Part B - Thoracic & Cervical

Question 1

known factors associated with neck pain

Answer 1

previous history neck pain
female gender
increasing age up to ~50
headache
back pain

Question 2

dizziness possibly cervical in origin

Answer 2

transient dizziness
neck pain
neck pain associated with dizziness
limited cervical movement
headache/upper limb symptoms
nausea

Question 3

dizziness that is non-cervical in origin

Answer 3

constant dizziness/vertigo
feelings of being pushed to one side
speech problems
swallowing problems
severe headache
sight problems
hearing problems
blackouts/falls
upper motor neuron signs and symptoms

Question 4

symptoms associated with VBI

Answer 4

dizziness
drop attacks
diplopia
dysarthria
dysphagia
nausea
nystagmus

Question 5

safeguards with cervical arterial dysfunction

Answer 5

always use progression of forces - test safety of movement and degree of force before progressing to end-range, overpressures or mobilization

Question 6

lateral deviation of cervical spine (wry neck)

Answer 6

head and upper cervical spine is visibly and unmistakably shifted to one side
onset of deviation occurred with neck pain
patient is unable to correct deviation voluntarily
if patient is able to correct deviation they cannot maintain correction

Question 7

_____ lateral deviation exists when the vertebra above has laterally flexed to the right in relation to the vertebra below, carrying the head with it

Answer 7

right

Question 8

_____ lateral deviation exists when the vertebra above has laterally flexed to the left in relation to the vertebra below, carrying the head with it

Answer 8

left

Question 9

differences in cervical anatomy when compared to lumbar

Answer 9

absence of intervertebral discs at occiput-C1 and C1-2
atypical vertebral bodies atlas and axis
uncinate processes forming uncovertebral joints (Luschka)
foramen transversarium in transverse process of C1-6 through which vertebral arteries pass

Question 10

upper cervical

Answer 10

occiput - C2

Question 11

mid and lower cervical

Answer 11

C2 - T1

Question 12

cervical retraction

Answer 12

maximal upper cervical flexion and mid-range lower cervical extension

Question 13

cervical protrusion

Answer 13

maximal upper cervical extension and mid-range lower cervical flexion

Question 14

uncovertebral joints are best developed at what cervical levels?

Answer 14

C2-4

Question 15

uncovertebral joints are least developed at what cervical levels?

Answer 15

C5-7

Question 16

arthrosis of zygapophyseal and uncovertebral joints occurs most severely and frequently at what cervical levels?

Answer 16

upper and middle cervical levels

Question 17

spondylosis of intervertebral disc occurs most severely and frequently at what cervical levels?

Answer 17

lower cervical levels (especially C5-7)

Question 18

are sagittal plane movements or lateral movements explored first in the case of wry neck?

Answer 18

lateral movements

Question 19

only the patient resolves their problem with self-management strategies in what syndrome?

Answer 19

postural

Question 20

only the patient is able to provide the appropriate loading strategies with sufficient regularity to enable a remodeling of the structural impairment in what syndrome?

Answer 20

dysfunction

Question 21

clues in history as to need for flexion principle in cervical derangement

Answer 21

anterior or antero-lateral symptoms
pain/problems with swallowing
pain on neck flexion

Question 22

indications for use of the lateral principle in cervical derangement

Answer 22

negative response to sagittal plane movements

acute wry neck (much less common)

Question 23

which side is explored first in a cervical derangement with lateral component, but no lateral deviation?

Answer 23

lateral procedures usually involve movements of the neck and head towards the side of pain

Question 24

what is the only condition in which the deliberate provocation of distal symptoms can be permitted during the application of treatment?

Answer 24

adherent nerve root

Question 25

what cervical movement is performed first when treating an ANR?

Answer 25

flexion

Question 26

what test can be used to monitor improvements in cervical ANR?

Answer 26

ROM of the ULLT position

Question 27

possible red flag indicators of serious pathology in headaches

Answer 27

``` progressive worsening of headache recent severe onset ("thunderclap") onset of headache after exertion nausea and vomiting history of major trauma visual changes preceding sore throat/respiratory infection problems with speech/swallowing ```

Question 28

possible clues to mechanical nature of cervicogenic headache

Answer 28

intermittent symptoms symptoms associated with consistent activity symptoms produced with sustained activity in one posture

Question 29

what are the most commonest reductive forces for headaches caused by derangement?

Answer 29

upper cervical flexion (retraction or a combination of retraction and flexion)

Question 30

what is the most commonest remodelling force for headaches caused by dysfunction?

Answer 30

upper cervical flexion and rotation (less common)

Question 31

whiplash associated disorders (WAD) classification = 0 | presentation in clinic?

Answer 31

no neck pain | no mechanical signs

Question 32

whiplash associated disorders (WAD) classification = 1 | presentation in clinic?

Answer 32

``` neck pain (stiffness or tenderness only) no mechanical signs ```

Question 33

whiplash associated disorders (WAD) classification = 2 | presentation in clinic?

Answer 33

neck pain and mechanical signs

Question 34

whiplash associated disorders (WAD) classification = 3 | presentation in clinic?

Answer 34

neck pain | mechanical signs and neurological signs

Question 35

whiplash associated disorders (WAD) classification = 4 | presentation in clinic?

Answer 35

neck pain and fracture or dislocation