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PT9133 - Lecture/Textbook/Research Paper Notes > C-Spine > Flashcards

C-Spine Flashcards

1
Q

What are the 5 classifications/grades of WAD

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2
Q

What are the criteria of mild, moderate, and severe TBI

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3
Q

Process of determining appropriateness of physiotherapy for concussions during an exam

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4
Q

Describe the ER algorithm for management of acute neck injuries

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5
Q

Describe the algorithm for Canadian C-spine rules (fractures) in terms of radiography

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6
Q

What are the 3 categories of red flags

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7
Q

Name 6 red flag conditions of the neck

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8
Q

Signs and symptoms of cervical myelopathy

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9
Q

Signs and symptoms of neoplastic conditions

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10
Q

Signs and symptoms of upper cervical ligamentous instability

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11
Q

Signs and symptoms of vertebral artery insufficiency

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12
Q

Signs and symptoms of inflammatory or systemic disease

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13
Q

What to do if there is a cervical fracture

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14
Q

Anatomy refresher slide

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15
Q

C1-C2 craniovertebral refresher slide

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16
Q

Describe C0-C1 (Occiput-Atlas)

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17
Q

Describe C1-C2 (Atlantoaxial)

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18
Q

Describe the alar ligaments

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19
Q

Describe the transverse ligaments

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20
Q

Describe C3-C7

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21
Q

Describe the neural structures of the cervical spine

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22
Q

Describe the intervertebral disc

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23
Q

Describe a disc herniation

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24
Q

Where is pain distribution, weakness, sensory loss and reflex loss for C5

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25
Q

Where is pain distribution, weakness, sensory loss and reflex loss for C6

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26
Q

Where is pain distribution, weakness, sensory loss and reflex loss for C7

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27
Q

Where is pain distribution, weakness, sensory loss and reflex loss for C8

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28
Q

What are 6 nerves commonly damages in WAD

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29
Q

What are the vascular structures of the neck

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30
Q

What are the myofascial structures of the neck (look up their function)

A

Traps: Stabilizes scapula and performs scapula elevation, retraction, depression, and UR
Splenius Capitis: Ipsilateral side head and neck flexion and rotation, extension
Splenius Cervicis: Head/neck lateral flexion, rotation, and neck extension
Longus capitis: Head flexion
Longus Colli: Bilaterally flexes head and ipsilaterally tils head at CV region
Scalenes: Neck flexion, lateral flexion and rotation, and for postural control
Longissimus capitis: Neck extension and lateral flexion, head rotation
Longissimus cervicis: Neck extension and lateral flexion
Multifidus: Spine stability and neck extension
Semispinalis Capitis: Neck lateral flexion and extension
Semispinalis Cervicis: Neck ipsilateral side flexion and contralateral rotation, and extension
Splenius Capitis: Laterally flex and rotate neck, extension
SCM: Neck flexion, rotation (contralateral side), and side flexion ipsilaterally

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31
Q

What is the pain pattern for facet joints C2-C7

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32
Q

What are 3 types of pain that are a risk of chronicity in WAD

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33
Q

What are some non-physical factors for WAD that could induce chronicity

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34
Q

Individuals with upper cervical instability report

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35
Q

What are some symptoms of movement with WAD and some other common complaints

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36
Q

What are some objective findings for WAD

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37
Q

What are some positive findings for WAD

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38
Q

According to Sarrami et al. what did they conclude about prognostic factors for WAD

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Post-injury pain, whiplash grades, cold hyperalgesia, post-injury anxiety, catastrophizing, compensation and legal factors, and early healthcare were associated with continuation of pain and disability with those with WAD. While factors such as MRI/radiographic findings, motor dysfunction, or factors related to the collision were not associated with continuation of pain and disability.

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39
Q

Walton et al found what risk factors also lead to poor prognosis

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-Grade of WAD (2 or 3)
-Higher NDI score (14.5/50)
-Female
-Less than post secondary education
-Preinjury neck pain
-Catastrophizing
-Low back pain at inception
-Headache at inception

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40
Q

Cleland et al found what about treating cervical radiculopathy

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Cervical traction, manual therapy, and deep neck flexor muscle strengthening may be beneficial to managing cervical radiculopathy

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41
Q

Wainner et al found

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That Wainner’s cluster was the most useful for diagnosing cervical radiculopathy

42
Q

Kjaer et al found what about management and treatment for neck pain and cervical radiculopathy

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Management should include info about prognosis, warning signs, and advise to remain active. While treatment suggested different types of supervised exercise and manual therapy for neck pain. Acupuncture only for neck pain and not cervical radiculopathy. Traction for only cervical radiculopathy. NSAID’s and tramadol for neck pain and cervical radiculopathy

43
Q

Describe specific vs non-specific neck pain

A

Specific - identifiable causes and less common
Non-specific - multi-dimensional and more common

44
Q

How can we manage non-specific neck pain

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45
Q

What are 4 key points for degenerative changes of the C-spine

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46
Q

Describe cervical radiculopathy

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47
Q

What are risk factors for cervical radiculopathy

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48
Q

What is the clinical pattern for cervical radiculopathy

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49
Q

Describe cervical myelopathy

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50
Q

What are the risk factors for cervical myelopathy

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51
Q

What are the clinical presentations for cervical myelopathy

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52
Q

Describe the neurological scan and its components

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53
Q

What is Wainners cluster

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54
Q

Spurlings

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55
Q

ULNT1a

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56
Q

Traction

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57
Q

What are important education pieces on cervical radiculopathy

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58
Q

Prognosis of cervical radiculopathy

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59
Q

Describe medications for cervical radiculopathy

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60
Q

Is traction and exercise beneficial for cervical radiculopathy

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61
Q

Can you use taping for cervical radiculopathy treatment

A

Yes

62
Q

Describe the NDI

A

Scoring:
0 to 4 = no disability
5 to 14 = mild
15 to 24 = moderate
25 to 34 = severe
Above 34 = complete

63
Q

Describe the Patient Specific Functional Scale

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Scoring:
0 = cant perform activity
10 = able to perform activity at same function as before injury

64
Q

When should we perform imaging

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65
Q

What is important about incidental findings and imaging

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66
Q

Is neck pain a financial burden to society?

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67
Q

What are the 4 categories of differential diagnosis for c-spine

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68
Q

What was found on the CBG for neck pain

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69
Q

What are the clinical findings for cancer

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70
Q

What are clinical findings for vascular pathologies in the neck

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71
Q

Describe the circle of willis

A
  • Paired vertebral arteries – arise from subclavian, to transv foramen of C6, join to create basilar arteries
    • Three arteries to the cerebellum = problems with coordination, balance etc

Pons
* Cranial nerve nuclei
* Midbrain
* Vasc compromise to vert artery/basilar will have clin presentation assoc w/ CN findings !!
Basilar artery to circle of willis = supplied by ICA = gives off INtCA and middle cerebral artery

Any disease or dysf of cerebrovascular system

72
Q

What are some pathologies for cerebrovascular dysfunction

A

Ones circled

73
Q

Should dizziness be a red flag?

A
74
Q

Describe cervicogenic dizziness

A

Alt in somatosensory input – mechanoreceptors, spindles, GTOs in upper c-spine
* In jt capsule, in tendon units
*Results in altered proprioceptive/kinesthetic sense in that region

75
Q

What are some MSK sources of dizzines

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76
Q

What are 4 types of dizziness

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77
Q

Describe vestibular dizziness

A
  • Common is BPPV
    • Complaints:
      ○ Sense that the world is spinning around them
      § Caused by large angular/rot movements of the head
      § Slight delayed response
      ○ Symptoms aggravated when they go to lie down at night or roll over, moving quickly to tip over and tie shoes etc
    • Symptoms will last 30s to a min and resolve
      -Common after trauma
78
Q

Describe concussion-related dizziness

A
  • Light and sound sensitivity
    • MOI: clear trauma
      -Headache
79
Q

Describe cervicogenic dizziness

A
  • Sense of feeling “not right”
    • Walk w/ hand on wall to balance themselves
    • Temporal association developing neck pain
    • Dizziness getting worse as neck pain gets worse
    • Often related to mechanical things in the neck
      ○ Ex. Working at computer for period of time, getting up + feeling off balance/not right, unsteady
      -Wont resolve on its own decisively
80
Q

What are all the types of flags in clinical history

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81
Q

Differential diagnosis for neck pain + Headache categories

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82
Q

Cervicogenic headache clinical pattern

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  • Pain MUST start in the neck
    • Inc of neck pain results in headache
    • Neck pain PRECEDES headache
    • Unilateral – side locked (always on that side)
    • Mechanical aggravating factors
      ○ Assoc w sustained postures or movements of the head/neck
    • Intensity can be variable from one episode to the next
    • Duration can vary
83
Q

Migraine clinical pattern

A
  • Tendency to side shift, doesn’t stay on same side/location all the time
    • Cause: known triggers that the px is aware of
      ○ Foods, hormonal, stress, weather
    • Preceded by an aura (sense of flashing lights, unique to migraine itself)
    • Predictable behavior
      ○ Know when they get one, how bad it’ll get
      ○ Lasts predictable amount of time
    • Starts in the head
    • Neck may get stiff after a day or two
    • CLUSTER = subcategory
84
Q

Tension type clinical pattern

A
  • Bilaterally – crossing post occiput or forehead
    • Low grade
    • Assoc w/ stress
85
Q

Post-concussive clinical pattern

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  • MOI; concussion
  • Concussion related symptoms
86
Q

Pain pattern for each type of headache

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87
Q

What is post concussion syndrome

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88
Q

Screening criteria for different types of neck pain

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89
Q

Describe migraines

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90
Q

Describe tension type headaches

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91
Q

Differential diagnosis chart for cervicogenic headaches, migraines, and tension type headaches

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92
Q

Should you check blood pressure with headaches

A

Yes, could be vascular pathology

93
Q

What are the 10 cranial nerves and tests for each one (also should it be used for testing cervicogenic headaches)

A

Yes for headaches

94
Q

What is the physical exam for vascular issues

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95
Q

What are week 1 exam objectives for neck pain + headache (not all necessary)

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96
Q

What are week 2 exam objectives for neck pain + headache (not all necessary)

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97
Q

What are the risks and benefits of manual therapy for a person with neck pain + headache

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98
Q

What is week 1 management for headache + neck pain person

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99
Q

What is week 2 management for headache + neck pain person

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100
Q

What prognostic factors can affect outcome for neck pain +headache persons

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101
Q

What are some outcome measures for a person with neck pain + headache

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102
Q

According to Ogince et al. what does the cervical flexion-rotation test do

A

Measures movement impairment of C1/2 region and cervicogenic headache

PT9133 - Lecture/Textbook/Research Paper Notes (9 decks)

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