Flashcards in Cervical Exam Deck (145)
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1
When does age becomes a risk factor for poor outcomes in cervical pathology?
> 40
2
What activity is related to a poor outcome of cervical treatment?
- Bicycling
3
What co-existing problem is related to poor outcomes of cervical treatment?
Low back pain
4
What 3 psychosocial factors are related to poor outcomes in cervical treatment?
- "worrisome" attitude
- Poor QoL
- "Less vitality"
5
What cervical PMH is related to poor outcomes of cervical treatment?
- Long history of neck pain
6
Does a "wait and see" approach work with mechanical neck pain?
No. The earlier a patient sees a PT. the better the outcome
7
What is the 1st question of the canadian cervical spine rules?
- Older than 65?
Dangerous mechanism of injury?:
- Fall from >1m or 5 stairs
- Axial load to head
- High speed MVA (100km/h)
- Motorized recreational vehicle
- Bicycle collision
- Parathesias in extremities?
8
If a patient answers yes to any of the first c-spine rules, what is the course of action? What if the patient answers no?
Yes: Get x-rays
No: Move on to #2...
9
What is the 2nd cervical spine rule question?
Are there low-risk factors that allow safe assessment of ROM?
- Simple rear-end motor vehicle accident?
- Normal sitting posture in exam?
- Ambulatory at any time since injury?
- Delayed onset neck pain and absence of midline tenderness?
10
If a patient answers yes to all of the #2 questions, what is the course of action? What if a patient answers no to any of the questions?
Yes to all: Ask #3
No to any: Get an x-ray
11
What is the 3rd cervical spine rule?
- Can the patient rotate the neck 45 degrees each direction?
12
If the patient answers no to the 3rd question, what is the course of action? If the patient answers yes, what is the course of action?
Yes: Proceed with exam
No: X-rays
13
What is VAS?
Visual analogue scale (pain)
14
What is NPRS?
Numerical pain rating scale
15
What is the MCID of VAS and NPRS?
2 points
16
What is the MCID for the Neck Disability Index?
5 points
17
What is GROC?
Global Rating of Change
15 statements from - 7 to + 7 (getting worse to getting better)
18
How is posture assessed during the examination?
- Note deviations, correct, note change in symptoms
19
What should be assessed in a postural exam of the cervical spine in the frontal plane?
- Lateral flexion
- Scapular position (elevated/ rotated/ winging
20
What should be assessed in a postural exam of the cervical spine on the transverse plane?
- Rotation
21
What should be assessed in a postural exam of the cervical spine in the sagittal plane?
- Eyes and mandibles horizontal
- Forward head posture
- Protracted and retracted shoulder
22
Which type of postural deviation is very common in the c-spine?
- Forward head posture
23
What muscles should be assessed for symmetry in an exam of the c-spine?
- Traps
- Deltoids (all 3)
- Pec major
- SCM
- Infraspinatus
- Latissimus dorsi
- Erector spinae
24
What term refers to the willingness to move?
Kinesiophobia
25
What 7 things should be assessed during palpation of the c-spine?
- Temperature
- Skin mobility
- Fascial tightness
- Muscle spasm
- TrP
- Tender Points
- Bony prominences
26
What 4 bony prominences should be palpated?
- Mastoid
- Nuchal line
- Spinous processes
- Articular pillar/ facets
27
How is cervical axial rotation measured in supine?
- Head is lifted off the surface so that it does not translate during rotation
28
** Review Cervical ROM **
** Review Cervical ROM **
29
What is the quadrant position of the cervical spine?
Combined movements of:
- Extension
- Rotation towards the tested side
- Side bending towards the tested side
30