Whiplash Injuries Flashcards
What is whiplash?
Mechanism whereby the neck is whipped in one direction and recoils in the opposite direction
Why is whiplash not a diagnostic term?
Does not give an indication of injured structures
At least how many people in the US suffer a neck injury following a rear-end accident?
1 million per year
What population is most likely to suffer a neck injury following a read-end accident?
Females ages 20-24
What is the most important factor for identifying the mechanism of injury following a rear-end accident?
Patient’s position
What areas of the spine will experience the greatest velocity during a whiplash injury?
1 Distal end
2 Area with more segments
What are the likely sites of injury following whiplash?
1 Facet joints 2 Vertebral endplates 3 Spinal ligaments 4 IVDs 5 Neck muscles 6 Vertebral arteries
What are the two documented mechanisms of injury of facet joints during a whiplash injury?
1 pinching of synovial fluid
2 excessive strain of capsule
What causes the facet joint injury following whiplash where the synovial fold is pinched?
Cervicals rotate about a higher center and fold is pinched on posterior side
What other type of injury accompanies capsular strain following a whiplash injury?
Inflammatory responses involving the spinal cord
What is the first structure to fail when subjected to compressive load?
Endplate
What area of the spine is at most risk for an ALL injury following a rear impact?
C3/C4-C7/T1
In what condition are alar and transverse ligament injuries following rear impact more severe?
When head is turned
Which IVD is most vulnerable after a rear impact?
C5-C6
What condition makes the C5-C6 especially vulnerable during a rear impact injury?
Lower speeds
Which ligaments are most at risk during a frontal impact?
1 Supraspinous/ligamentum nuchae
2 Interspinous
3 Ligamentum flavum
What range of IVDs are most at risk during a front impact injury? What disc is most at risk?
C2/C3-C7/T1; C5/C6 = most at risk
What is the major chiropractic consideration following a neck injury?
HVLA adjustments rapidly increase tension in ligaments
The SCM becomes damaged during what motion?
Hyperextension
Which neck muscle becomes damaged during hyperflexion?
Trapezius
Where are the vertebral arteries most susceptible to injury?
Posterior AO membrane
Space between occiput and posterior arch of atlas
Between lateral mass of C1 and TP of C2
What system is used to grade neck injuries?
Quebec Task Force (5 Points)
Which grade of the Quebec Task Force involves complaints of pain, stiffness, or tenderness, but no physical signs are noted?
WAD-1
Which grade of the Quebec Task Force involves fracture/dislocation or cord injury?
WAD-4
Which grade of the Quebec Task Force involves neck complaints and the examining physician finds decreased ROM and point tenderness in the neck?
WAD-2
Which grade of the Quebec Task Force involves no signs or symptoms?
WAD-0
Which grade of the Quebec Task Force involves neck complaints plus neurological signs such as decreased deep tendon reflexes, weakness, and sensory deficits?
WAD-3
Can a concussion occur without head strike?
Yes
What kinds of symptoms can be seen due to occlusion of the vertebral arteries following a neck injury?
Blurred vision, pupil dilation, vertigo, tinitus, auditory disturbances, and headache
Irritation of what area can also present symptoms similar to that of occluded vertebral arteries?
Vertebral sympathetic plexus
