Cervicogenic Dizziness/Concussion Flashcards
1
Q
Treatment for Cervicogenic dizziness
A
- SNAGs and Maitland passive joint mobilizations are safe & effective manual therapy interventions
- Both reduced intensity & frequency of dizziness, reductions were of similar magnitude
2
Q
Tests for Cervicogenic dizziness
A
- Canadian C-spine Rule
- Alar ligament test
- Sharp Purser test
- CAD testing (cervical artery dysfunction)
- Head impulse test (AKA head thrust test)
- Head neck differentiation test
- Cervical relocation test
3
Q
Describe cervical joint position error
A
- Test for Cervicogenic proprioception
- Distance from center of the target to a 4.5º error depends on the distance the patient is from the target
- If the pt is 90 cm from the target then a 7 cm error from the center of the target translates to a 4.5º error
- Found the center, close your eyes, rotate head, then try to come back to the center still with eyes closed, open eyes to check if close to center
4
Q
Cluster for Meneire’s
A
- tinitus
- attacks of vertigo that lasts for hours
- feeling of fullness in the ears
- hearing something***
5
Q
Effects of SNAGs and/or passive joint mobilization
A
- No conclusive effects on head repositioning and balance
- SNAGs did improve cervical ROM and effects were maintained for 12 wks after treatment but PJMs had limited impact
6
Q
Concussion management is symptom based True/False
A
- True
7
Q
Indicators for immediate emergency medical evaluation of a concussion
A
- Declining level or loss of consciousness, cognition, or orientation (GCS score <13)
- New onset of pupillary asymmetry, seizures, repeated vomiting, or other focal neurologic signs
- Severe or rapidly worsening headache or neurologic deficits
- S/S indicating undiagnosed skull Fx
- Serious cervical spine Fx, dysfunction, or pathology
8
Q
Concussion diagnostic criteria
A
- A direct blow to the head, neck, or face followed by any of the following
- Any period of decreased orientation or loss of consciousness
- Posttraumatic amnesia
- Any alteration in cognition pro mental state immediately related too the concussive event
- Headache, dizziness, balance disorders, nausea and vomiting
- Emotional/behavioral symptoms: depression, anxiety, agitation
- Glasgow Coma Scale of 13-15
- Brain imaging is normal
- S/S not otherwise explained by drug, alcohol, or medication
- Symptoms are present that cannot be explained by pre injury history of medical diagnosis
9
Q
What is going to dictate/influence your evaluation
A
- Type, severity, frequency, & irritability of concussion related symptoms
10
Q
Individualized patient education for symptom management may emphasize reassurance that
A
- (1) the symptoms experienced are common and to be expected following a concussive event,
- (2) full recovery is expected in the majority of patients, and
- (3) occasional mild to moderate exacerbation of symptoms is expected and does not indicate harm to the brain or other systems.
11
Q
Describe the King-Devick Test
A
- Developed to assess eye movement in children with reading difficulty, quantifies saccadic movements & has been proposed for both oculomotor assessment & acute diagnosis in pts with concussion
- Due to variability in performance, pts require a baseline measurement for valid post-injury comparison
- Inadequate sensitivity & specificity in concussion identification
12
Q
Describe the VOMS Slide 41
A
13
Q
Define habituation
A
- Graded exposure to stimuli that causes symptoms
14
Q
Descibre the Borg’s rating of perceived exertion (RPE) scale
A
- Graded from 6-20 and no exertion to maximal exertion
- The numbers are thought to correlate with the person’s HR
15
Q
Describe the Buffalo concussion treadmill test (BCTT)
A
- Set treadmill at a speed of 3.6mph for patients over 5’5”, and 3.2mph for those 5’5” and under.
- Starting incline is 0 degrees
- After one minute at this pace, treadmill incline is increased to 1 degree. Participant is asked to rate RPE and symptom severity.
- This procedure is repeated each minute, with ratings and heart rate being recorded, and treadmill increasing in incline at a rate of 1 degree/minute.
- Once treadmill reaches maximum incline (15 degrees or 12 degrees in modified test), speed is increased by 0.4mph each minute in lieu of increased incline.
- Once test is terminated (see below), speed is reduced to 2.5mph and incline reduced safety back to 0 for a 2 minute cool-down (if participant is safe to continue)
