C-Spine Flashcards
(102 cards)
1
Q
What are the 5 classifications/grades of WAD
A
2
Q
What are the criteria of mild, moderate, and severe TBI
A
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
A
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
A
7
Q
Name 6 red flag conditions of the neck
A
8
Q
Signs and symptoms of cervical myelopathy
A
9
Q
Signs and symptoms of neoplastic conditions
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10
Q
Signs and symptoms of upper cervical ligamentous instability
A
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
A
15
Q
C1-C2 craniovertebral refresher slide
A
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
A
19
Q
Describe the transverse ligaments
A
20
Q
Describe C3-C7
A
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
A
24
Q
Where is pain distribution, weakness, sensory loss and reflex loss for C5
A
25
Where is pain distribution, weakness, sensory loss and reflex loss for C6
26
Where is pain distribution, weakness, sensory loss and reflex loss for C7
27
Where is pain distribution, weakness, sensory loss and reflex loss for C8
28
What are 6 nerves commonly damages in WAD
29
What are the vascular structures of the neck
30
What are the myofascial structures of the neck (look up their function)
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
31
What is the pain pattern for facet joints C2-C7
32
What are 3 types of pain that are a risk of chronicity in WAD
33
What are some non-physical factors for WAD that could induce chronicity
34
Individuals with upper cervical instability report
35
What are some symptoms of movement with WAD and some other common complaints
36
What are some objective findings for WAD
37
What are some positive findings for WAD
38
According to Sarrami et al. what did they conclude about prognostic factors for WAD
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.
39
Walton et al found what risk factors also lead to poor prognosis
-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
40
Cleland et al found what about treating cervical radiculopathy
Cervical traction, manual therapy, and deep neck flexor muscle strengthening may be beneficial to managing cervical radiculopathy
41
Wainner et al found
That Wainner's cluster was the most useful for diagnosing cervical radiculopathy
42
Kjaer et al found what about management and treatment for neck pain and cervical radiculopathy
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
Describe specific vs non-specific neck pain
Specific - identifiable causes and less common
Non-specific - multi-dimensional and more common
44
How can we manage non-specific neck pain
45
What are 4 key points for degenerative changes of the C-spine
46
Describe cervical radiculopathy
47
What are risk factors for cervical radiculopathy
48
What is the clinical pattern for cervical radiculopathy
49
Describe cervical myelopathy
50
What are the risk factors for cervical myelopathy
51
What are the clinical presentations for cervical myelopathy
52
Describe the neurological scan and its components
53
What is Wainners cluster
54
Spurlings
55
ULNT1a
56
Traction
57
What are important education pieces on cervical radiculopathy
58
Prognosis of cervical radiculopathy
59
Describe medications for cervical radiculopathy
60
Is traction and exercise beneficial for cervical radiculopathy
61
Can you use taping for cervical radiculopathy treatment
Yes
62
Describe the NDI
Scoring:
0 to 4 = no disability
5 to 14 = mild
15 to 24 = moderate
25 to 34 = severe
Above 34 = complete
63
Describe the Patient Specific Functional Scale
Scoring:
0 = cant perform activity
10 = able to perform activity at same function as before injury
64
When should we perform imaging
65
What is important about incidental findings and imaging
66
Is neck pain a financial burden to society?
67
What are the 4 categories of differential diagnosis for c-spine
68
What was found on the CBG for neck pain
69
What are the clinical findings for cancer
70
What are clinical findings for vascular pathologies in the neck
71
Describe the circle of willis
* 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
What are some pathologies for cerebrovascular dysfunction
Ones circled
73
Should dizziness be a red flag?
74
Describe cervicogenic dizziness
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
What are some MSK sources of dizzines
76
What are 4 types of dizziness
77
Describe vestibular dizziness
* 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
Describe concussion-related dizziness
* Light and sound sensitivity
* MOI: clear trauma
-Headache
79
Describe cervicogenic dizziness
* 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
What are all the types of flags in clinical history
81
Differential diagnosis for neck pain + Headache categories
82
Cervicogenic headache clinical pattern
* 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
Migraine clinical pattern
* 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
Tension type clinical pattern
* Bilaterally – crossing post occiput or forehead
* Low grade
* Assoc w/ stress
85
Post-concussive clinical pattern
* MOI; concussion
- Concussion related symptoms
86
Pain pattern for each type of headache
87
What is post concussion syndrome
88
Screening criteria for different types of neck pain
89
Describe migraines
90
Describe tension type headaches
91
Differential diagnosis chart for cervicogenic headaches, migraines, and tension type headaches
92
Should you check blood pressure with headaches
Yes, could be vascular pathology
93
What are the 10 cranial nerves and tests for each one (also should it be used for testing cervicogenic headaches)
Yes for headaches
94
What is the physical exam for vascular issues
95
What are week 1 exam objectives for neck pain + headache (not all necessary)
96
What are week 2 exam objectives for neck pain + headache (not all necessary)
97
What are the risks and benefits of manual therapy for a person with neck pain + headache
98
What is week 1 management for headache + neck pain person
99
What is week 2 management for headache + neck pain person
100
What prognostic factors can affect outcome for neck pain +headache persons
101
What are some outcome measures for a person with neck pain + headache
102
According to Ogince et al. what does the cervical flexion-rotation test do
Measures movement impairment of C1/2 region and cervicogenic headache
