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Flashcards in MSK 2 Deck (40):
1

what are the most common levels of cervical impingement?

Joints: C5-C6 and C6-C7

2

Principles of MDT

- primary uses symptom response
- reproduce the symptoms they came in with
- decrease patient reliance on therapist
- utilize progression of forces and direction of prefrence

3

Centralizing

Describes the phenomenon by which distal pain originating from the spine is progressively abolished in a distal to proximal direction.

4

Peripheralization

Describes the phenomenon by which proximal symptoms originating from the spine are progressively produced in a proximal to distal direction.

5

Disc model flexion:

Flexion- Anterior disc compress , Posterior disc stretch

NP “squeezed” posterior

6

Disc model extension:

Extension- Posterior disc stretch , Anterior annulus compress

NP displaced anterior

7

Postural syndrome

Pain remains local only to cervical spine and is time-dependent

No UE pain or parasthesias

cervical ROM is full and pain-free

8

Dysfunction syndrome


Similar to tissue shortening, scar tissue, etc. Pain is local to cervical spine.

No UE pain and/or parasthesias

Pain present > 8 weeks
No pain at rest, only at end-range
ROM HALLMARK = consisten

9

Derangment syndrome

directional preference is an essential feature and centralizatoin is an important phenomenon observed in the spine

HALLMARK is RAPID CHANGE in symptom severity and location, as well as ROM, with repeated movements

Patient can have pain at rest, during movement, and at end-range of movement

Pain onset can be acute or chronic

10

Most important question on MDT form is knowing if it constant vs intermittent why?

intermittent means it can be more mechanical

11

Repeated motions are usually done how?

Seated

12

Tests for radiculopathy?

Spurling’s
Cervical distraction
Upper limb tension tests

13

when is Spurlings test positive

+) test is reproduction of pain or parasthesias into UE

14

What are the variations of Spurlings ?

1.Head neutral
2.Cervical spine extended
3.Cervical spine extended and rotated

15

when is CERVICAL DISTRACTION TEST positive

(+) is decrease or relief of pain and parasthesias

16

What are the benefits of upper limb testing?

Excellent screen to rule out cervical radiculopathy

17

MDT cervical treatment principle: green light

decreased, abolished/ Better or Centralized

18

MDT cervical treatment principle: yellow light

no effect, produce no worse, increase no worse, decrease or abolish no better

19

MDT cervical treatment principle: red light

increase, pheralizing, remains worse, worse or pheripheralized

20

Examine sagittal motions first


Retraction

Retraction & Extension

Protrusion

Flexion

21

What is the progression of forces?

Repeated motions/sustained postures
 Repeated motions with patient-overpressure
Repeated Motions with clinician overpressure
Mobilization
Manipulation

22

Dysfunction syndrome tx:

repeated end range loading in direction of movement loss

movement has to produce pain and discomfort to be effective

pain should be abolished after loading is removed

23

Treatment of derangement step 1

reduce derangement

24

Treatment of derangement step 2

maintain derangement

25

Treatment of derangement step 3

recovery of function

26

Treatment of derangement step 4

prevention of recurrence

27

Cervical MDT dosage:

initial pts require 10 reps every 2-3 hours

28

What are the 4 categories of neck pain?

1. Neck pain with mobility deficits
2. Neck pain with headaches
3. Neck pain with movement coordination impairments
4. Neck pain with radiating pain

29

Neck disability index out of 50 and what is the MDC and MDIC

– 0-4 = No disability
– 5-14 = mild disability
– 15-24 = moderate disability – 25-34 = severe disability
– >34 = completely disabled

MDC = 5
MDIC = 5- 9.5

30

Acute pain is

< 6 weeks

31

Sub acute pain is

6-12 weeks

32

Chronic pain is

> 12 weeks

33

What factors influence your interventions of neck pain?

– Classification
– Identification of impairments
– Stage of condition
– Tissue irritability
– Presence of psychosocial risk factors

34

What causes the tension type headache?

myofascial dysfunction and trigger point

35

what causes cervicogenic headache?

upper spine forward head posture

36

Neck pain with headache chacteristics?

Intermittent unilateral neck and suboccipital pain

decreased Cervical ROm

Decreased upper cervical segmental mobility

37

Cranial cervical flexion test

assess activation and endurance of deep neck flexors and how long they can be active for

38

Normal deep neck flexors can hold contraction for

26- 30 mmHg

39

Deep neck flexor test is positive when?

(+) = skin folds separate (loss of chin tuck) or occiput touches therapist’s hand >1 second

40

Neck pain with radiating pain symptoms

cervical rotation less than 60 degrees of involved side

signs of nerve root compression

success with reducing UE symptoms during exam and intervention