SMT-1 Manual, pgs 66-72 Flashcards
- Who had more cardiovascular risk factors between the controls & dissection in Thomas 2011 study?
Controls
- What were the most common complaints of symptoms for ICA according to Thomas et al 2011 study?
Headache, ptosis, facial palsy, UE/LE weakness
- For UCS integrity, what did Ross & Cheeks 2008 report to use as a screening test?
Canadian C-spine Rules
- What patient presentation was studied by Ross & Cheeks 2008?
MVA –> neck pain with decreased AROM in all planes
- What should Physical Therapists be most alert for when seeing a patient with c/o of neck pain following trauma?
Cervical fracture; even weeks after the trauma occurred.
- What cervical fractures are common in individuals over the age of 65?
Odontoid fracture
- What percent sensitivity is the Canadian C-spine Rules?
100%
- What percent specificity is the Canadian C-spine Rules?
43%
- What are the Canadian C-spine Rules according to Stiell et all 2001?
- > 65 years old
- paresthesia in extremities (dermatome changes)
- dangerous mechanism of injury (MVA/ fall/ trauma)
- AROM less than 45 degrees rotation bilaterally
- history of long term steroid use or osteoporosis
- What are the 3 types of odontoid fracture?
- ) oblique fracture - upper portion
- ) fracture at base as it attaches to base of C2 (most common
- ) fracture line extends through the axis of odontoid
- What type of exam needs to be performed when screening for cervical spine fractures?
Neurological (myotome/ dermatome/ DTRs/ bowel & bladder dysfunction/ UMN/ LMN)
- According to Mintken 2008, is there evidence to support the transverse ligament test?
No evidence exists that an anterior shear test is valid.
- When a transverse ligament test was perform in supine in the Mintken 2008 study, what occurred?
Paresthesia in both feet and toes
- What is os odontoideum?
Dens is separated from the body of axis
- What are the signs of craniovertebral instability?
1) . Occipital numbness due to C2 nerve irritation given the anterior translation of C1.
2) . Neck-tongue syndrome (paresthesia of ipsilateral 1/2 tongue with contralateral rotation –> RR = left tongue parsthesia)
3. ) headache with sustained flexion/ lump in throat/ UMN or cord signs
196.What are you looking for with open mouth X-ray?
- ) Is the SP of C2 in midline (off midline = alar rupture)
- ) Are periodontoid spaces equal? (ipsilateral narrow or lateral shift?)
- ) Are the articular margins of C1 and C2 lined up?
- Is a craniovertebral instability test valid according to Mintken et al 2008?
No, very little evidence to establish validity
- Is craniovertebral instability testing reliable according to Cattrysse et al 1997?
Inter-examiner reliability of transverse ligament test, alar ligament test, and sharp-purser have all been found to be “poor to unacceptable”
- What percentage of Australian PTs used pre-manipulation stress tests according to Osmotherly & Rivett 2011?
Rarely - 54.5%
Never - 62.4%
- What amount of skin slack was reported in the thoracic fascia interface according to Beneznick et al 2008?
38.75 mm
201-205. What movements were visualized in the thoracic spine following prone PA thrust to Rt TP of T10, 11, 12 according to Gal et al 1997?
6-12 mm anterior translation
3-6mm Lt lateral translation
Axial rot of .4-1.2 deg
Sagittal rot of .5-1.8 deg
- What is the purpose of HVLA manipulation according to Herzog et al 1993?
Restore joint integrity/ restore joint motion/ relax hypertonic muscles
- The systematic review by Bronfort et al 2004 concluded what? in relation to exercise, SMT, and medication for the treatment of chronic low back pain?
SMT and exercise > meds for chronic low back pain
- When Dunning et al 2012 directly compared HVLA manipulation with mobilization for patients with mechanical neck pain, what were the changes in disability and pain at 48 hrs?
HVLA = decreased --> 50.5% disability and 58.3% pain Mobs = decreased --> 12.8% disability and 12.6% pain
- How does joint manipulation effect the alpha motor neurons?
The quick stretch to a joint capsule and surrounding tissues stimulate GABA release which actives interneurons that inhibits the alpha motor neuron.
- What is the definition of cervicogenic headache according to Braud 2005 and Xiasbin et al 2005?
Benign recurrent headache presenting with pain in the trigeminal nerve distribution, cervical pain, and biomechanical provocation features of varying proportions.
- According to Nilsson 1995 & Pfaffenrath & Kaubel 1990, what is the prevalence of CGH?
15-20% of all chronic & recurrent HAs
- What did Jull 1997 list regarding CGHs?
CGHs are those which arise from musculoskeletal impairments in the neck, aggravated by neck movements and posture and patients cannot recognize relieving factor
- What year did the International HA Society diagnose CGH?
1988, 2004
- How many diagnostic criteria for CGH for IHS?
- What is #1?
- # 2 Where is pressure reproduced?
- # 3 Other assoc pain? Does it make sense neuroanatomically?
- # 4 Does the pain shirf to other regions?
- # 5 Starting and referring point? Reflecting what branch?
- # 6 Do head pain characteristic add value?
- # 7 what confirms a CGA?
214=7
- Jull 1997 aggravated by neck movements or sustained posture, pt cannot recognized aggravating factors or relieving factors
- reproduced pressure over upper cervical spine
- ipsilateral neck and arm pain and does not make sense neuroanatomically
- No seems to be unilateral during attack unlike migraine and it may shift between episodes
- Starts occipital region, spreads to occiput and commonly to front, retro-orbital or temporal aspect reflecting trigeminal nerve opthalmic branch
- Not really intensity can be mild, moderate, severe, but there is not a “build up” like with migraine
- Diagnostic block but many UK neurologist will not do this because it can trigger additional problems.
- What population is most likely to get CGH?
Females 4 to 1
- Is there a familiar tendency with CGH?
No
- Is thereGenerally trauma related with CGH?
Not all patient can identify a specific onset, Jull 1997 feels increased sedentary nature of modern day work contributes
- Do migraine medications help for CGH?
No
- What did Jull & Niene 2004 list as other side effects to CGH?
- nausea, phono-phobia, dizziness, blurred vision, swallowing difficulty, periocular edema
- Does Jull 1997 agree with Jull & Niene 2004?
Jull 1997 feels they are not a dominant feature as migraine with aura of cluster HAs
- What did Bogduck 2005 find as a source of CGH?
C0-C3 joints and discs, C0-C3 ligament, muscle, dura,
- Can the thoracic spine cause a CGH?
Yes Paris & Vitti 2001 found T2 HA in case study
- What does T1-T4 supply?
- T1-T4 supplies sympathetic efferents out flow for head and neck and face region
- Migraine HA acupuncture point?
GB-20 superior oblique
- Fernandez-de-la-penas et al 2005 found what referred pain pattern?
- Did Travell & Simmons document this?
- Multiple TrPs in superior oblique muscle evoked typical referred pattern
- No fernandez-de-la-penas 2005 was the 1st
- What does the SOM refer to?
deep within the eye
retro-orbital (inter-cranial)
Supra-orbital (extra-cranial)
Homo-lateral forehead (extra-cranial)
- According to Bogdak 2005 what segment is most likely the source of CGH?
C2-C3 facet joint but evidence is inconclusive
- According to Hall & Robinson 2004 and Jull et al 1997 what was the most likely source for CGH?
C1-C2, 24/28 had and was unilateral restricted and reproduced pain
- According to Crossman & Neary 2000 what CN is most inferred?
- Main sensory to what areas?
- For what proprioceptive pathways?
- Via what branch?
- Affecting what muscles of mastication?
- CN V, trigeminal nerve
- Scalp, face, cornea, oral and nasal cavity, cranial dura matter
- muscle of mastication and TMJ
- Auriculltemporal branch from mandibular branch of CN5
- masseter, temporalis, medial & lateral pterygoids
