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Flashcards in MSK Deck (65):
1

How do you treat hypomobility?

joint and soft tissue mobilization

2

What is treated with stabilization movements?

Hypermobility and instability

3

OA movement occipital condyles on atlas what movements occur here

movement include nodding (forward and backward bending) and side bending

4

AA atlas on axis, what is the primary motion and how much of it occurs at the AA?

primary motion: rotation

50% of cervical

5

What are principle movements?

upslides and downslides at facet joint

translatory movements at lateral inter-body articulations

6

What is the degree orientation for the mid cervical spine?

45 degrees

7

What is the degree orientation for the mid thoracic spine?

60 degrees

8

With forward nodding what happens arthrokinematically?

- occiput rolls foward on atlas, glides posteriorly

- atlas translates foward on axis

- axis translate foward and up on C3

9

With backward nodding what happens arthrokinematically?

Occiput rolls back on atlas and glides anteriorly

• Atlas translates backward on axis

• Axis translates back and down on C3

10

With side bending what happens arthrokinematically?

Primarily at OA

Example of SBR:
• Occiput rolls Right on atlas and glides Left

Atlas translates Right

11

With rotation what happens arthrokinematically?

Primarily at AA

• Example of rotation Right:

Occiput and atlas rotate to Right on axis

Atlas translates to the Left

12

Physiological motion

combines sidebend and rotation to the same side

13

Non-physiological motion

SB - head is forward

Rotation - head remains upright

14

What is mid-cervical facet capsular restriction on left facet?

look at the lack of upslide restrictions at right rotation, right side bend, and forward bend limited with possible left deivation

15

subcranial facet capsular pattern for forward nodding?

deviate away from restriction

16

subcranial facet capsular pattern for backward nodding?

deviate towards the restriction

17

In mid cervical vs upper cervical involvement a limitation in side bend to right maybe b/c of limitation to what?

limitation in mid cervical right downslide or left upslide

limited right side glide of OA and left rotation of AA

18

PIVM graded as

normal, hypermobile, hypomobile

19

Cervical PAIVMS test for what

assess for resistance to motion and pain provocation

20

Patient is presented with hypertonicity and decreased ROM from an injury/trauma/dsyfunction...what are they presenting with?

involuntary muscle guarding

21

Patient is presented with pt apprehension and decreased AROM/PROM from fear of pain/pain...what are they presenting with?

voluntary muscle guarding

22

Patient is presented with loss of muscle bulk and weakness from lack of use/stiff joints?

muscle atrophy

23

Patient is presented with normal muscle tone and loss of flexibility/ROM and caused by muscle held in shortened posture and think posture?

adaptive shortening

24

facet restriction causes?

immobility and resolved joint synovitis and hemarthorsis

25

facet restriction signs and symptoms?

decreased ROM in facet capsular pattern

26

patient is presented to you with head held at angle away from midline and pain with DOWNSLIDE. Patient say she slept weird wtf is wrong with her?

Wry neck

27

Hypermobility instability shows this on x ray

osteophytes

28

what are facets positioned at in the C Spine?

45 degree angle

29

Pathway of the vertebral artery?

thru c6 and up

30

A of ABCs

alignment

31

B of ABCs

bone density

32

C of ABCs

Cartilage

33

s of ABCs

soft tissue

34

What is the atlantodens interval?

radiolucent line anterior to the articular facet of dens

35

ADI in adults, what is abnormal? (atlanto-axial dislocation)

more than 3 mm

36

ADI in adults, what is abnormal? (atlanto-axial dislocation)

more than 5 mm

37

How do you examine the Odotnoid AP view of c1/c2?

open patients mouth and assess and ask about trauma

38

what is the purpose of the candian C spine rule?

determines if the patient with acute trauma do not require imaging

39

Canadian C spine: Step 1-If YES to any then radiograph needed:

ge >/= 65
• Dangerous MOI
• Fall >/+ 3 feet or 5 stairs
• Axial load to head
• High-speed MVA (>100 km/62 mph) or with rollover or ejection
• Motorized recreational vehicle accident
• Bicycle struck or collision

- paresthesias in extremities

40

Canadian C spine: if NO to any of these, pt needs radiograph

• Simple rear-end MVA
• Able to sit in ED
• Ambulatory
• Delayed onset of neck pain
• Absence of midline cervical tenderness

41

Canadian C spine: if NO pt needs radiograph

Able to actively rotate neck 45 degrees to right and left

42

Nerve root compression symptoms

• Diminished or absent DTRs
• Diminished or absent sensation to light touch in dermatomal pattern
• Muscle weakness along a specific myotome

43

Causes of cervical spondylosis

osteoarthritis, DDD, DJD

44

Cervical stenosis: what is lateral cervical stenosis

unilateral UE symptom, LMN signs, usually 1 segment

45

Cervical stenosis: what is central cervical stenosis

B/L UE symptoms, multi-segmental, UMN signs

46

Cervical myelopahty signs:

Sensory disturbance of 1 or both hands and/or feet
• Muscle wasting of hand intrinsics
• Unsteady gait
• (+) Hoffman’s Reflex
• (+) Babinski sign
• Hyperreflexia of UE & LE
• Clonus at ankle
• Bowel & bladder disturbances
• Multi-segmental weakness and/or sensory changes below level of compression

47

In cervical radiculopathy DTRs are ?

hyporeflexive

48

In cervical Myelopathy DTRs are?

hyper-reflexive

49

Cervical instability hyperflexion injuries:

sprain posterior ligamentous structures & possible fx

50

Cervical instability hyperextension injuries:

sprain anterior ligamentous structures and soft tissue

51

Cervical instability: atlanto-axial dislocation

Distance between the anterior surface of dens and posterior surface of anterior arch on C1

52

vertebral artery supplies how much blood to the brain?

20 percent

53

80 % of blood supply brain is from what?

carotid artery system

54

vertebral artery proximal:

origin to entry to cervical spine

55

vertebral artery transverse:

entry to cervical spine to C2 transverse foramen

56

vertebral artery suboccipital:

Exit from C2 to entry to foramen magnum

57

vertebral artery intracranial:

entry to foramen magnum to formation of basilar artery

58

Where is the vertebral artery most vulnerable?

suboccipital portion

59

During rotation which side of the Vertebral artery is most vulnerable?

contralateral side

60

What are the 5 Ds?

• Dizziness
• Drop attacks
• Diplopia
• Dysarthria
• Dysphagia

61

What are the 3 Ns?

• Numbness
• Nausea
• Nystagmus

62

what is the average time between event and onset of symptoms for CAD and stroke?

2-3 days

63

IFOMPT decision making red light?

- high number/ severe nature of RF, low predicted benefits for therapy, avoid treatment

64

IFOMPT decision making yellow light?

Moderate number and nature of RF, moderate predicted benefits of PT, avoid or delay tx then reassess and monitor

65

IFOMPT decision making green light?

low number and low RF, low to high predicted benefit and treat with care, monitor and make sure new symptoms do not arise