Irat Week 2 Flashcards by Sally June

All of the following may be damaged in extreme flexion, extension, or lateral flexion of the head EXCEPT

Inner ear (neural structures, soft tissue, cervical spine all can)

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The lower cervical spine consists of

C2-7/T1

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Like the other regions of the spine, the outer annulus fibrosis is innervated by the ___ nerves as are the vertebral bodies

Sinuvertebral nerves

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The cervical discs have less weight to bear than the lumbar disc for which two reasons

They only bear the head and plus gravity

2. The discs and two facet joints have nearly equal load distribution

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The facets of the upper cervical spine are angled approximately ___ to the horizontal plane, whereas the cervical spine facets are orientated at approx ___ angle

35o

65o

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The facet joints of the cervical spine are surrounded by a joint capsule that is generaly ___ than in the thoracic and lumbar spine allowing more range of motion

Looser

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Facet joints are innervated by the

Medial branch of the posterior rami

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Facet joint capsules contain all of the following EXCEPT

Silent nociceptors

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Of the following structures below, which ones help to stabilize the dens of C2 to the anterior arch of C1

Denticulate ligament

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Deterioration of the __ ligament will allow abnormal movement between C1 and C2

Transverse ligament

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According to Souza, “___ muscles including the ___ are essential as antigravity/postural muscles….”

Suboccipital

Obliquus capitis inferior and obliquus capitis superior

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Acocrding to Souza, “…contrary to accepted knowledge the ___ does not connect the posterior arch of atlas to the laminae of the axis

Ligamentum flavum

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Cervical spine disc herniation’s are

Not common over the age of 50

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If Bakody’s sign is present this indicates a radiculopathy because the motion of the test elevates the ____ nerve and relieves traction on the upper brachial plexus

Dorsal scapular

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In the thoracic outlet which is NOT a potential site of entrapment or compression

Acromioclavicular articulation

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The passive elements of the cervical spine motion include all of the following EXCEPT

Muscle

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Flexion and extension occurs ____ in the cervical spine. Select all

Between C4-C6
The atlantooccipital joint
The C1-C2 level

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Coupled motions in the cervical spine include all the following except

Below C4-5 extension accompanies rotation

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Approximately ____ of axial rotation occurs between C1 and C2

50-60%

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According to Souza in reference to hyperextension/hyperflexion injury, although global hyperextension does not always occur, intersegmental hyperextension does appear to occur and may be the most prominent injury mechanism

True

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All of the following are common neck pain patient presentations EXCEPT

Acute dizziness

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When arm complaints accompany neck pain it is essential to make a determination of whether the ___ or a ____ is the source

Nerve root irritation

Referral phenomenon

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Patients with clinical, radiographic, or laboratory evidence of tumor, infection, fracture, or dislocation should be

Sent for medical evaluation

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A stinger usually involves a traction injury of either the nerve root or plexus

True

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According to souza, a patient presenting with a nontraumatic onset of neck pain without radiationinto the arm possibly accompanied by a ____ could be ____ requiring ____

Neck stiffness; meningitis; immediate MD referral 1 or 2 restricted ROM patterns; facet syndrome; manual therapy/cervica l adjustments Congenital muscle spasm; torticollis; advanced imaging

According to Souza, recurrent bouts of neck and arm pain in nontraumatic patients should be

Evaluated using orthopedic and neurological exams

According to souza, a patient presenting with neck pain and a history of recent, significant trauma should

Have a cervical radiographic series taken

According to souza, a patient presenting with transient symptoms with other assocaited neurological signs and symptoms should be referred for evaluation for ALL of the following EXCEPT

Compression fracture

According to souza, a patient presenting with positionally related arm numbness/tingling with secondary neck pain complaint should be

Evaluated for TOS

According to souza, a patient experiencing chronic neck pain with restricted cervical ROM and positive cervical orthopedic examination results but no radiating pain should

Be adjusted immediately

According to souza, there is currently strong evidence to substantiate the use of traction for neck pain patients

False

According to Souza, a diagnosis of cervical sprain/strain should be reserved for acute traumatic sprain/strain with all of the following being TRUE except

Management includes mechanical traction

According to Souza, cervical neuritis or radiculitis due to disc usually consists of all of the follwoing except

Weakness in the lower limbs

Non-specific cervical pain is a diagnosis

All og the above (used for patients without cervical trauma, that may be used for unspecific neck pain, that does not require radiography)

Spastic torticollis (wryneck) may be ___ and is ___ or correctable

Congenital | Self-resolving

Which diagnosis can be treated using myofascial therapy and preventative exercises and stretches

Cervical sprain/strain Non-specific cervical spine pain Thoracic outlet syndrome

Acute onset pain with severe global restriction to neck movement can be included in nontraumatic neck pain category

True

Any patient with head trauma should be monitored for several

Weeks

According to souza, a chiropractic adjustive technique is the recommended treatment for

Segmental dysfunction of cervical spine joints

Radiographs positive for fracture or dislocation should receive an immediate orthopedic referral

True

According to souza, ___ of cervical radiculopathy patients fully recover or have only mild residual disfunction

90%

According to souza, cervical manipulation at sites other than herniation is used by many chiropractors to manage cervical radiculopathy adjustments. T/F

True

According to souza, MRI or electric diagnostic settings maybe needed after 1 month of care without resolution of cervical radiculopathy symptoms. T/F

True

According to souza, inspection, palpation and ROM testing are clinical approach taken when neck pain and stiffness are the primary complaint. T/F

True

When the complaint involves radiation into the back or extremities souza recommends

Specific orthopedic tests | Specific neurological tests

According to souza, what standard battery of what orthopedic tests includes various forms of the following tests designed to compress or stretch structures on your subject except

Spinal percussion

Burner or stinger are names given to injuries of the brachial plexus or nerve roots often caused by ___. They are very common in sports.

Lateral flexion injuries

According to souza, cervical radiculopathy due to disc herniation may occur in only 20-25% of the cases because of

The natural dehydration of the intravertebral discs in hte cervical spine.

According to souza, which test is specific or the most useful when confirming cervical radiculopathy

Spurling test

According to souza, the neurological examination attempts to rule in or rule out the following except

Non-recurrent pain

According to souza, patient presenting with positionally related arm numbness, tingling with secondary neck pain

Should be evaluated for TOS

Exhibit 2-4 in souza illustrates that the patient has a 45% probability of having a cervical radiculopathy if

3 or more tests are positive

According to souza, when ordering x-rays, ____ should be ordered in suspected cervical radiculopathy patients

Oblique view to determine to the degree of boney parameter encroachment

According to souza, weakness found during the physical exam is actually more than subjective weakness. T/F

True

When the complaint involves radiation into the back or extremities, souza recommends

Specific ortho and neuro test

According to souza, home traction for 30 minutes twice a day will benefit some cervical radiculoapthy patients. T/F

False

According to souza, patients with cervical radiculoaphty may report

All of the above - cervical compression reproduces the neck and arm pain; radiation into the medial scapular area; relief of arm pain by putting the hand behind the head

According to souza, the standard neurological exm attempts to differentiate the cause of the following except

Migraine

According to merck, C6 radiculopathies produce the ofllowing symptoms except

Pain in the rhomboids and latissimus dorsi

According to souza, larger, more diffuse patterns of sensory or motor loss require a search for brachial plexus and spinal cord involvement. T/F

True

According to souza, patients with cervical radiculopathy will have painful restriction in active and passive ROM

Irat Week 2 Flashcards

(63 cards)