Cervicothoracic Spine III Flashcards
(58 cards)
What is the etiology of whiplash associated disorder?
Counter Coo Mechanism
What kind of injury can lead to whiplash associated disorder?
Head injuries including concussions
What should we do with ALL neck trauma?
Craniovertebral scan initially
What are common symptoms of whiplash associated disorder?
Trauma
acute neck pain
referred over radiculating pain
Concussion or trigeminocervical nucleus symptoms
What are some common scan signs for whiplash associated disorder?
Concussion or TCN signs
likely splinting
ROM is limited with empty and painful end feels in most if not all directions
Resisted/MMT weak and painful in most if not all directions
Neuro- possible positive UMN or LMN findings
Stress tests positive for involved tissues
What are some common biomechanical exam signs of whiplash associated disorder?
Joint dysfunction
- accessory motion testing = joint hypo-mobility due to scar tissue/fibrosis esp with prolonged immobilization
- Stability testing = joint hypermobility/instability will likey be present more commonly due to laxity from sprains
Muscle inhibition
TTP
What are some concussion or TCN signs or symptoms?
Cervicothoracic MSK impairments
Vestibulo-oculormotor impairments
Autonomic dysfunction/exertion tolerance impairments
motor function impairments
Where is TCN usually located?
C2,3 segment that is often involved
Why can concussion/TCN cause head, face, and neck symptoms?
Inflammation and/or sensitization
What does the mandibular nerve produce with concussion?
ear - pain/tinnitus/hypersensitivity to sound
tongue - altered/hypersensitive taste
What symptoms can the opthalmic nerve produce with concussion /TCN?
Eye pain/hypersensitivity
dry eye
hypersensitive upper face and scalp sensation
What symptoms can the maxillary nerve produce with concussion/TCN?
Tooth pain
hypersensitive peri-oral, cheek, nostril, and lower eye lid sensation
What are Concussion or TCN signs and symptoms?
C1-3 spinal nerve involved
- CV region = upper cervical pain
- Headache
- dizziness
- paresthesias
-Face -> Pain/paresthesias
- Jaw -> TMJ pain
Why can the vagus nerve play a role in concussion / TCN symptoms?
C3,4 roots and can become hypersensitive
What can happen with a hypersensitive vagus nerve?
Irregular HR, lack of sweating, dyspnea, nausea, indigestion, and other GI s&s
Why can coordination be influenced with concussion / TCN?
Retrograde branch of trigeminal nerve goes to cerebellum
What are the MOST OFTEN involved structures in whiplash associated disorder?
Z jt sprains
- C1-3 due to transitional joint surface anatomy
muscle strain
What are the less often involved structures for whiplash associated disorder?
Dens fx
- splinted with SB due to alar ligament pulling on dens
- possible cord S&S if dens displaced
What are signs and symptoms for fractures?
*Trauma HX
*Splinting
*Pain with palpation, compression, and possible distraction
*Limited ROM with empty and painful end feels in most directions
*weak and painful in most if not all directions of resisted testing
*crepitus
*possible positive neuro tests in spine
*positive special tests= percussion with stethoscope, CDR and CPRs for FXs
What is the role of bone?
Support, protection, and attachment
Produces blood cells
houses minerals and fat
Bone is highly ______ & highly __________
Vascular and neural (particularly in peristeum)
What are the elements of bone?
Osteocytes
crystalline calcium phosphate hydroxyapatite
What does type I collagen do?
Resist tension
What are the two types of bone?
Cortical - outer layer, 80% of skeletal tissue
Cancellous (trabecular) - 20% of skeletal tissue, inner layer
