Week 1-4 Flashcards
What muscles with MFTP mimic C8 radiculopathies?
LATs, Pecs, and serratus anterior
What muscles with MFTP can mimic C6 radiculopathy?
Scalenes, supraspinatus, subclavius, infraspinatus
What are the common causes of neck and arm symptoms?
Disc herniation, osteophytes, and stenosis
If there is no radicular symptoms, what are the top Ddxs for neck pain combined?
Facet syndrome, sprain, strain, disc derangement, fracture, joint dysfunction, muscle spasm
What are the traumatic ddxs for neck?
Sprain, strain, facet syndrome, fracture, disc derangement
What are the non-traumatic ddxs for neck pain?
Facet syndrome, disc derangement, sprain, strain, joint dysfunction, myospasm
How can the arm squeeze test help us diagnose when there is both neck and arm symptoms?
If the difference in pain score is greater than 3 in the ARM it indicates the lesion is compressing the NR
What are the indications for x-rays?
Trauma (with Ottawa rules), red flags for disease, significant SMR deficits, nerve damage, progressive muscle weakness
What are the red flags for disease?
Unexplained weight loss, change in appetite, fever, fatigue, maliase
What are the signs of cord involvement?
Hypereflexia, hypersensitivity, Changes in bowel or bladder habits, urinary incontinence, saddle parasthesia, changes in pain sensation
What are the indications for an MRI?
Progressive muscle weakness, cord involvement, neurological deficits, profound muscle weakness
How can you treat discs?
McKenzie and Neuro mobilization exercises
What are the symptoms for disc derangement?
Arm symptoms improve with repetitive or sustained end range movements, flexion sensitivity, positive valsalva, aggravated by compression, relieved by distraction
What is the common age range for disc herniations and derangement?
40-60
What is the difference between disc derangement and herniation?
If there is nerve damage, it is a herniation. If there is not, call it a derangement
What is the clinical prediction rule for facet syndrome?
Lack of a P-A glide (better specifity), tenderness on facet (better sensitivity), and recreating pain with extension and rotation (better sensitivity)
What are the cervical big 5?
ULTT, valsalva, compression, distraction, shoulder abduction
What creates tension on the NR?
ULTT, shoulder abduction, shoulder depression, any other TOS tests
What is the difference between AOM and OME?
AOM is frequently due to a bacterial infection and presents as SICK (fever, effusion, redness of tympanic membrane) and OME presents as sick (no fever, effusion, and retracted tympanic membrane).
How do you determine viral and bacterial rhino sinusitis?
If symptoms last 10 days or longer, it is bacterial. Bacterial also has what is considered a double sickening around day 5.
What is rhinosinusitus?
The common cold
What are the treatment options for rhinosinusitus?
Nasal specific therapy, manipulation, saline irrigation, nasal specific therapy, intranasal corticosteroid sprays
What muscles are common causes of TOS?
Pec, scalenes, and subclavius
What are the types of TOS?
Neurogenic, vascular and nonspecific
What ancillary studies are needed to diagnose a true neurogenic TOS?
EMG and nerve conduction study
What are the two types of vascular TOS?
Arterial and venous
How do you distinguish between the two types of vascular TOS?
Arterial- red, cold, splinter hemorrhages, decreased radial pulse, asymmetry of BP
Venous- edema, cyanosis, heaviness in the arm, distended veins
What can cause TOS besides tight muscles?
Cervical ribs
What are the TOS tests?
Roos, eden’s, hyperabduction, Tinel’s, Allen’s and Adson’s
What are the treatment options for nonspecific TOS?
Stretch pec/ scalene, adjust, cupping, massage, at home work: corner stretches, scalene stretches, or tennis ball to knots
What is the B list for causing arm and neck symptoms?
Structural instability, SOL, infection, NR adhesions, trauma to the NR directly
What orthopedic tests distinguish between a sprain and a strain?
Muscle testing and PROM
How are sprains and strains different?
Strains with have painful or weak muscle testing
Sprains will have painful or limited PROM in midrange
How do you grade strains?
Grade 1 is pain with contraction
Grade 2 is weakness and pain with contraction, potential for bruising or a palpable defect
Grade 3 has no resistance to muscle testing, marked swelling/ bruising/ palpable defect
How do you grade sprains?
Grade 1- pain only at end range, mild swelling, no gross instability
Grade 2- pain on stress of tissue before end range, generalized swelling, mild laxity, localized bruising
Grade 3- gross instability, generalized swelling, bruising, loss of ROM
What are the Canadian-Nexus rules for x-rays?
Trauma + over 65
A dangerous mechanism of injury
Trauma + paresthesia in the extremities
Trauma + painful distracting injury elsewhere
Trauma + altered level of awareness or intoxication
Trauma + patients with known vertebral disease
Trauma + inability to rotate >45 total
Trauma + Midline cervical tenderness
Focal neurological deficit
What is a dangerous mechanism of injury?
A fall from a height, an axial load, a high speed collision, or a motorcycle or bicycle accident
What are known vertebral diseases?
Diseases that increase risk of fracture or predispose to instability: fusions, stenosis, RA, AS, down’s, marfan’s, klippel- feil
What is Rust’s sign?
Patient feels like they have to always support their neck, especially in transition movements
What is a Davis series?
A complete 7 view study of the neck (AP, APOM, Lateral, Obliques, and Flex-Ext
What is the nerve family for biceps reflex?
C5 and C6
What is the nerve family for brachioradialis reflex?
C6 and C5
What is the nerve family for Triceps reflex?
C7 and C8
What is the nerve family for patellar reflex?
L4 and L3
What is the nerve family for medial hamstring reflex?
L5 and S1
What is the nerve family for Achilles reflex?
S1 and S2
