Cervicothoracic Spine II

Question 1

Sensitization is an underlying mechanism with __________ P!

Answer 1

nociplastic

Question 2

With nociplastic pain, there is increased _________ and __________ by central structures

Answer 2

sensitivity; misinterpretation

Question 3

With nociplastic pain, there is increased _________ of segmental ______ horn neurons

Answer 3

excitability; dorsal

Question 4

With ____________ P! there is no loss of descending anti-nociceptive mechanisms

Answer 4

Nociplastic

Question 5

With loss of descending anti-nociceptive mechanisms (noicplastic pain)

there is less __________ opiates released

less ______ control

Answer 5

endogenous; P!

Question 6

With nociplastic P! there are ____-fibers that transmit ______ and travel at least 2 spinal segments sup. and inf..

Answer 6

C; Pain

Question 7

With nociplastic P! which part of the brain is “sumdged”?

Answer 7

homunculus

Question 8

What are 3 conditions that contribute to nociplastic P!?

Answer 8

• Neck P!
• Migraine
• Shoulder P!
• Lateral elbow P!
• Low back P!
• Age-related joint changes
• Persistent fatigue syndrome
• Fibromyalgia

Question 9

What is the condition for these symptoms?

• ≥ 3 months of P!
• Regional or spreading symptoms
• P! that cannot be explained by nociceptive or neuropathic pathways
• P! hypersensitivity or allodynia (non-painful stimuli causing P!_)
• Sensitivity to sound, light, and or odor
• Sleep disturbances
• Fatigue
• Cognitive problems

Answer 9

Nociplastic p!

Question 10

What is the most accepted manual therapy for nociplastic pain?

Answer 10

JM

Question 11

Doing JM on ___________ p! patients help stimulate decreasing inhibitory P! mechanisms, which creates more ________

Answer 11

Nociplastic; endorphins

Question 12

JM for nociplastic p! patients helps to reduce ….

Answer 12

dorsal horn excitability and inflammatory mediators

Question 13

What is the MET prescription for Nociplastic P! patients?

Answer 13

low to moderate-intensity global and aerobic resistance activities

2-3x/wk

30-90 mins per session

at least 7 weeks

Question 14

What are the purposes of MET for patients with nociplastic P!?

Answer 14

• Endogenous/opiate analgesia
• Helps pt. interpret p! and motion as non-threatening
• Reorganizes Homunculus

Question 15

What should you educate your pt. on for nociplastic pain?

Answer 15

Explain increased sensitivity and misinterpretation to reduce stress/anxiety of misperceived tissue injury

Question 16

What do you want to transition to overall with nociplastic pain?

Answer 16

adaptive P! coping

Question 17

What is the prognosis for nociplastic pain patients?

Answer 17

• Varying degrees of improvement
• Longer recovery
• Likely not full resolution of symptoms

Question 18

What is the percentage of people who will experience Neck pain?

Answer 18

70%

Question 19

What is the percentage of people who will develop persistent neck P!?

Answer 19

33-44%

Question 20

Neck P! is more prevalent with what biological sex and age?

Answer 20

older biological females

Question 21

Risk factors for Neck P!

Biological _________
Hx of _______ P!

> ______ yrs. of age
______P! (UBP or LBP)

Answer 21

females
neck
40
LBP

Question 22

Neck P! is MOST often…

A. identified
B. unidentified

Answer 22

B

Question 23

Neck P! is often misdiagnosed as ________ or _______

Answer 23

MND; N. root compromise

Question 24

Full Neck EXT is ____-_____

Answer 24

50-70

Question 25

Function Neck rotation for driving is ____-_____ and full ROM is ____-____

Answer 25

60-70 70-90

Question 26

With Neck P! there will be impaired ________ mechanics

Answer 26

scapular

Question 27

_______ often fails to identify neck P! symptoms

Answer 27

imaging

Question 28

With neck pain... ____-______ % w/bulging herniated discs ____% annular tears _____% spinal cord compression

Answer 28

50-73 94 13

Question 29

With neck pain, _______ _____ lacks strong diagnostic accuracy measures necessary for clinical decision-making

Answer 29

clinical tests

Question 30

Neck P! with movement coordination impairments (whiplash associated disorders) is associated with ____________

Answer 30

hypermobility

Question 30

Neck P! with mobility deficits is ____________

Answer 30

hypomobility

Question 31

With neck pain, cervical JM modulate _______ function This also increases ________ muscle recruitments

Answer 31

muscle; deep

Question 32

With MET for neck pain, there is ______ evidence

Answer 32

strong

Question 33

MET for neck pain should consist of ___-_____ minute sessions __-__x/wk __-___ wks

Answer 33

30-60 2-3 7-12

Question 34

With neck pain, it should include exercise for...________, _______, _______, and _______ regions

Answer 34

cervical, thoracic, scapular, and shoulder

Question 35

What are the 3 purposes of MET for neck pain?

Answer 35

1. stabilization 2. endurance 3. strength

Question 35

Local and global muscle training should consist of ____ load endurance for _____ weeks

Answer 35

low; 6

Question 36

With local and global muscle training, exercise is effective in _________

Answer 36

isolation

Question 37

What is an example of isotonic and isometric local/global muscle training?

Answer 37

forward nodding

Question 38

What should you tell your patient to do before beginning any exercises?

Answer 38

SIT TALL!

Question 39

How to keep up with exercises for neck P? ___x a week for over a year ___-___ visits ___x week for _____ wks.

Answer 39

3 8-12 2x/ 6 wks.

Question 40

With neck P! ________ is NOT beneficial in isolation this should be combined with MET

Answer 40

stretching

Question 41

What is the current evidence regarding modalities for Neck Pain?

Answer 41

lacking, limited, or conflicting and NOT recommended for Neck P!

Question 42

What are two main things you should you educate your pt. on for neck P?

Answer 42

early movement w/o provocation reassure them of a good prognosis and full recovery in MOST cases

Question 43

Prognosis regarding neck P! _____ trauma: quicker recovery ______ trauma: longer recovery

Answer 43

acute; worse

Question 44

With ______ ______: there are major limitations of pharmaceuticals are the lack of replication of the findings indicating inconsistency of results

Answer 44

MD Rx

Question 45

With epidural injection, it occurs around the ....

Answer 45

dura of the spinal n.

Question 46

Oral medication has _______ results and _____ benefits

Answer 46

mixed; unclear