OAT Neck Pain

Question 1

Steps of thinking through an osteopathic structural exam

Answer 1

general palpation/ROM, palpation of entire structure, check for SD, check region above and below area of complaint, think about referred pain

Question 2

Sources of acute pain

Answer 2

muscle, tendon, ligament, joint capsule, cartilage, fascia

Question 3

Enthesopathies

Answer 3

weakness of attachment point of tendon or ligament to bone

Question 4

Sxs of enthesopathies

Answer 4

chronic pain with flares, worse in morning and with activity

Question 5

Regional instability occurs due to…

Answer 5

ligament laxity, often from insufficient healing

Question 6

Why does instability cause muscle tension?

Answer 6

surrounding muscles are attempting to stabilize the joint

Question 7

Bursitis

Answer 7

often identified by location, fluctuance and tenderness, near enthesis

Question 8

Upper anterior neck muscles

Answer 8

mylohyoid, digastric, sternohyoid

Question 9

Lower anterior neck anatomy

Answer 9

SCM, sternohyoid, longus coli, sternothyroid, thyroid gland

Question 10

Upper posterior neck anatomy

Answer 10

occipital n. and triangle

Question 11

Deep posterior neck muscles

Answer 11

splenius capitis, semispinalis capitis, cervical rotatores

Question 12

Supraspinous ligament

Answer 12

superficial, palpated at spinous process and superior/inferior edge

Question 13

Interspinous ligament

Answer 13

palpated at interspinous and deep portion of superior edge

Question 14

Typical mechanisms of supraspinous and interspinous ligaments

Answer 14

slouching, lifting, MVA

Question 15

Radiculopathy LR with spurling’s

Answer 15

1.9 to 18.6

Question 16

Radiculopathy LR with upper limb tension, limited rotation, cervical distraction

Answer 16

30.3

Question 17

Cervical myelopathy sxs

Answer 17

hoffman’s, babinski, age>45, gait disturbances

Question 18

Common ligamentous causes of neck pain

Answer 18

facet capsule, interspinous ligament issues

Question 19

SD is the primary diagnosis in neck pain is indicated when….

Answer 19

when SD is unusual, location of sx and significant TART, pressure at SD reproduces quality of sxs

Question 20

Tx of biomechanical model

in cervical issues

Answer 20

reduce tension, improve symmetry, reduce impingement, reduce strength imbalances

Question 21

Tx of neurological model in cervical issues

Answer 21

reduce impingement, muscle relaxer, antidepressant, antiseizure

Question 22

Tx of resp-circulatory model in cervical issues

Answer 22

reduce tissue congestion, improve blood flow and nutrient delivery

Question 23

Tx of metabolic model in cervical issues

Answer 23

reduce inflammation with NSAID and steroids

Question 24

Tx of behavioral model in cervical issues

Answer 24

change studying position, improve posture, activity breaks, strengthening, and stretches