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A: MSK UQ > Lecutre 3: C Spine Interventions > Flashcards

Lecutre 3: C Spine Interventions Flashcards

(62 cards)

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1
Q

What are the 2 main objectives to cervical spine interventions

A

Reverse dysfunctions

Prevent recurrence/transition to chronic SYMTOMS

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2
Q

What do u want to encourage in the acute phase goals for c spine

A

Pt to perfomr ADLS as tolerated

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3
Q

How should the head Reamin during sleeping in the acute phase goals of C spine

A

Neutral in SL or supine

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4
Q

In the acute phase goasl for c spine do we want to rest

A

NO NO NO unless symptoms are very severe

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5
Q

Is early motion within tolerated ROM encourage for acute phase goasl

A

Yes

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6
Q

What does research support in the acute phase interventions in the c spine q

A

Use of manual therapy techniques early

  • t spine more stiff then C spine so if improving t spine mobility can decreased stress on c spine
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7
Q

What is a great intial choice for TX for the acute phase interventions

A

Walking bc less stress on the tissues

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8
Q

Are the use of passive intervention or active interventions more common w c spine

A

Active

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9
Q

Do cervical collars help with C spine

A

No a lot of studies suggest it delays recovering

Buttt it can be used to support head and neck if pt has SEVERE capsular restriction

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10
Q

What are the functions of the Ccervical collars

A

• Maintain erect c-spine
• Reminds pt neck is injured
• Allows pt to rest chin during
activity, thereby offsetting weight
of head
• Allows pt to perform cervical
rotation while weight of head is
offset

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11
Q

What phase should u achieve significant decrease or complete resoluation of pt pain

A

Sub acute

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12
Q

How much ROM is restored in the sub acute phase

A

Full and pain free

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13
Q

What are teh subacute phase goals for c spine

A
  • decrease pain
  • full pain free ROM
  • postural stabilization re traiing of spine
  • full integration of entire upper and lower kinetic chains
  • ergonomics changes to workspace to decrease stress
  • overall strength and CV fitness training
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14
Q

what is critical to prevent in the subacute phase

A

Prevention chronicity and distability

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15
Q

What is vital for successful outcomes in the sub acute phase

A

Correctly categorizing and then re categorizing

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16
Q

What is the chronic phase approach

A
  • max function
  • pay attention to yellow flags
  • use multi modal approach tailored to pt needs
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17
Q

What are common S/S for neck pain w mobility deficits bucket

A
  • central or unilateral neck pain
  • limitation in neck ROM that consistently reproduces SYMTOMS **
  • associated shoulder girdle or UE pain may be present
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18
Q

What are the expected exam findings for neck pain w mobility deficits bucket (5)

A
  • Limited cervical ROM
  • Neck pain reproduced at end ranges of AROM
    and PROM
  • Restricted segmental cervical and thoracic
    mobility
  • Neck and referred pain reproduced w/
    provocation of involved cervical or upper
    thoracic segments
  • Deficits in cervico-scapulo-thoracic strength and
    motor control`
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19
Q

For patient w acute neck pain w mobility deficits what should PT provide

A

Thoracic manip
Neck ROM exercise
ST and UE strengthening

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20
Q

For patient w subacute neck pain w mobility deficits what should PT provide

A

Neck anf shoulder girdle endurance exercises

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21
Q

For patient w chronic neck pain w mobility deficits what should PT provide

A

Thoracic manip and cervical manip

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22
Q

What phase does PT use dry needling , laser and traction to help w neck pain w mobility deficits

A

Chronic phase

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23
Q

• MOI linked to trauma or whiplash; OR general
hypermobility (gradual onset, no clear MOI)
• Associated (referred) shoulder girdle or UE pain
• Associated varied non-specific concussive S&S
• Dizziness/nausea
• HA, concentration or memory deficits
• Confusion
• Hypersensitivity to mechanical, thermal,
acoustic, odor or light stimuli
• Heightened affective distress

This sounds like common s/s for which neck bucket

A

Neck pain w movement coordination impairments (WASD)

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24
Q

What is a common MOI for neck pain w movement coordination impairment

A

Linked to trauma or whiplash or general hypermobility

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25
What 3 test are postivie w **neck pain w movement coordination impairments**
* (+) Cranial Cervical Flexion Test * (+) Neck Flexor Muscle Endurance Test * (+) pressure algometry
26
What are 5 most expected **exam findings** along w the 3 positive test for **neck pain w movement coordination impairments**
* Strength and endurance deficits in neck mm. * Neck pain w/ mid range motion that worsens w/ end range positions * Point tenderness, may include trigger points * Sensorimotor impairments may include altered mm activation patterns, proprioceptive deficits, postural balance or control * Neck pain and referred pain reproduced by provocation of involved segments`
27
What pt education is provided w **Neck Pain w/ Movement Coordination Impairments (WAD)**
Stay active !!!! Should be goood in 1st 2-3 months
28
What exercises should u start with for **Neck Pain w/ Movement Coordination Impairments (WAD)**
Cervical isometrics —> scap stabilizer —> cervical spine extensors —> general conditioning —> pt education
29
If a patient is experiencing delayed/prolonged recovery for Neck Pain w/ Movement Coordination Impairments (WAD) what should u do
Include multi modal approach including early pain science education
30
In the **acute phase** of Neck Pain w/ Movement Coordination Impairments (WAD) what should the clinicians provide
- retunr to normal - dont use cervical color - recovery in 2-3 months - provide multimodal intervention approach
31
What is common signs and symptoms for **neck pain w HA (Cervicogenic)**
* Non-continuous, unilateral neck pain and associated (referred) HA * HA precipitated or aggravated by neck movements or sustained positions/postures
32
What **test** will be **positive** for **Neck Pain w/ Headaches (Cervicogenic)**
Cervical flexion rotation test ( testing AA joint)
33
What are 3 expected **exam finding** with N**eck Pain w/ Headaches (Cervicogenic)**
- * HA reproduced w/ provocation of involved upper cervical segments * Limited cervical ROM and joint mobility * Strength, endurance and motor control deficits in neck mm
34
In what phase of Neck Pain w/ HAs is **cervical manipulation and mobilization** recommended
Subacute
35
In what phase of Neck Pain w/ HAs should PT provide cervical or CT manipulation or mobilization combined w shoulder girdle and neck strtching , strength ting and endurance
Chronic
36
When should pt recommend **self SNAGS to AA joint** for Neck Pain w/ HAs
Acute
37
What should pt recommend during the **acute phase** of Neck Pain w/ HAs
Active mobility exercises
38
Who do Cervicogenic HA often occur in
Pts w deficits in OA , AA and C2-C3 mobility
39
If a patient comes in and complains of **bilateral** HA what do we automatically think of
Tension bc it is the only bilateral HA
40
What is symptoms with Cervicogenic HA
Unilateral Decreased vertical ROM from tissues innervated by C1-C3
41
How do u treat Cervicogenic HA
Posture MT Exercise Analgesics NSAIDS
42
If a patient comes in w neck pain w radiating pain in invovled UE and UE dermatomyositis parasthesia or numbness or myotomal mm weakness what bucket for we thinking
Neck pain w radiating pain
43
What is most likely (+) for neck pain w radiating pain
CPR (at least 3 have to be positive) (+) ULTT Neck pain reproduced or delivered w cervical ROM - (+) spurling - (+) distraction
44
45
At what phase is **laser therapy** recommend for **neck pain w radiating pain**
Acute
46
What should a PT do for **chronic phase** neck pain w radiating pain
- mechanical traction - strtching - strengthening - mobs
47
Do u do thrust or non thrust in the C spine for manual therapy? What about T spine
Both Just thrust in T spine
48
What are teh CPR variables that would identify a pt who would benefit from T spine thrust (6)
* Symptoms <30 days * No symptoms distal to shoulder * Looking up does not aggravate symptoms * FABQ physical activity score <12 * Diminished upper thoracic spine kyphosis * Cervical extension ROM <30º Only 3 or more out of the 6 need to be present to work
49
50
What is the sequencing of manual therapy interventions for neck pain
1. Rule out t spine hypomobility 2. Start lower cervical / CT junction and work superiorly
51
What is the RX for **Cervicogenic HA** short and long term
Manual therapt short term Neck exercises in long term
52
How do you joint mob C2-C3 , C2 , and C1 for HA
• Rx C2-3 in neutral • Rx C2 under C1 in rotation • Rx C1 under occiput
53
How does traction + nerve glides help
Decrease neck and arm pian and increase function
54
How does **manual therapy + exercise** help
Decrease neck and arm pian and increase function
55
When would u do a surgialca intervention in the C spine (5)
- fx - signifcant weakness - progressive neurological deficits - severe , unremitting pain - persistent radicualr pian
56
What are common surgical procedures
• Anterior cervical discectomy and fusion • Anterior corpectomy and fusion • Laminectomy • Laminoplasty
57
What is the most common sx for c spine
• Anterior cervical discectomy and fusion
58
How do they do an **anterior corpectomy and fusion**
1. Diseased/damaged bone removed 2. Bone graft placed 3. Fusion using metal plate and screws`
59
What is a **laminectomy** indicate for
* Spinal stenosis * Multi level DDD w/ ant spinal cord compression
60
What is a **laminoplasty** indicate for
Multi level spondylotic myelopathy
61
What is the goals for a **laminoplasty**
X * Eliminate nerve compression lesion * Preserves segmental spine motion
62

A: MSK UQ (30 decks)

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