Question Bank

Question 1

When is neck pain most common?

Answer 1

In the 5th decade of life

Neck pain increases with age

Question 2

What percent of the population reports neck pain, LBP?

Answer 2

neck: 20-30%

LBP: 80%

Question 3

T/F: Dorsal nerve root pain presents with sensory alteration and mm spasm.

Answer 3

False, just sensory alteration

Question 4

T/F: Ventral root stimulation is associated with muscle spasm

Answer 4

True

Question 5

What is the typical age of onset for cervical disc herniation?

Answer 5

20-30 yo

Question 6

What are the differences between DDD and DJD?

Answer 6

They don’t occur simultaneously

DDD occurs earlier (~35 yo), by 55 the discs are dried out

DJD onset occurs after DDD

Question 7

T/F: All degeneration leads to instability

Answer 7

True

Question 8

The nucleus polposus disappears by what age in the c-spine?

Answer 8

40-45 yo

Question 9

T/F: Cervical Spondylosis can present with either median or ulnar neural tension

Answer 9

True: as well as radial nerve tension

Question 10

What condition is associated with cervical myelopathy

Answer 10

Cervical stenosis

Question 11

Approximately what percent of back pain is thoracic?

Answer 11

15%

Question 12

How are ribs named?

Answer 12

For the lower vertebra

Question 13

T/F: Most of the muscles in the T-spine have specific thoracic functions

Answer 13

False: not many have pure action in the T-spine

Question 14

T/F: The thoracic dermatomes follow their nerve root level more closely than any other dermatomal area

Answer 14

True

Question 15

What nerve rami becomes the intercostal nerve?

Answer 15

Anterior rami

Question 16

What is innervated by the recurrent branch of the sinuvertebral nerve?

Answer 16

Facet joints

Annulus

Proximal ribs

Multifudus

Question 17

T/F: The bimechanics of the T-spine are the same throught the whole section.

Answer 17

False: depends on the region

C/T junction, Mid Thoracic, T/L junction

Question 18

What motions put the sympathetic chain in tension?

Answer 18

Flexion

Contralateral Rotation

Contralateral SB

Question 19

What typically causes thoracic outlet syndrome?

Answer 19

Elevated 1st rib or repeatative OH activity

Question 20

What condition can be ruled out if a spurling’s test is negative?

Answer 20

Cervical radiculopathy

Question 21

What is the standard operation for cervical radiculopathy?

Answer 21

Discectomy

Question 22

What is the standard operation for cervical stenosis?

Answer 22

Laminectomy

Question 23

The following is the ideal patient for what procedure?

• normal sagittal alignmet
• compression at disc level only
• no posterior compression
• no axial neck pain
• non smoker
• negative spurling’s

Answer 23

Disc replacement

Question 24

What is key to cervical pain?

Answer 24

Shoulder girdle alignment

Question 25

T/F: Alignment of the thorax affects alignment of the c-spine

Answer 25

True

Question 26

What could be the 1st indicatory of ankylosing spondylitis?

Answer 26

Marked morning stiffness

Question 27

T/F: While surgical and conservative tx options for L-spine conditions have similar long term outcomes, those who receieve surgery have lower satisfaction.

Answer 27

False: higher satisfaction

Question 28

T/F: While disc protrusions have less severe sx, they are more likely to require surgical revisions following their initial discectomy.

Answer 28

True

Question 29

What condition causes grocery cart syndrome?

Answer 29

Neurogenic claudication/spinal stenosis

Question 30

Spondylolisthesis occurs in what % of the population?

Answer 30

5%

Question 31

What is the success rate of lumbar fusion?

Answer 31

50%

Question 32

T/F: Indiscriminate stabilization exercises can be just as damaging as poor body mechanics.

Answer 32

True

Question 33

What is the most used joint in the body in daily function?

Answer 33

TMJ

Question 34

Most pt. with TMD have a hx of?

Answer 34

Cervical whiplas injury

Question 35

T/F: If you TMD no longer clicks your condition is improving.

Answer 35

False: progressing

Question 36

What is maximal and function jaw depression/opening?

Answer 36

Max = 4 fingers; 40-50 mm Functional = 3 fingers; 35 mm

Question 37

What is the amount of protrusion and retrusion at the TMJ?

Answer 37

Protrustion = 6-9 mm Retrusion = 3 mm

Question 38

What is the amount of lateral deivation at the TMJ?

Answer 38

1/4 of the opening range

Question 39

If a mm is short, how will it test in test position?

Answer 39

Strong

Question 40

If a mm is long, how will it test in test position?

Answer 40

Weak BUT it can produce the most torque

Question 41

Do you need to make a lengthened mm stronger?

Answer 41

No, you need to teach it use be used in a midrange position to improve posture

Question 42

T/F: The medial pterygoid has a small deep head ans large superificial head

Answer 42

False: Large deep, Small superficial

Question 43

Cervical distraction primarily tests which ligament?

Answer 43

Tectorial membrane

Question 44

T/F: Lack of the Alar ligament would allow the dens process to compress the spinal cord.

Answer 44

False: transverse ligament Cord compression sx with 50% rupture of ligament and at least 8 mm of posterior displacement of dens

Question 45

How do you test the alar ligament?

Answer 45

With the spine in neutral, flex, and ext Laxity in all 3 positions = + test

Question 46

The USC is coupled in the ___________ direction, the LCS is coupled in the _________ direction

Answer 46

OPPOSITE, SAME

Question 47

How long should you wait post trauma to test VA?

Answer 47

6 weeks (the time it takes to heal the VA)

Question 48

Why are we worried about a USC pt. having RA?

Answer 48

Because it's likley to compromise the ligaments of the USC As will anticoagulants and steroids

Question 49

T/F: With a trauma or MVA you must clear the LCS.

Answer 49

False: UCS

Question 50

How do you screen for CNS issues in those with USC issues?

Answer 50

Tone: spasticity and clonus DTR Babinski reflex (+ = toe ext) Hoffman reflex (- = finger flex)

Question 51

What is the key to cervicogenic HA tx?

Answer 51

Whole body integration (at least trunk up)

Question 52

What does onset of sx following an MVA tell you about the pt. prognosis

Answer 52

Those who feel pain immediately have a worse prognosis than those you feel pain the next day or a few days after the accident

Question 53

Which direction of force from an MVA is most detrimental?

Answer 53

AP force (head on collision)

Question 54

What is the impact of decreased cervical lordosis in an MVA

Answer 54

Can't tolerate forces as well

Question 55

T/F: If your head is neutral you are more likely to damage the alar ligament

Answer 55

False: Rot = alar damage Neutral = transverse damage (with head on)

Question 56

T/F: You should perform palpation in the acute stage of MVA/whiplash injuries

Answer 56

False

Question 57

How much translation is available at each level of the C-spine?

Answer 57

3.5 mm (1.9 mm anteriorly, 1.6 mm posteriorly)