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S3- Musculoskeletal > C-Spine Examination Lab Refined > Flashcards

C-Spine Examination Lab Refined Flashcards

1
Q

PART 1: INTRO

A

PART 1: INTRO

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2
Q

Factors Associated with Development of Chronic Neck Pain:

  • Less baseline pain and disability intensity
  • Hx ________ and ________ symptoms (pain)
  • Age (>___ years)
  • Longer symptom duration
  • Decreased _______ strength (disability)
  • Headache
  • Concomitant LBP
  • Previous _________
  • Bicycling as regular activity
  • Worse health perceptions
  • Worse ____
  • More worrying
A
  • neck and shoulder
  • 40 years
  • hand
  • trauma
  • QoL
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3
Q

The lifetime risk of developing neck pain is __-__%.

Approximately __-__% of individuals develop persistent pain and disability.

A
  • 22-70%

- 20-44%

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4
Q

It is important in the patient interview to ask ______________ when patients present with neck pain for things such as:

  • Cervical Arterial Dysfunction
  • Structural Instability (upper cervical ligament, Frx)
  • Pain referral from cardiopulmonary systems
  • TMD
  • UE Radiculitis/ Radiculopathy
  • Central neurologic system
  • Screening for other non-musculoskeletal health condition or musculoskeletal condition where referral is indicated
A

screening questions

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5
Q

It is important in the patient interview to ask their _________ limitations such as:

  • Checking blind spot
  • Prolonged static positioning (computer work, driving, etc.)
  • Scanning ground for safety (older adults)
  • Looking over head
  • Lifting/ pushing/ pulling with UEs (heavy doors, etc.)
A

functional

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6
Q
  • What is the most common outcome measure used?

- What are some others?

A
  • PSFS (Patient-Specific Functional Scale)

- Neck Disability Index (NDI), Whiplash Disability Questionnaire, QuickDASH, Dizziness Handicap Inventory (DHI)

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7
Q

PART 2: VISUAL INSPECTION AND SYSTEMS REVIEW

A

PART 2: VISUAL INSPECTION AND SYSTEMS REVIEW

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8
Q

What are we looking for in our visual inspection?

A
  • Gross abnormalities
  • Alertness
  • Integumentary
  • Posture Assessment (resting vs ability to correct)
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9
Q

What is our goal with the systems review?

A

Identify impairments for continued tests and measures.

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10
Q

What are the 5 parts of the systems review?

A
  • Cardiopulmonary
  • Integumentary
  • MSK
  • Neuromuscular
  • Cognition/Affect
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11
Q

PART 3: ELIMINATION TESTS

A

PART 3: ELIMINATION TESTS

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12
Q

What parts are included in elimination testing?

A
  • UQ Screen
  • Neuro Screening Tests
  • Other Screening Tests
  • Special Tests
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13
Q

Describe the UQ Screen.

A
  1. ) C-Spine AROM is done (flexion/extension, lateral flexion, rotation)
  2. ) C-Spine Resistance is done
  3. ) UE AROM is done (shoulder flexion and abduction, reach behind head, reach behind back, elbow flexion/extension, wrist flexion/extension, fist/open hand)
  4. ) UE Resistance is done (shoulder flex/abd/ER/IR, elbow flex/ext, wrist flex/ext, grip)
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14
Q

What is applied at the end of each AROM during the UQ Screen?

A

Overpressure is applied to stress joint structures

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15
Q

Describe the myotome screening for each nerve root.

A 
C1= capital flexion
C2= capital extension
C3= lateral flexion
C4= shoulder elevation
C5= shoulder abduction
C6= elbow flexion/wrist extension
C7= elbow extension/wrist flexion
C8= thumb abduction
T1= finger adduction
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16
Q

What elimination tests are used for CAD?

A
  • End Range Rotation Test
  • VBI Test
  • Modified VBI Test
17
Q

What elimination tests are used for Upper Cervical Stability?

A
  • Modified Sharp Purser Test
  • Upper Cervical Flexion Test
  • A-O Membrane Test
  • Tectoral Membrane Test
  • Alar Ligament Stability Test
18
Q

What elimination test is used for Cervicogenic Headaches?

A

Cervical Flexion-Rotation Test

19
Q

What elimination test is used for Radicular Pain/ Radiculopathy?

A

ULTT

20
Q

PART 4: STRUCTURAL STRESS TESTING

A

PART 4: STRUCTURAL STRESS TESTING

21
Q

With structural stress testing we are trying to better understand what?

A

The patients MSK pattern via active, passive, resistive testing

22
Q

With stress testing what 4 things are we looking for?

A
  • Quality
  • Quantity
  • Willingness
  • Provocation
23
Q

With structural stress testing, we might also want to look at contractile unit ________.

A

length

24
Q

Why is resistive testing done in mid range?

A

Helps to decide whether it is a contratile or inert tissue issue.

25
Q

PART 5: PALPATION AND JOINT MOB

A

PART 5: PALPATION AND JOINT MOB

26
Q

Palpation involves both ______ and _________ structures.

A

bony and soft tissue

27
Q

What is PAIVM Testing?

A

Passive Accessory Intervertebral Movement Testing (PAIVM)

-CPAs and UPAs

28
Q

What is PPIVM Testing?

A

Passive Physiological Intervertebral Movement Testing (PPIVM)

  • CO/C1 Mob testing (flex/ext, lateral flex)
  • C1/C2 Mob testing (rotation)
  • Mid and Lower C-Spine (up/down glides)w
29
Q

PART 6: CONFIRMATION TESTS

A

PART 6: CONFIRMATION TESTS

30
Q

What are the confirmation tests for Radicular Pain/ Radiculopathy?

A
  • Spurling’s Compression Test
  • Cervical Distraction Test
  • Valsava Maneuver
  • Brachial Plexus Compression Test
  • Cervical Compression Test
31
Q

What 4 things are in Wainner’s Test Item Cluster?

A
  • Spurling’s Test +
  • Cervical Distraction Test +
  • ULTT +
  • C-Spine Rotation AROM <60 degrees
32
Q

What is Wainner’s Test Item Cluster useful for?

A

Ruling In cervical radiculopathy, radicular pain if 4/4 are +

33
Q

Describe the Neck Flexor Muscle Endurance Test.

A
  • Pt Position: Supine/ hook lying
  • Position pt into maximal retraction
  • Pt maintains retraction while lifting head ~ 1 inch off of table
  • Line drawn on skin folds (anteriolateral neck)
  • If position begins to be compromised, verbal cues to hold the head up or tuck the chin
  • Time pt’s ability to hold until (1) loss of capital flexion position or (2) head touches examiners hands > 1 sec
34
Q
  • What are the mean hold times for the Neck Flexor Muscle Endurance Test?
  • What is a MDC for the test?
A
  • Male: 38.9s +/- 20.1s
  • Female: 29.4 +/- 13.7s

-17.8s for change in muscle endurance

35
Q

Describe the Craniocervical Flexion Test (CCF Test)

A
  • The pressure biofeedback unit placed behind the subjects’ upper neck
  • Baseline pressure of 20 mm Hg
  • Patient instructed on CCF & practice the head-nodding action
  • Progressively target and hold the 5 pressure levels (2 mm Hg each) x 10 seconds (between 22 mm Hg and 30 mm Hg)
    • 10 sec rest breaks between each level
  • Terminated when:
    • Pressure decrease > 20mmHg
    • Pt cannot perform motion without substitutions
36
Q

What is the activation score normal?

A

10s hold without substitution at 26-30mmHg

S3- Musculoskeletal (27 decks)

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