C-spine

Question 1

Approximately 70% of patients with chronic neck pain exhibit decline in muscular strength and endurance of the

Answer 1

SCOM and deep cervical flexor

Question 2

Continuous imbalance between deep and superficial muscles will lead to

Answer 2

forward head posture

Question 3

most common postural dysfunction causing chronic neck and shoulder pain

Answer 3

forward head posture

Question 4

what can c0-c1 problem lead to

Answer 4

H/A, vertigo, fatigue, poor concentration, irritability
Physical attachment of dura

Question 5

C0-C2 problem is most likely issue with

Answer 5

fascial connections

Question 6

what can cause Muscle Impairment with Chronic Neck Pain

Answer 6

delayed cervical neck muscle contraction with upper body movement

Increased use of superficial cervical neck flexors during functional activities

Increased fatigability of cervical neck flexors in pain patients

Question 7

common injuries of cervical spine

Answer 7

DDD
Posterior disc herniation
Spinal stenosis
Upper cross syndrome
Facet joint irritation
Strains of trapezius muscle, SCM etc.

Question 8

what can happen if deep muscle of the neck become weak

Answer 8

Superficial muscles- become overactive to protect the neck
= excessive shear and compression

Question 9

Example Progressions of Cervical Core Training

Answer 9

Seated (avoid gravity)
Laying down
Chin tuck with combined movements
4 point against gravity
Standing with ball behind head
PNF patterning (Diagonal, CARs)
Proper positioning with functional movements

Question 10

Interventions to Manage a Disc Lesion in the Cervical Spine -> early phase

Answer 10

Early phase
Decrease acute symptoms
Examples: Modalities, massage, traction

Teach awareness of neck position and movement
Scapular movements

Passive cervical nods
Chin in midline gently nod the patient’s head and allow neck to flatten against the table
Patient does in sitting position on their own

Traction
Sustained traction 10 min, intermittent traction 15 min
15lbs of force causes vertebral separation

Question 11

Management of Disc Lesions in the Cervical Spine -> subacute phase

Answer 11

Completed once S/S of inflammatory process are under control and pain is no longer constant

Increase mobility in restricted muscles/joint/fascia/nerve
Head nods for longus colli and multifidus
Movement of the head with proper postural awareness
Add in upper extremity movement

Question 12

give exemple of proprio exercise for cervical

Answer 12

Laser pointer
Moving eyes only
Moving cervical spine keeping eyes fixated
Tracing/drawing objects with cervical movement
Balancing object on head with walking

Question 13

cervical extensor tend to be

Answer 13

Tend to be tonic and tight
Compensatory muscles

Question 14

people with incorrect FHP can suffer from

Answer 14

chronic or unpleasant conditions such as, pinched nerves and blood vessels, like thoracic outlet syndrome, muscle and tissue pain, syndromes like fibromyalgia, chronic strains and early degeneration and arthritis

Question 15

FHP can cause tension in

Answer 15

TMJ, give headache and bite problem

Question 16

cervicogenic headache referred pain where

Answer 16

head or face from first three to four CN

Question 17

TX of cervicogenic headache

Answer 17

ROM for mobility, Stretches for tight muscles, deep neck flexor activation

Question 18

_ is an intervention that is often recommended for the treatment of patients with neck pain

Answer 18

mechanical cervical traction

Question 19

cervical traction is used to

Answer 19

relieved pressure on neural structure

Question 20

Cervical Traction Parameters

Answer 20

1-3 times/day
10-15 minutes of sustained traction
10-30lbs of traction force
Intermittent vs sustained
Neck position- midway between flexion and extension (acute/subacute), flexion or extension (chronic)

Question 21

how munch time do put cervical traction for disc herniation

Answer 21

5-10min, 25-40lbstuiioip

Question 22

is a little post treatment muscle soreness common after cervical traction

Answer 22

yes

Question 23

indication for spinal traction

Answer 23

Nerve root impingement
Disk herniation
Spondylolisthesis
Narrowing within intervertebral foramen
Osteophyte formation
Degenerative joint diseases
Subacute painJoint hypomobility
Discogenic pain
Muscle spasm or guarding
Muscle strain
Spinal ligament or capsular contractures
Improvement in arterial, venous, and lymphatic flow

Question 24

contraindication for spinal traction

Answer 24

Acute sprains or strains Acute inflammation Fractures Vertebral joint instability Any condition in which movement exacerbates existing problem Bone diseases Osteoporosis Infections in bones or joints Vascular conditions Pregnant females Cardiac or pulmonary problems

Question 25

There is (high/low) level evidence that cervical manipulation and mobilisation as unimodal interventions are effective on pain and range of motion at the immediate follow up

Answer 25

low

Question 26

There is (high/low) level evidence that traction is no more effective than placebo traction

Answer 26

low

Question 27

when can you do neuromeningeal mobs

Answer 27

once symptoms have centralized

Question 28

contradiction of neuromeningial mobs

Answer 28

Acute or unstable neurological signs Spinal cord injury or symptoms Neoplasm and infection **Watch for vascular compromise

Question 29

Relaxation Techniques Cervical and Upper Thoracic Regions

Answer 29

Seated or standing with arms by the side Diaphragm breathing Bend neck forward and backwards Side bend head and rotate from side to side Roll the shoulders; protract, elevate, retract and relax scapula Circle the arms with elbows flexed or extended Jaw relaxation

Question 30

exercise that target upper trap

Answer 30

prone rowing military press T with neutral glenohumeral rotation shoulder shrug shoulder lateral rais upright row

Question 31

exercise that target mid trap

Answer 31

prone shoulder extension prone rowing sideline GH ER side line shoulder flexion T with neutral GH rot or ER

Question 32

exercise that target lower top

Answer 32

shoulder abd bilateral GH ER at 0º abd prone GH ER at 90º abd prone shoulder rowing Y T with GH ER side line with GH ER