Spine

Question 1

CPR for manipulation

Answer 1

-no pain below knee
-<16 days duration
-<19 FABQ
-positive PA glide
->35 hip IR

Question 2

SIJ test cluster

Answer 2

need at least 3/5 pain good SP & SN
-distraction
-thigh thruster
-gaenslen
-compression
-sacral thrust

Question 3

radiculopathy cluster

Answer 3

ULTT
spurling
distraction
cervical rotation <60 deg

Question 4

ULTT

Answer 4

SN 97, good for ruling out radiculopathy

Question 5

Spurlings

Answer 5

good for ruling in SP 92, LR+ 4.87 (SB & add compression)

Question 6

headache special tests

Answer 6

C1-2 mobs
flexion rotation - rule in or out cervicogenic at C1-2l SN 86%, SP = 100, LR 18+

Question 7

cervicogenic headache referrals?

Answer 7

-C6 frontal
-C1 orbital / frontal?
-C1-2 temporal
-tension occipital
-C2-3 parietal

Question 8

WHO concussion criteria

Answer 8

-history of TBI and 3 or more symptoms: HA, dizzy, fatigue, irritability, insomnia, concentration, memory difficulty, intolerance of stress/emotion/alcohol

Question 9

C spine rules

Answer 9

-65 + or high energy accident
-unable to sit up during exam, midline tenderness, early onset of pain
-unable to rotate head 45 degrees

Question 10

cervical stability testing

Answer 10

-Sharp purser test
-Transverse ligament stress test
-Alar ligament stability test
-stabilizes with SB & rotation, very thick ligament
-stabilize C2 SP by grab firmly laterally
-side flex with opposite arm, rotate with opposite arm- feel for movement

Question 11

myelopathy CPR

Answer 11

Age >45 years
+ hoffmans – flick nail of middle finger DIP (pronated)
+ inverted supinator sign – brachioradialis reflex test – looking for C7 response which would be extension or finger movement (NORMAL = elbow flexion or C6)
+Babinski / Oppenheim - + if toe extends; WANT flexion response
+gait abnormality

Question 12

Mechanical traction CPR for neck radiculopathy

Answer 12

Pt reported peripheralization with C4-7 mobility testing
+ shoulder abduction test
Age >55
+ ULTT A
+ distraction

Question 13

ruling out DVT

Answer 13

-age <50, pulse <100bpm, pulse ox >94%, no unilateral leg swelling, no coughing up blood, no recent surgery, no prior DVT/PE, no oral hormone use

Question 14

lumbar stenosis CPR

Answer 14

Bil symptoms
Leg pain more than back pain
Pain during walking/standing
Pain relief upon sitting
Age >48 years

Question 15

odotonoid fracture

Answer 15

C2

Question 16

Jefferson fracture

Answer 16

burst fracture of C1

Question 17

Hangman fx

Answer 17

C2 - line through posterior element

Question 18

Clay Shovelers

Answer 18

C7 SP fx
Hyper flexion
Or could be C6,T1,T2

Question 19

Chance fx

Answer 19

flexion-distraction MOI (seatbelt)
Common at L1-2
high rate of instability/GI injury

middle+anterior spinal column tension, posterior under compression

Question 20

spinal neoplasm

Answer 20

“winking out” sign in image

Question 21

most common spinal fractures

Answer 21

C1-2
C5-7
T9-L2