Question Bank Flashcards
When is neck pain most common?
In the 5th decade of life
Neck pain increases with age
What percent of the population reports neck pain, LBP?
neck: 20-30%
LBP: 80%
T/F: Dorsal nerve root pain presents with sensory alteration and mm spasm.
False, just sensory alteration
T/F: Ventral root stimulation is associated with muscle spasm
True
What is the typical age of onset for cervical disc herniation?
20-30 yo
What are the differences between DDD and DJD?
They don’t occur simultaneously
DDD occurs earlier (~35 yo), by 55 the discs are dried out
DJD onset occurs after DDD
T/F: All degeneration leads to instability
True
The nucleus polposus disappears by what age in the c-spine?
40-45 yo
T/F: Cervical Spondylosis can present with either median or ulnar neural tension
True: as well as radial nerve tension
What condition is associated with cervical myelopathy
Cervical stenosis
Approximately what percent of back pain is thoracic?
15%
How are ribs named?
For the lower vertebra
T/F: Most of the muscles in the T-spine have specific thoracic functions
False: not many have pure action in the T-spine
T/F: The thoracic dermatomes follow their nerve root level more closely than any other dermatomal area
True
What nerve rami becomes the intercostal nerve?
Anterior rami
What is innervated by the recurrent branch of the sinuvertebral nerve?
Facet joints
Annulus
Proximal ribs
Multifudus
T/F: The bimechanics of the T-spine are the same throught the whole section.
False: depends on the region
C/T junction, Mid Thoracic, T/L junction
What motions put the sympathetic chain in tension?
Flexion
Contralateral Rotation
Contralateral SB
What typically causes thoracic outlet syndrome?
Elevated 1st rib or repeatative OH activity
What condition can be ruled out if a spurling’s test is negative?
Cervical radiculopathy
What is the standard operation for cervical radiculopathy?
Discectomy
What is the standard operation for cervical stenosis?
Laminectomy
The following is the ideal patient for what procedure?
- normal sagittal alignmet
- compression at disc level only
- no posterior compression
- no axial neck pain
- non smoker
- negative spurling’s
Disc replacement
What is key to cervical pain?
Shoulder girdle alignment
T/F: Alignment of the thorax affects alignment of the c-spine
True
What could be the 1st indicatory of ankylosing spondylitis?
Marked morning stiffness
T/F: While surgical and conservative tx options for L-spine conditions have similar long term outcomes, those who receieve surgery have lower satisfaction.
False: higher satisfaction
T/F: While disc protrusions have less severe sx, they are more likely to require surgical revisions following their initial discectomy.
True
What condition causes grocery cart syndrome?
Neurogenic claudication/spinal stenosis
Spondylolisthesis occurs in what % of the population?
5%
What is the success rate of lumbar fusion?
50%
T/F: Indiscriminate stabilization exercises can be just as damaging as poor body mechanics.
True
What is the most used joint in the body in daily function?
TMJ
Most pt. with TMD have a hx of?
Cervical whiplas injury
T/F: If you TMD no longer clicks your condition is improving.
False: progressing
What is maximal and function jaw depression/opening?
Max = 4 fingers; 40-50 mm
Functional = 3 fingers; 35 mm
What is the amount of protrusion and retrusion at the TMJ?
Protrustion = 6-9 mm
Retrusion = 3 mm
What is the amount of lateral deivation at the TMJ?
1/4 of the opening range
If a mm is short, how will it test in test position?
Strong
If a mm is long, how will it test in test position?
Weak
BUT it can produce the most torque
Do you need to make a lengthened mm stronger?
No, you need to teach it use be used in a midrange position to improve posture
T/F: The medial pterygoid has a small deep head ans large superificial head
False: Large deep, Small superficial
Cervical distraction primarily tests which ligament?
Tectorial membrane
T/F: Lack of the Alar ligament would allow the dens process to compress the spinal cord.
False: transverse ligament
Cord compression sx with 50% rupture of ligament and at least 8 mm of posterior displacement of dens
How do you test the alar ligament?
With the spine in neutral, flex, and ext
Laxity in all 3 positions = + test
The USC is coupled in the ___________ direction, the LCS is coupled in the _________ direction
OPPOSITE, SAME
How long should you wait post trauma to test VA?
6 weeks (the time it takes to heal the VA)
Why are we worried about a USC pt. having RA?
Because it’s likley to compromise the ligaments of the USC
As will anticoagulants and steroids
T/F: With a trauma or MVA you must clear the LCS.
False: UCS
How do you screen for CNS issues in those with USC issues?
Tone: spasticity and clonus
DTR
Babinski reflex (+ = toe ext)
Hoffman reflex (- = finger flex)
What is the key to cervicogenic HA tx?
Whole body integration (at least trunk up)
What does onset of sx following an MVA tell you about the pt. prognosis
Those who feel pain immediately have a worse prognosis than those you feel pain the next day or a few days after the accident
Which direction of force from an MVA is most detrimental?
AP force (head on collision)
What is the impact of decreased cervical lordosis in an MVA
Can’t tolerate forces as well
T/F: If your head is neutral you are more likely to damage the alar ligament
False:
Rot = alar damage
Neutral = transverse damage (with head on)
T/F: You should perform palpation in the acute stage of MVA/whiplash injuries
False
How much translation is available at each level of the C-spine?
3.5 mm (1.9 mm anteriorly, 1.6 mm posteriorly)
