Things To Know

Question 1

What are the Canadian c spine rules

Answer 1

Dangerous mech- 62 mph or fall from 5 step or 3’

Age over 65

Paresthesias of UE

Question 2

What are low risk factors for c spine fx

Answer 2

Ability to sit
Ability to amb
No midline tenderness
Delayed onset of pain
Simple rear end accident

Question 3

What are signs of cervical myelopathy?

Answer 3

Ataxia
Age over 45
Positive Hoffmann
Positive babinski
Positive inverted supinator sign

Question 4

What are signs of vascular issue to not manipulate

Answer 4

5 ds 3 ns
Dysphasia
Dysarthria
Drop attacks
Dizziness
Diplopia
Nausea
Nystagmus
Facial numbness

Question 5

Poor prognosis after WAD

Answer 5

Pain intensity 6 or greater
Ndi 30% or greater
Pain catatrophizing score 20 or greater
Impact of events score 33 or greater
Cold hyperalgesia

Question 6

What is the cervical radiculopathy CPR

Answer 6

-ULTT A
-Cervical spine ROM <60 toward involved side
-Cervial distraction test
-spurlings a test

Question 7

What patients will benefit from cervical spine traction?

Answer 7

-Peripheralization with C4-7 testing
-positive shoulder abduction test
-age >55
-positive ULTT a
-positive cervical spine distraction test

Question 8

Besides traction what else do you do?

Answer 8

Seated posture exercise and supine deep neck flexor exercises

Question 9

Cervical manipulation CPR

Answer 9

-Symptom duration <38 days
-Positive expectation of manip
-Side to side difference of rotation ROM of 10 or greater
-Pain with posterioanterior spring testing of middle cervical spine

Question 10

Neck pain with mobility deficits acute Tx

Answer 10

-Thoracic manipulation
-cervical manip/mob

Question 11

Subacute mobility deficits Tx

Answer 11

-Neck and shoulder girdle endurance exercise
-thoracic manip, cervical manip or mob

Question 12

Chronic neck pain with mobility deficits Tx

Answer 12

-Multimodal- cerv and thoracic mob/manip, exercise, strength and endurance, aerobic, stretching

-neck trunk shoulder endurance exercise along with patient education

Question 13

Movement coordination impairments: acute Tx

Answer 13

-Education to return to normal, non provocative activities
-minimize cervical collar
-perform postural and mobility exercises
-reassure patient that recovery is expected in 2-3 mo.

If moderate to slow recovery
Multimodal approach

If low risk
Comprehensive exercise program
Education
TENS

Question 14

Movement coordination deficits Tx for chronic patient

Answer 14

-Advice on encouragement, pain management

-mobilization combined with submax exercise including cervical thoracic strength endurance flexibility and coordination

Question 15

Headache Tx for acute

Answer 15

Active mobility exercise
C1-2 snag

Question 16

HA Tx for subacute

Answer 16

Cervical manip or mob
C1-2 self snag

Question 17

HA Tx for chronic

Answer 17

Cervical/thoracic manip
Shoulder girdle and neck stretches
Shoulder girdle and neck strength and endurance exercises

Question 18

Cervical radiating pain acute Tx

Answer 18

Mobilizing and stabilizing exercises
Laser
Short term use of cervical collar

Question 19

Radiating pain chronic Tx

Answer 19

-Mechanical intermittent traction
-Stretching and strengthening
-Cervical and thoracic mob/manip
-Eduction and counseling to encourage occupational and exercise activities