Ortho Neck Acupuncture Flashcards
What are four questions to ask of MC?
- Onset of pain
- What is mechanism of injury
- Structures involved
- Level of disability
Three questions to ask about pain?
- Pain location
- Pain quality
- Pain Type
Other questions to ask patient about neck pain?
- Headaches
- Dizziness/Fainting/Seizures
- Sleep Position
Where does nerve impingement below C5 create numbness and tingling?
Shoulder, arm and hand
What meridians are associated with C6?
LU/LI
What meridians are associated with C7?
PC/TW
What meridians are associated with C8?
HT/SI
Where can nerve impingement above C5 produce numbness and tingling?
Along the GB meridian and affect the ear and throat.
What is Upper Extremity Movement Impairment Syndrome?
Rounded shoulders and forward head posture.
How is palpation of neck structures best performed?
Supine where muscles are relaxed.
What does Myotome assessment achieve?
Determines muscle weakness that originates from motor fibers of cervical nerve roots. Hold for 5 seconds.
Neck Flexion tests which muscle group and which nerve root?
SCM and C1/C2
Neck side flexion/bending tests which muscle group and which nerve root?
Levator Scapula, Upper Trap, Scalenes medius) and C3
Thumb Extensions tests which which nerve root?
C8
How do you test C6 and which muscle group is affected?
- Elbow flexion, wrist extension.
- Brachialis, Bicep Brachii, wrist extensors
What Cervical Vertebrae is tested by shoulder abduction?
C5 - Supraspinatus (rot cuff), deltoid
Arms out to the side, press down on upper arms.
How do you test C4?
- Shoulder elevation, press down.
- levator snap, upper trap, scalenes (ant/med)
How do you test C7?
- Elbow extension, wrist flexion
- patients arm straight out palm faced down. Place your hand on patients elbow crease press down there while pressing up on patient’s hand. Have patient resist. Count for 5-6 seconds.
The patient is standing during Myotome testing - true or false?
False - sitting is best.
True or False: Perform the most painful movements first, when assessing AROM?
False
What is the normal ROM for neck flexion?
80-90°
What is the normal ROM for neck extension?
70°
What is the normal ROM for neck side bending?
AROM 20-45°
What is the normal ROM for neck rotation?
70-90°
Source and Luo Points for the Neck?
Si4 + HT5, BL64 + KD4, TW4 + PC6, GB40 + LV5
What is Wry Neck?
- Invasion of wind cold (acute)
- Cervical facet joint disorder (chronic)
Where does myofascial pain typically present?
- Levator scapula
- Upper Trapezius
- Rhomboids
Name five typical TCM diagnosis for neck pain?
- LV Qi Stagnation
- Lu Qi Deficiency
- SP/LV Blood Deficiency
- KD deficiency
- OPI
What are the group Luo points?
- TW8 (3 arm yang)
- PC5 (3 arm yin)
- GB39 (3 leg yang)
- SP6 (3 leg yin)
What do the Group Luo point treat?
- Qi and Blood btw 3 channels
- 3 channel disharmony
- Imbalance of yin/yang
Name 4-6 physical things that neck pain and injury can involve?
- bony misalignment
- ligament injuries
- muscle injury
- disk compression
- osteoarthritis
- compression of the spinal chord
Causes of cervical nerve root lesion?
- stenosis
- cervical spondylosis
- osteophytes
- facet joint problems
- herniated disc
What is the most common muscle in the neck associated with stiff neck?
Levator Scapula (pain referring into the Si14 area and extends into the scapula.
What muscle is worse with side bend-flexion away from effected side?
Levator scapula
What is the likely TCM diagnosis of myofascial pain of the levator scapula AKA “stiff neck”?
Constrained Liver Qi / Local stagnation of Qi and blood in Si,BL, TW channels
Name some points to treat levator scapula “stiff neck”
GB20, GB21, Si3, Si11, Si14, Si1, Bailao, LV3, Li4, LV14, BL18…Tuina, traction
What is TCM pattern for Wry Neck?
Acute Invasion of wind cold, usually due to cold room while sleeping.
What is treatment for Wry Neck?
Do neck ROM. Disperse Wind and Cold in BL & GB Meridians. Louzhen on effected side. stimulate while moving. Moxa over Ahi needle. Warming Tuina. 1-3 tx. resolve in a week.
