Cervical Spine

Question 1

True or false: Blood flow restriction tests like the Cervical Extension-Rotation Test have a high specificity to help rule in the possibility of arterial dysfunction.

Answer 1

True

Question 2

True or False: 15-25% of Patients with traumatic neck pain formerly called whiplash-associated disease are reported to suffer from dizziness

Answer 2

True

Question 3

True or false: A high load exercise program targeted at the superficial cervical flexors and extensors is superior to a low-load neck exercise program focusing on the deep neck flexor and extensor muscles in terms of pain and disability reduction in patients with chronic neck pain

Answer 3

True

Question 4

Sensory disturbance of the 4th and 5th digits (excluding the forearm) is consistent with which of the following diagnoses: (1) C8 radiculopathy, (2) ulnar neuropathy, (3) thoracic outlet syndrome with lower plexus compression

Answer 4

C8 Radiculopathy

Question 5

Sensory disturbance of the ulnar 1.5 digits is consistent with which of the following diagnoses: (1) C8 radiculopathy, (2) ulnar neuropathy, (3) thoracic outlet syndrome with lower plexus compression

Answer 5

Ulnar Neuropathy

Question 6

Sensory disturbance of the medial forearm is consistent with which of the following diagnoses: (1) C8 radiculopathy, (2) ulnar neuropathy, (3) thoracic outlet syndrome with lower plexus compression

Answer 6

Thoracic outlet syndrome with lower plexus compression

Question 7

True of False: There is no single diagnostic test with a high accuracy to confirm TOS

Answer 7

True

Question 8

Which physiotherapy/manual therapy intervention is probably most effective in reducing frequency of tension-type headache?

Answer 8

Cervical strengthening

Question 9

True or False: Intervertebral motion assessment has a moderate to high reliability

Answer 9

True

Question 10

True or False: Compared to physiotherapy, surgery might lead to superior short and long-term outcomes in patients with cervical radicular svndrome

Answer 10

True

Question 11

True or false: Cervical radicular syndrome and cervical radiculopathy are two terms that can be used interchangeably

Answer 11

True

Question 12

What is the most commonly affected cervical nerve root in case of cervical radicular syndrome

Answer 12

C7

Question 13

True or false: Physiotherapeutic treatment seems to be effective in reducing intensity, frequency and duration of tension-type headache, migraine and cervicogenic headache

Answer 13

True

Question 14

Patients who suffer from which headache form - on average - display the greatest limitation in range of motion and the greatest decrease in cervical muscle strength

Answer 14

Cervicogenic headache

Question 15

True or false: The flexion-rotation test is a highly reliable test and able to distinguish patients with limited range of motion in the upper cervical spine from healthy individuals

Answer 15

True

Question 16

Which nerve innervates the
frontotemporal area of the head and converges onto spinal level C2 in the pars caudalis of the trigeminal nerve nucleus?

Answer 16

Opthalmic nerve

Question 17

True or false: A normal course of neck pain after onset is a decrease in pain by 65% and in limitations in ADLs and participation within 3 weeks

Answer 17

False

Question 18

A young patient is suffering from dizziness which he reports as “seeing black before his eyes”. The complaints last for a couple of seconds and are provoked after getting up from bed or a chair. There are no other concomitant symptoms. This patient is probably suffering from:

Answer 18

Presyncope or orthostatic dizziness

Question 19

What are two positive prognostic factors for long-term recovery in cervical radicular syndrome?

Answer 19

Greater cervical ROM, paresthesias

Question 20

A female patient with recurrent unilateral, pulsating headache attacks lasting for about 10 hours, with a rather high headache intensity that is aggravated by physical activity, sound and light is probably suffering from

Answer 20

Migraine

Question 21

The 3 subsystems for postural control are: the somatosensory, the visual and the _______ system

Answer 21

Vestibular

Question 22

True or False: Neural tissue management, manual therapy and neck exercises all seem to be effective treatment options for cervical radicular syndrome

Answer 22

True

Question 23

True or false: Carpal Tunnel Syndrome can be distinguished from cervical radiculopathy of C6 and C7 by a finding of reduced motor function of thumb abduction amongst others.

Answer 23

True

Question 24

Choose the correct answer: Which grade is neck pain without signs and symptoms indicative of major pathology and minimally affecting daily activities according to the Neck pain Task Force?

Answer 24

Grade I

Question 25

True or false: Dizziness symptoms in cervicogenic dizziness are reported to be less severe than in BPPV

Answer 25

True

Question 26

Order four different types of headache from the most prevalent form to the least prevalent form

Answer 26

1. Tension-type headache 2. Migraine 3. Cervicogenic headache 4. Cluster headache

Question 27

Which spinal segment is most likely to refer pain primarily to the base of the neck extending into lower shoulder and shoulder blades; involvement of anterior neck; arm pain; only level where chest pain has been reproduced during discography

Answer 27

C6-7

Question 28

True or false: The most common reason for cervical radicular syndrome is degenerative disk degeneration, also called a hard disk lesion

Answer 28

True

Question 29

What do the letters of the acronym S.N.A.P.S. stand for?

Answer 29

1. Smoking 2. Nutrition 3. Alcohol 4. Physical Activity 5. Stress & Sleep

Question 30

What are three negative prognostic factors for the recovery from neck pain?

Answer 30

Pain-related anxiety, advanced age, serious neck-related limitations in activities

Question 31

Put the etiology of dizziness into order from the most prevalent form to the least prevalent form

Answer 31

1. Cardiovascular 2. Otologic peripheral 3. Psychogenic 4. Central Neurological

Question 32

Which physical examination test should be chosen if you suspect BPPV due to loose otoconia in the lateral semicircular canal?

Answer 32

Supine head roll test

Question 33

What are seven early signs & symptoms for cervical artery dysfunction?

Answer 33

1. Ipsilateral, posterior neck pain 2. “Headache like no other” in occipital or fronto-temporal regions 3. Horner’s syndrome 4. Acute onset of headache 5. Minor trauma in medical history 6. Pulsatile tinnitis 7. Cranial nerve palsies (CN IX to XII)

Question 34

True or False: The Epley Maneuver is equally effective as the Semont Maneuver and effective in 80% of patients with posterior BPPV?

Answer 34

True

Question 35

Which semicircular canal in the inner ear is most often affected by canalithiasis?

Answer 35

Posterior semicircular canal

Question 36

Which are the 2 most common otologic peripheral causes of vertigo?

Answer 36

1. Vestibular Neuritis 2. BPPV

Question 37

What is the mean hold-time for men and women in the deep neck flexor endurance test?

Answer 37

39 seconds in men and 29 seconds in women

Question 38

True or False: Svstematic reviews show that the combination spinal mobilization or manipulation combined with vestibular rehabilitation are more effective than either of these treatment modalities alone.

Answer 38

False

Question 39

True or False: Screening for upper cervical instability can be done accurately by the use of physical examination tests

Answer 39

False

Question 40

Choose the correct answers - multiple can be correct: Which cranial nerves are most commonly affected in case of cervical artery dysfunction?

Answer 40

CN IX - XII

Question 41

Which of the following tests is able to rule out cervical radicular svndrome due to its high sensitivity?

Answer 41

Upper limb neurodynamic test I

Question 42

Which items are parts of the cluster of Cook to diagnose cervical myelopathy?

Answer 42

1. Gait deviation 2. (+) Hoffman’s sign 3. Inverted Supinator sign 4. (+) Babinski sign 5. Age > 45

Question 43

True or False: Intervertebral motion assessment in the upper cervical spine has at least fair reliability

Answer 43

True

Question 44

What type of pain is associated with the C2-C3 spinal segment, according to Cooper et al. (2007)?

Answer 44

Upper cervical area pain, often extending into the occipital region

Question 45

What classification do Verhagen et al. (2001) suggest for patients with whiplash-associated disorders experiencing mild to moderate pain?

Answer 45

They should not be considered a specific subgroup of patients with non-specific neck pain

Question 46

What cervical disk/facet joint level is irritated if the patient describes "Pain experienced primarily in the shoulder girdle, often extending upward to mid-cervical area; adjacent to or coincidental with spine; first involvement of upper limb pain."?

Answer 46

C5/C6

Question 47

What mechanical input might result in an increase in pain intensity in the context of referred pain?

Answer 47

Pressure or load on the place of the sensitized nociceptors

Question 48

According to the Royal Dutch Society of Physiotherapy, recovery is considered deviant if neck pain persists longer than this amount of time (or recurs within this time)?

Answer 48

6 weeks

Question 49

What are the findings of Carroll et al. (2008a) regarding the recurrence rate of neck pain within 5 years?

Answer 49

50%-85%

Question 50

How does the somatosensory cortex contribute to the experience of referred pain?

Answer 50

It makes a projection error, resulting in pain being felt in a different area