WAD Flashcards
Sudden hyperextension followed by hyperflexion of the neck describes
whiplash
Lack of info labeling
diagnosis
injury
prognosis
treatment
definition of whiplash
Acceleration-deceleration mechanism of energy transfer to the neck
Whiplash impacts result in what type of injury?
bony of soft tissue injuries
Who is a typical patient with WAD?
middle aged
women
(women/men) have increased head and neck mass and slower recovery time from whiplash injury
women
What symptoms are present with WAD?
neck pain/stiffness headache shoulder pain back pain focus concentration memory blurred vision dizziness sleep disturbance fatigue depression buzzing in the ears
There is a link between chronicity and litigation/compensation claims (true/false)
false
What is the biggest indicator of chronicity in WAD?
a. compensation claims
b. impact of MVA
c. nerve damage
d. amount and severity of acute pain
amount and severity of acute pain
The direction of the hit from an MVA matters to injury (true/false)
false
What type of injury is the worst in terms of damage?
extension
What forces occur with hyperextension injury?
extension posterior shear posterior compression anterior distraction traction torsion if hit off center
Speed is relevant to injury (true/false)
false
Intra-discal pressure (increases/decreases) with flexion
increases
intra-discal pressure (increases/decreases) with extension
decreases
(higher/lower) inter-vertebral disc pressure in C-spine compared to t-spine
higher
Which muscle is the most at risk with extension during a whiplash?
a. rectus capitis posterior minor
b. scalenes
c. longus coli
d. longus capitus
longus coli
Which muscle is the most at risk with lateral impact?
a. rectus capitis posterior minor
b. scalenes
c. longus coli
d. longus capitus
longus capitus
_ is delayed in muscle contraction in response to sudden movement of head and neck
reaction time
What are the symptoms of VAI?
5 Ds
A
3 Ns
Which muscles are commonly injured?
a. anterior
b. posterior
c. lateral
d. back muscles
posterior
WAD patients do not have trigger points (true/false)
false
Trigger points in WAD patients are due to
damaged tissue
not the originator of pain
Trigger points are _
latent
a forward head effects improvement in WAD (true/false)
true
Neural injury with WAD can cause
injury to brain
spinal cord
nerve roots
What neural injury can happen with WAD?
DRG refractory period and not fire for 2 weeks following MVC
This is defined as the DRG not firing for 2 weeks after the injury and suddenly being flared up
refractory period
What injury can occur soon after the crash?
central sensitization
Anxiety disorder that can develop after a person is exposed to one or more traumatic events, such as major stress, sexual assault, warefare, or other threats on a persons life describes
PTSD
What symptoms are indicative of PTSD?
disturbing recurring flashbacks
avoidance or numbing of memories of the event
hyperarousal
symptoms not present before exposure to event
inability to sleep
symptoms of _ may result in an overactive adrenaline response
PTSD
Which ligaments can be torn or injured with WAD?
a. longitudinal ligament
b. alar and transverse ligament
c. ALL
d. PLL
alar and transverse ligament
A patient has a stiff, rigid neck and multi level symptoms, which type of injury potentially resulted from WAD?
a. facet joint injury
b. disc lesion
c. ligament injury
d. muscle tear
disc lesion
Rim lesion includes
annulus tearing off the VB anterior > posterior bleeding from VB and ALL hemarthroses stiff, rigid neck multi-level symptoms
Which area of the c-spine is unstable?
occiput/atlas/axis
scalenes refer to what area
a. shoulder blades
b. front of neck
c. occiput
d. around eye and back of ear
around eye and back of ear
What can a headache from WAD be caused by?
facet joints atlanto-occipital joints and ligaments ligaments of c-spine annulus of IVD periosteum of the VB cervical muscles
Which tissues are primarily damaged with WAD?
a. muscles and facet joints
b. disc, facet joint, neural tissue
c. muscles and ligaments
d. facets and neural tissue
disc, facet joint, neural tissue
Which tissues are secondary damage with WAD?
a. muscles and facet joints
b. disc, facet joint, neural tissue
c. muscles and ligaments
d. facets and neural tissue
muscle and ligament
What treatment is the most effective for WAD short term?
a. manipulation and collars
b. traction and exericse
c. collars and rest
d. manip/mobs, and active exercise
manip/mobs, and active exercise
Collars help neurobehavioral issues with WAD (true/false)
false
There is evidence that rest improves neurobehavioral component of WAD (true/false)
false
Spinal manipulation gives a _ effect
placebo
What is the most powerful treatment for addressing neurobehavioral component?
a. rest and spinal mobs
b. exercise, advice and info
c. posture and education
d. spinal manip and rest
exercise, advice and info
What is the purpose in doing a short period of no therapy?
allow tissue to heal with inflammatory process to slow down
Patients should wean use of collar based on
a. pain
b. psychological fear
c. disability
d. time or function
time or function dependent
Patients should engage in frequent _
movement
What position is the most beneficial for exercise?
a. prone
b. supine
c. sidelying
d. seated
supine
symptom exam cluster for tissue issues
proportionate pain
aggs/eases
intermittent sharp, dull ache or throb at rest
no night pain, dysesthesia, burning, shooting or electric
Patients injured in stressful environments are _
adreno-sensitive
Abnormal nociceptive processing occurs
a. immediately, < 7 days
b. after 3 months
c. after 2 weeks
d. when it becomes chronic
<7 days
What predicts chronic whiplash?
abnormal nociceptive processing
What changes are seen in ROM?
less ROM
How does a slump test change symptoms?
increase intensity of cervical symptoms
Peripheral neurogenic symptom cluster
pain in dermatomal or cutaneous distribution
positive neurodynamic and palpation
history of nerve pathology or compromise
Pain in dermatomal or cutaneous distribution, positive neurodynamic and palpation
history of nerve pathology or compromise shows
a. central sensitization
b. peripheral neurogenic
c. nociceptive
peripheral neurogenic
Proportionate pain, aggs/eases intermittent sharp, dull ache or throb at rest, no night pain, dysesthesia, burning, shooting or electric suggest a. central sensitization b. peripheral neurogenic c. nociceptive
nociceptive
Patients show sensitivity to _ and _ _
adrenaline
mechancial pressure
symptom and sign cluster for central sensitization
disproportionate pain
diffuse palpation tenderness
psychosocial issues
disproportionate aggs/eases
disproportionate pain, diffuse palpation tenderness, psychosocial issues, disproportionate aggs/eases suggest
a. central sensitization
b. peripheral neurogenic
c. nociceptive
central sensitization
central sensitization affects
pain experience
smudging
left/right discrimination
Patients experience
a. central sensitization
b. peripheral neurogenic
c. nociceptive
d. all of the above
ALL
Anterior > posterior lesion, bleeding from VB and ALL, stiff and rigid neck, multi level symptoms and hemathroses suggest which type of injury occurred with WAD
a. VA
b. neural
c. ligament
d. disc
disc
