VIII. Done- Clinical Criteria For Diagnosing Motion Segment Dysfunction Syndrome

Question 1

______ and _______ postures are common in acute presentations but are often within normal limits in mildly symptomatic patients.

Answer 1

Antalgic and asymmetric

Question 2

_________ is an important etiologic consideration for motion segment pain and dysfunction.

Answer 2

Postural dysfunction

Question 3

Differential tools are helpful in

Answer 3

differentiating and excluding other conditions

Question 4

If moderate, midline pressure is uncomfortable, what is it called?

Answer 4

allodynia

Allodynia Definition: pain perceived from stimulus that normally would not provoke pain

Question 5

In the ______, there are only a couple of degrees of rotation to each side. It’s difficult to palpate loss of ROM. End play is more palpable and valuable diagnostically in this area.

Answer 5

lumbars

Question 6

Many techniques overemphasize one _____.

Answer 6

diagnostic test

Question 7

What may be associated with sites of induration, which palpate as deep sites of nodular or rope-like consistency?

Answer 7

Long standing dysfunction

Question 8

Measuring instruments have played a large part in validating some chiropractic
therapies in recent years. What are some examples?

Answer 8

• Visual Analog Scale (VAS)
• Verbal Numerical Rating Scale (VNRS)
• Oswestry pain questionnaire
• Faces Pain Scale – Revised (FPS-R)
• Patient-Specific Functional Scale (PSFS)
• Pain drawing

Question 9

Abnormal motion is reflected by _______ to

segmental range of motion, joint play or end play.

Answer 9

altered resistance (decreased or increased)

Question 10

What are some examples of differential tools?

Answer 10

• Specific orthopedic and Neurologic tests
• Imaging procedures
• Lab tests

Question 10

What is the SOAP format of recording methods

Answer 10

• Subjective
• Objective
• Assessment/action
• Plan

Question 11

What is one of the most statistically reliable criteria for underlying dysfunction?

Answer 11

Palpable Pain

Question 12

What is PARTS?

Answer 12

• Palpable pain
• Asymmetry
• Rang of Motion
• Tone, texture, temperature
• Special tests

Question 13

Should moderate, midline pressure normally be uncomfortable?

Answer 13

No

Question 13

How would alterations in segmental alignment be noted?

Answer 13

comparing

adjacent spinous processes and symmetry of transverse processes.

Question 14

Asymmetry (PARTS) can be found where?

Answer 14

• in posture

- in static abnormalities

Question 16

At _______, we expect 40 degrees of rotation per side. SROM is
more valuable here than in the lumbars. End play is also valuable.

Answer 16

C1-2

Question 18

If you have limited movement of a joint, which is more valuable to you as the doctor: segmental ROM or end play?

Answer 18

(a) In the lumbars, there are only a couple of degrees of rotation to
each side. It’s difficult to palpate loss of ROM. End play is more palpable and valuable diagnostically.
(b) At C1-2, we expect 40 degrees of rotation per side. SROM is
more valuable here than in the lumbars. End play is also valuable.

Question 19

What is a fairly reliable outcome measure?

Answer 19

Increased range of motion, decreased pain

Question 20

________ is of limited diagnostic value in the absence of other
abnormal physical findings.

Answer 20

Misalignment, because there is some possible normal variation and high prevalence of anomaly

Question 23

Global movements are characteristically _____ and _____ in acute presentations, but may be within normal limits in mildly symptomatic patients.

Answer 23

guarded and restricted

Question 27

Examples of lab tests used as differential tools?

Answer 27

Blood work looking for Rheumatoid factor or HLA-B27

Question 28

Additional physical exam and/or laboratory procedures which aid in the diagnosis of joint dysfunction

Answer 28

Special tests, the “S” in parts

Question 29

Examples of Specific orthopedic and Neurologic tests used as differential tools?

Answer 29

Deep tendon reflexes (DTRs), Sensory testing, Motor testing and Nerve traction tests

Question 30

Reactive changes in segmentally related soft tissues often lead to local _______.

Answer 30

muscle spasm