Advanced Cervical Spine I Flashcards
(24 cards)
What 2 things do you need to rule out for pre manip screening
Sx of vascular pathology or cervical cord compression
Risk factors for upper cervical instability
Trauma
Congenital collagenous compromise (EDS, DS)
Inflammatory arthritides (RA, AS)
Recent head/neck/dental Sx
Early Sx
Neck and head pain
Instability feeling
Cervical muscle hyperactivity
Constant support needed for head
Worsening symptoms
Late Sx
B/L or Q/L Sx
Hyper reflexia
Clonus
Babinski
Arm/leg weakness
B/L lack of coordination
Gait disturbances
Instability tests are positive or negative if pain only
Negative
Not cardinal Sx but caution
HAs
Dizzy
Vomit
Nausea
Anxiety
Lump in throat
Active stability tests of UCS
Seated cervical rotation (unable to do if dens fx)
Upper cervical side bend
Active upper cervical flx (unable if dens or transverse lig problem)
Active upper cervical extension
Scapulohumeral reflex
Hit tip of spine of scap and acromion
+ if humeral abduction or scap elevation
Good for C1-C3 issues
ICA athlereclerosis incidence
> 80% of older white patients
ICA arthersclerosis risk factors
Smoking
HTN
High cholesterol
Diabetes
Infections
Dissection risk factors
(Most to least)
Trauma
Vascular anomaly
Current/past smoker
Migraine
High total cholesterol
Recent infection
HTN
Oral contraception
Family hx stroke
Non dissection risk factors
Current/past smoker
HTN
High cholesterol
Migraine
Vascular anomaly
Family hx stroke
Oral contraception
Recent infection
Recent trauma
Dissection Sx
HA
Neck pain
Vision
UE parasthesias
Dizzy
Face parasthesias
LE parasthesias
Non dissection Sx
HA
UE parasthesias
LE parasthesias
Vision
Facial paralysis
Neck pain
Dizzy
VBA Sx
Unsteady/ataxic gait
Dysphasia/arthria/aphasia
LE weakness
UE weakness
Dysphagia
Vomit
Facial palsy
Dizzy
Ptosis
Loc
Confusion
Drowsy
ICA Sx
Ptosis
UE weak
Facial palsy
UE weak
Aphasia
Ataxia
Vomit
Drowsy
Loc
Confused
Dysphagia
Non dissection VBA or ICA Sx
UE weak
Aphasia
LE weak
Ptosis
Facial palsy Dizzy
Ataxic gait
Confused
Vomit
Dysphagia
Loc
Drowsy
How many manipulations to get adverse effect
416,666
Most common stroke early presentation Sx
Mid upper cervical pain
Pain around ear/jaw
Head pain (fronto parietal temporal)
Occipital HA
Pain “unlike any other”
What is good safe alternative for neck pain
T spine manip
Manip rules
Do not overlock
No follow through on thrust
Low amplitude
Dominant rhomboids
If scapula moves in first 50% of ER
Arm elevation with cervical rotation towards elevating arm is tight
UT
Away would be levator
Deep cervical flx training cuff
Start at 22, 10sh x 10 reps
Goal to get to 30 x 10
