Cervical Spine Assessment & Treatment Flashcards Preview

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Flashcards in Cervical Spine Assessment & Treatment Deck (18):
1

When is a neurological exam indicated?

- Patient reports pins & needles or numbness
- Pain past the shoulder

2

What movements are tested for each upper limb myotome?

C1: CSp flexion
C2: CSp extension
C3: CSp lateral flexion
C4: Shoulder shrug
C5: Shoulder abduction
C6: Elbow flexion
C7: Elbow extension
C8: Thumb extension, finger flexion
T1: Finger abduction/adduction

3

What are the upper limb neurodynamic tests?

Upper limb tension tests
1a: Median
2a: Radial
3: Ulnar

4

What is the cervical flexion-rotation test used for?

- Assess dysfunction at the C1-C2 motion segment
- Rotation at this level accounts for 45-50% rotation in cervical spine
- Normal > 44 degrees
- Restricted in patients with cervicogenic headaches

5

What is a positive Spurling's test?

- Reproduction of arm symptoms
- Indicates nerve root compression

6

What is the diagnostic test cluster that indicates a radiculopathy?

- ULTT 1a
- Cervical rotation <60 degrees
- Distraction test
- Spurling's test

7

What pathologies are associated with poor deep neck flexor strength?

Cervicogenic headaches, whiplash, chronic neck pain

8

What are the important deep neck flexor muscles?

- Longus capties
- Longus colli

9

What does evidence show about immobilisation in neck pain?

- Use of soft collar, rest, time off work associated with poor recovery
- Better outcomes in the "act as usual" group
- Exceptions: Cervical spine instability or fracture

10

What are the first line treatments for whiplash?

- Reassure & stay active
- Return to usual activities
- ROM, load load isometric endurance & strengthening exercises

11

What treatments are not recommended in acute whiplash?

Not routinely recommended:
- Manual therapy
- Kinesio tapiing
- Acupuncture
- Surgery

Not recommended:
- Reduction of usual activity
- Collars
- Muscle relaxants
- Steroid injections

12

What evidence is there for massage for neck pain?

- May be beneficial if there is excessive tightness or trigger points
- No long term studies so far

13

What is mechanical traction used for?

Relieving nerve root compressions (poor evidence)

14

What are the CIs to mechanical traction?

- Medical red flags
- CNS symptoms
- Hypermobility
- Pregnancy
- RA
- OP
- Infection of spine/bone
- Cancer
- Vascular compromise

15

What are the indications for mobilisations?

Joint pain & dysfunction

16

What are the CIs for mobilisations?

- Acute inflammatory disease
- Infection
- Tumours/cancer
- Arteriosclerosis
- Aneurysms
- DVT
- Spinal cord compromise
- Cauda equina syndrome

17

What are the precautions for mobilisations?

- Neurological changes
- RA
- Ligament laxity
- Pregnancy
- Prolonged use of anticoagulants & corticosteroids

18

What does evidence show regarding exercise for neck pain?

- Strengthening exercises are effective for chronic neck pain, cervicogenic headache & cervical radiculopathy
- Should focus on neck, shoulder & scapula region
- Strengthening exercises should be combined with endurance or stretching exercises (but not endurance or stretching alone)