02 C-spine CPRs and Traction Flashcards Preview

7232 Ortho > 02 C-spine CPRs and Traction > Flashcards

Flashcards in 02 C-spine CPRs and Traction Deck (35):
1

purpose of CPRs for c-spine

help guide decision making
- diagnosis
- treatment

2

What is wrong with a level 4 CPR?

- lowest level
- good place to start, but we don't really know if they're accurate or valid

3

For higher level CPRs, what generally happens?

- validation study in a small sample
- validation study in a large sample
- impact analysis for trx and cost

4

cluster of S/S to rule out cervical radiculopathy

If there are 4 variables present, what is the % success?

90%

5

cluster of S/S to rule out cervical radiculopathy

If there are 3+ variables present, what is the % success?

65%

6

cluster of S/S to rule out cervical radiculopathy

If there are 2+ variables present, what is the % success?

21%

7

The Canadian c-spine rule is used in what population? What for?

alert and stable trauma patients where cervical spine injury is a concern

determine whether imaging is necessary

8

underlying principle of McKenzie method and specific exercises

one direction of motion makes you worse, the opposite makes you better

do the specific exercise to make them feel better

9

using the McKenzie method with protrusion that causes peripheralization

- opposite motion centralizes or makes it better
- once you centralize it, you can decrease volume

10

McKenzie method rep scheme

could be 10 reps every hour they're awake

11

What is involved in postural retraining?

- pecs and suboccipitals need to be stretched
- rhomboids and mid traps need strengthening
- emphasis on HABITS (pt needs to be more aware of posture)

12

How do you emphasize habits?

- taping
- postural support
- education on sleeping position
- visual cues in the car (mirror trick)

13

For the specific exercise category, what is often the treatment?

some variation of the diagnostic test

14

What is the only group that doesn't require postural retraining?

pain control
- more related to TRAUMA
- in the absence of trauma, posture plays more of a role

15

What is often added into conditioning and exercise tolerance category?

postural component as an adjunct to strengthening

16

indications for traction

- nerve impingement
- hypomobility of joints from degeneration
- joint pain from facet joint impingements
- muscle guarding/spasms
- herniated disc

17

effects of traction

- reduces pain and paresthesia from nerve root impingement
- reduces pressure on nerve roots
- assists circulation
- decreases muscle guarding and spasm

18

How do you know traction is appropriate?

+ compression
+ distraction
+ Spurling

19

What do you do when someone has positive repeated motion tests?

ALWAYS do specific exercises

20

When would you use traction (with respect to test results)?

- positive radicular symptoms
- negative repeated motion tests

21

_______ trumps compression/distraction tests

positive repeated motion tests

22

HNP

herniated nucleus pulposus

23

DDD

degenerative disc disease

24

HNP traction guidelines

- more for acute symptoms
- on/off time = 60:20
- begin with 3-5 mins, progress to 15

25

HNP traction - steps

- 1st time begin with 3 steps
- if tolerated, go down to 2 steps

26

DDD traction guidelines

- more for chronic symptoms
- on/off time = 30:10 (intermittent)
- begin with 10-12 mins, progress to 20

27

DDD traction - steps

1-2 steps per patient comfort/tolerance

28

HNP and DDD traction guidelines

- 7% body weight supine
- no more than 30#
- angle of pull is 20˚
- MUST stay with the patient for one full cycle

29

traction - important things to remember

- monitor symptoms through one full cycle
- give emergency on/off switch
- make sure you take earrings off and pull hair back

30

prognosis

how well you think a patient will do in PT
- excellent
- good
- fair
- poor

31

How do you determine how long the pt needs PT?

- look at primary impairment to determine
- cost is a factor, HEP content, patient compliance

32

You wouldn't use these prognoses if you think the pt is a good candidate for PT

- fair
- poor

33

How many exercises should you have the patient do in their first session?

try to keep it around 7

34

first day of trx for a conditioning/exercise tolerance category patient

- warm up: UBE great option - just move the arms
- strengthening and postural control
- deep neck flexor strengthening
- pec stretch
- any of the top 10 ST (3 x 10r)

35

clusters of S/S to rule out cervical radiculopathy

1. ULTT
2. involved c-spine rotation less than 60˚
3. (+) distraction
4. (+) Spurlings