NMS 2-Exam #1 Flashcards
When should a cervical brace be used
Acute phase, where there is still benefit
Contained vs. Non-Contained Disc Herniation
-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
Common manifestation of TMJ
-Bruxism
-Others: TMJ synovitis or disc derangement, hyper/hypomobile TMJ, muscle spasms, trauma, poor fitting dentures, dental conditions, OA, or RA
Kirkaldy-Willis Stages of Spinal Degeneration
-Dysfunction Phase, Destabilization Phase, Restabilization Phase
Dysfunction Phase
Synovial reaction, cartilage degeneration, circumferential and radial tears, disc herniation, facet syndrome
Destabilization Phase
Capular laxity, subluxation, disc narrowing, internal disruption, stenosis, degenerative spondylolisthesis
Restabilization Phase
Osteophyte Formation, facet and Lamina hypertrophy, vertebral body hypertrophy, stenosis, spondylitis
Rheumatoid Arthritis observations
-Observations: Swelling, deformity of the hand and wrist, rheumatoid nodules
Condition associated w/ Blood Glucose >100
DISH
Congenital vs. Acquired Torticollis
-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)
Lab factors of rheumatoid arthritis
RH Factor, ESR, CRP, ANA
Disc Injuries
-Osteophytes
-DJD
Common Level of Cervical Radiculopathy
C6/7
Grade 1 Sprain/Strain
-Mild swelling/tenderness, no bruising, <10% fiber damage, mild stretch/no instability, (-) stretch tests, no instability
-Recovery: 2-14 days
Grade 2 Sprain/Strain
-Mild to moderate swelling, can include partial tearing, 11-90% fiber damage, mild to moderate instability
-Recovery is 14 days-2 months
Grade 3 Sprain/Strain
-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
Proliferative Phase (Scar Tissue Formation)
-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
C5
-Motor: Deltoid
-Sensory: Lateral upper arm to elbow
-Reflex: Biceps
C6
-Motor: Biceps/Wrist extensors
-Sensory: Lateral lower arm to thumb and web
-Reflex: Brachioradialis
C7
-Motor: Triceps/Wrist flexors
-Sensory: Middle wrist to middle digit (palmar)
-Reflex: Triceps
C8
-Motor: Finger Flexors
-Sensory: Medial lower arm from elbow to 5th digit
-Reflex: Finger flexors
T1
-Motor: Interossei
-Sensory: Medial upper arm from elbow to axilla
-Reflex: None
Cervical Ortho’s
Compression, distraction, shoulder depression
TOS Orthos
Roo’s, Adson’s, costoclavicular, Wright’s and hyper abduction
HIPPIRONILS
-Hx
-Inspection
-Percussion
-Palpation
-Instrumentation
-ROM
-Ortho Tests
-Neuro Tests
-Imaging
-Labs
-Special Tests
Impairment
Problem/Dysfunction
Disability
How debilitating the problem is to the patient
Cervical Myelopathy
-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
Cervical Radiculopathy
-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
Inflammation
-Usually 1-3 days
-Swelling, heat, loss of function, redness, pain
-PRICE
-Supplementation: Vitamin A/C, increase protein, bromelain
-Gentle adjustments
Remodelling Phase
-May take months to years for complete remodeling
-Phase of fibroblastic activity and fibrosis
-Tx: Adjust, soft tissue therapies, ROM, postural training
Most common region of the spine for RA
Cervical
Symptoms of RA
Significant hand and forearm complaints as well as involvement of the lower extremity
Torticollis
Condition of the cervical spine in which the neck assumes a rotated and/or laterally flexed deformity
Cervical ROM
-Flexion: 50 degrees
-Extension: 60 degrees
-Lateral flexion: 45 degrees
-Rotation: 80 degrees
Cervical Radiculopathy Tx
-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
Evidence Informed Practice Components
-Patient preference/experience
-Provider experience
-Peer reviewed research
Cervical Disc Herniations/Lesions refer to the _______ of the Scapula
Superior/Medial Angle
