upper cervical course summaries Flashcards
What are the risk factors for a dissecting event?
Recent Trauma 40-64%
Vascular anomaly 39%
Past smoker 30%
Migraineur 23%
Total high cholesterol 23%
This includes both dissecting and non-dissecting vascular issues.
hat are the risk factors for a non-dissecting event?
Current or past smoker - 65-75%
Hypertension 53-73%
Total cholesterol 53%
Migraine 19%
Vascular anomaly 16%
Family Hx of stroke 14%
These are critical signs that may suggest spinal cord involvement.
What are the red flags associated with neoplasm?
Previous history of cancer, over 50 years old, unexplained weight loss, constant pain with no relief from bed rest, night pain
These factors increase suspicion for a possible neoplasm.
what is the specificity of the Sharp-Purser test and Alar ligament test
Sharp-purser specificity 70-96%
Alar lig test 96-100%
Sensitivity for both is up to 70%
These tests help assess the stability of the upper cervical spine.
What are the prognostic factors for poor outcomes in neck pain?
High initial pain and disability, PTSD, catastrophizing, cold hyperalgesia all associated with poor outcome
you can assess by asking:
catastrophizing - “how do you think you will recover”
PTSD - “do you have flashbacks, nightmares?”
These factors can influence recovery from neck pain.
What is the SNNOOPx10 acronym used for?
Identifying red flags in headaches:
Systemic symptoms
Neoplasm in history
Neurological deficit of dysfunction
Onset of headache is sudden or abrupt:
Older age (>50Yrs):
Px10: Pattern change, positional headache, precipitated by cough/sneeze/exercise, pregnancy, painful eye with autonomic features.
Each letter corresponds to a specific warning sign for serious underlying conditions.
What are the criteria for diagnosing migraine without aura?
At least 5 attacks lasting 4-72 hours, unilateral location, pulsating quality, moderate to severe intensity, aggravated by physical activity, with associated nausea/vomiting, photophobia/phonophobia
These criteria help differentiate migraine from other headache types.
How is frequent episodic tension-type headache characterized?
Bilateral, pressing or tightening quality
mild to moderate severity
lasting 30min to 7days
no associated nausea,
only one of photo or phonophobia
It can coexist with migraine without aura.
What are the criteria for cluster headaches?
Severe unilateral pain lasting 15-180 minutes,
occurring 1x every other day to 8x a day,
may have associated with ipsilateral symptoms including conjunctival injection and nasal congestion, ptosis
Cluster headaches are known for their severe intensity and specific associated symptoms.
What is a significant feature of cervicogenic headache?
Headache appears in a temporal relationship to the onset of the cervical disorder
It must also improve with resolution of the cervical disorder.
What is the Total Tenderness Score used for?
Assessing tenderness in myofascial tissues related to tension-type headache
It helps differentiate between tension-type headache and migraine.
What is the gold standard for detecting vertebrobasilar insufficiency (VBI)?
MR angiogram
This imaging technique provides detailed visualization of the vertebral arteries.
What is cervicogenic dizziness?
Dizziness caused by conflicts between proprioceptive inputs from the neck and visual/vestibular systems
It can present with musculoskeletal findings and sensorimotor deficits.
What is the role of manual therapy in managing cervicogenic dizziness?
Moderate evidence supports its effectiveness in reducing symptoms
Manual therapy combined with exercise is more effective than manual therapy alone
Exercise therapy has conflicting results when used alone.
What does the Quebec Taskforce classify regarding whiplash?
Grades of WAD from 0 (no complaint) to IV (fracture or dislocation)
This classification helps in assessing the severity of whiplash injuries.
What tool can be used to assess recovery potential in whiplash patients?
WhipPredict
It incorporates factors like age, neck disability index, and hyperarousal index.
What is the criteria for a WAD-II injury
Neck complaint AND musculoskeletal signs
- ie reduced ROM
No neurological signs
Cx ROM refers to cervical range of motion, which is crucial for assessing neck conditions.
What questions would you ask to differentiate cervicogenic headache from other conditions?
Vascular, neoplasm, migraine, TTH
TTH stands for tension-type headache.
How would you differentiate vestibular dizziness from cervicogenic dizziness?
SMNT test can differentiate,
slow head movement with gaze stability
postural stability with comfortable stance eyes open (CGD), narrow stance eyes closed (vestib)
what are the different types of headache
Primary: Migraine, TTH, Cluster HA (trigeminal cephalgias)
Secondary: Neoplasm, Vascular, instability,cervicogenic
Neuralgias/radiculopathies: Trigeminal, occipital
