roo’s, Adson’s, costoclavicular, Wright’s and hyper abduction

Question 25

HIPPIRONILS

Answer 25

-Hx
-Inspection
-Percussion
-Palpation
-Instrumentation
-ROM
-Ortho Tests
-Neuro Tests
-Imaging
-Labs
-Special Tests

Question 26

Impairment

Answer 26

Problem/Dysfunction

Question 27

Disability

Answer 27

How debilitating the problem is to the patient

Question 28

Cervical Myelopathy

Answer 28

-Damage to the SC in the cervical region d/t space occupying lesions such as disc herniation, tumour..
-Clumsiness of fine motor activity of fingers/difficulty walking
-Lower Motor Lesion (Upper)/Upper Motor Lesion (Lower)
-Cord AND nerve roots
-Lhermittes, Babinski’s, compression, Jackson’s, Sprulings, Dejerines
-EMERGENCY

Question 29

Cervical Radiculopathy

Answer 29

-Neurocompressive disorder of cervical nerve roots
-Deep aching or burning neck pain/radicular arm pain, previous history of neck pain
-Muscle weakness in the arm or sensory changes
-Resisted ROM, Dejerines triad, compression, Spurling/s distraction, brachial stretch test, Soto-Hall, Lhermittes, Bakody

Question 30

Inflammation

Answer 30

-Usually 1-3 days
-Swelling, heat, loss of function, redness, pain
-PRICE
-Supplementation: Vitamin A/C, increase protein, bromelain
-Gentle adjustments

Question 31

Remodelling Phase

Answer 31

-May take months to years for complete remodeling
-Phase of fibroblastic activity and fibrosis
-Tx: Adjust, soft tissue therapies, ROM, postural training

Question 32

Most common region of the spine for RA

Answer 32

Cervical

Question 33

Symptoms of RA

Answer 33

Significant hand and forearm complaints as well as involvement of the lower extremity

Question 34

Torticollis

Answer 34

Condition of the cervical spine in which the neck assumes a rotated and/or laterally flexed deformity

Question 35

Cervical ROM

Answer 35

-Flexion: 50 degrees
-Extension: 60 degrees
-Lateral flexion: 45 degrees
-Rotation: 80 degrees

Question 36

Cervical Radiculopathy Tx

Answer 36

-90% should be treated with conservative care
-Should show improvement over 6-8 weeks
-Adjusting after cervical joint play, cervical distraction, electro therapy, myofascial release, cervical collar/bracing

Question 37

Evidence Informed Practice Components

Answer 37

-Patient preference/experience
-Provider experience
-Peer reviewed research

Question 38

Cervical Disc Herniations/Lesions refer to the _______ of the Scapula

Answer 38

Superior/Medial Angle