C-Spine lecture2

Question 1

Test ____ first

Answer 1

uninvolved/less involved side/direction

Question 2

active motions done _____ passive

Answer 2

before

Question 3

resistive motions done ___ passive

Answer 3

after

Question 4

when should painful/provocative tests be done

Answer 4

towards the end of the exam

Question 5

What is the exception to the rule that special ortho testing is done after motion and strength assessments

Answer 5

testing that is done to ensure that movement testing is safe. EX ligamentous testing

Question 6

What does SINSS stand for

Answer 6

Severity, Irritability, Nature, Stage, Stability

Question 7

refers to the intensity of the pain provoking activity

Answer 7

severity

Question 8

delineates when caution is necessary during the exam and treatment

Answer 8

severity

Question 9

refers to the pain level

Answer 9

irritability

Question 10

describes how far into a movement pain is provoked

Answer 10

irritability

Question 11

how long it takes to subside after the movement is withdrawn

Answer 11

irritability

Question 12

T/F irritability is an emotional measure

Answer 12

F

Question 13

Refers to the type of tissue that is causing the symptoms

Answer 13

nature (MSK, mechanical, inflammatory, neural, etc)

Question 14

high fear avoidance can be considered part of which aspect of SINSS

Answer 14

Nature

Question 15

What does stage refer to

Answer 15

acute, sub-acute or chronic

Question 16

is the problem worsening, improved or stabilizing

Answer 16

stability

Question 17

a positive with rule in a diagnosis

Answer 17

specificity

Question 18

a negative will rule out a diagnosis

Answer 18

sensitivity

Question 19

Likelihood ratios for positive tests above ___ and for negative tests below ___ provide strong evidence to rule in or out diagnoses

Answer 19

10, 0.1

Question 20

T/F the vetebral artery has a high sensitivity, therefore it is a good screening test

Answer 20

F. it has a very low sensitivity

Question 21

Cluster testing for radic

Answer 21

1. ULNT (median)
2. Cervical rotation (<60)
3. Cervical distraction test
4. spurlings test

Question 22

ULTT 1 (median)

Answer 22

shoulder depression and abduction, forearm supinated, wrist extended, elbow extended, fingers/thumb extended

Question 23

most cervical special test tend to be highly____

Answer 23

specific

Question 24

ABC’s of c-spine film

Answer 24

alignment, bones, cartilage, soft tissue

Question 25

sensitivity during assessment is greatly increased by

Answer 25

listening to the patient

Question 26

recommended tests for neck pain with mobility deficits

Answer 26

cervical AROM, cervical/thoracic segmental mobility

Question 27

recommended tests for neck pain with headache

Answer 27

cervical AROM, cervical/thoracic segmental mobility, cranial cervical flexion test

Question 28

recommended tests for neck pain with movement coordination impairments

Answer 28

cranial cervical flexion test, deep flexor endurance test, flexibility deficits of upper quarter muscles

Question 29

recommended tests for neck pain with radiating pain

Answer 29

cervical AROM, spurlings maneuver, upper limb tension tests, neck distraction test

Question 30

3 mckenzie classifications

Answer 30

postural, dysfunction, and derangement syndromes

Question 31

proposed as caused by mechanical deformation or vascular insufficiency of normal tissue as a result of sustained loading

Answer 31

postural syndrome

Question 32

characteristics of postural syndrome

Answer 32

gradual onset, symmetric pain, full cervical AROM, no referred pain, neck pain with sustained end range positions (may take >15 min)

Question 33

caused by mechanical deformation or vascualar insufficiency of abnormal tissue

Answer 33

dysfunction syndrome

Question 34

characteristics of dysfunction syndrome

Answer 34

intermittent neck pain, loss of cervical AROM, neck pain at end range, no arm pain

Question 35

caused by internal disruption or displacement of tissues (disc related)

Answer 35

derangement syndrome

Question 36

characteristics of derangement syndrome

Answer 36

loss of cervical AROM, constant neck pain, pain radiates, neck/arm pain affected by repeated movment

Question 37

the mckenzie classification for constant pain in all movement directions as a result of inflammatory or infections process

Answer 37

non-mechanical pain (trauma syndrome). intervention is rest and pharmacology

Question 38

effect of FHP on c-spine

Answer 38

increased facet loading, slight extension of upper c-spine for a forward gaze

Question 39

effect of FHP on muscle activity

Answer 39

increased post cervical mm activity

Question 40

what muscles are hyperactive and short in upper crossed syndrom

Answer 40

levator scap, upper trap, pec maj/minor

Question 41

what muscles are hypoactive and long in upper crossed syndrom

Answer 41

deep neck flexors, middle and lower trap

Question 42

_____ _______ increases the load on the median nerve by 50% or more

Answer 42

scapular protraction

Question 43

annulus of disc in c spine is thickened...

Answer 43

anteriorly

Question 44

what is the support for the nucleus pulposus posteriorly in the c-spine

Answer 44

posterior longitudinal lig

Question 45

when does disc fibrosis and desiccation typically start to occur

Answer 45

30-40s

Question 46

where in the c spine is disc disease occurrence most often

Answer 46

C67

Question 47

in order of greatest to least occurence of disc diseased

Answer 47

C67 (C7), C56 (C6), C45 (C5)=C7T1 (C8)

Question 48

cough/sneeze is irritating for what condition

Answer 48

cervical disc lesion

Question 49

Stage 1 cervical spondylosis

Answer 49

dysfunction stage: pt reports nonspecific neck pain and decreased ROM, neuro exam negative

Question 50

Stage 2 cervical spondylosis

Answer 50

instability stage: increased facet laxity, neck apin and "catch" and possible radic. often movement greater in this stage

Question 51

Stage 3 cervical spondylosis

Answer 51

stability stage: fibrosis, radicular symptoms are more common

Question 52

what is the most serious consequence of cervical spondylosis

Answer 52

spondylitic myelopathy

Question 53

test cluster for cervical spondyolitic myelopathy

Answer 53

Babinski, inverted supinator sign, hoffman's reflex, reflex testing