Flashcards in rando fin Deck (134):
Most common nerve root involve in cervical radiculopathy is
C7 folowed by C6
Patient with cervical radiculopathy will have pain in
active and passive ROM or on one side
Patient with cervical radiculopathy will report: Radiation into the medial scapular area, relieve of arm pain by putting the hand behind the head cervical compression reproduces the neck and arm pain
(all of the above).
Radiographic imagine of the neck in suspected cervical radiculopathy patient should include : an oblique view to determine the
degree of bony foraminal enchroachment.
________of cervical radiculopathy patient have only mild disfunction
Cervical manipulation at site of the pain herniation is used by many chiropractor to manage cervical radiculopathy patients.
home Traction of the neck for ___ minutes twice a day will Benedict some cervical radiculopathy patients
Valsalva test maybe produce radicular symptoms in a patient with cervical radiculopathy due to possible
all of the above
-cervical disc material in the ivf,
-inflamation of ivf structure
MRI or electrodiagnosic studies maybe needed after one month of care without resolution of cervical radiculopathy symptoms
Inspection palpation and rom testing are clinical approach taken when neck pain and stiffness are the primary complain
When the complain involve radiation into the back or the extremities susa recommends
Specific orthopedic test, specific neurological test
Standard battery of orthopedic test includes various form of the following test design to compress and stretch structure like facets or nerve roots except
spinal precosion test
-Burner or stinger are given names to injury of the brachial plexus or nerve roots often cause
bilateral flexion injury very common in sports
Cervical radiculopathy due to disc herniation may occur in only of patient because of the natural dehydration of ivf due to cervical spine
Which test is specific for confirming cervical radiculopathy
Standard neurological examination of muscle reflex sensory attempts to differentiate the cause of the following excepct
Neurological examinations attempts to rule in or rule out the following except
none enteric pain
Patient present with positional related arm numbness, tingling or secondary neck pain complain would be evaluated for
Exibit 2-4 illustrated a patient has a 45% probability of having a cervical radiculopathy if 3-or greater radiculopathy test are
1 Which of the following is not considered a non surgical intervention for whiplash associated disorders
Evidence that a educational pattern was not associated with a recovery in patients with acute whiplash associated disorders.
Which of the following are modifying risk and protector factors for neck pain disorders
exosure to 2nd hand smoke
physical activity level
There is no advantage for using collars compare to other aproaches in acute whiplash associated disorders
Nexus guideline state that for patient for neck trauma no radiographs are needed if the following are true.
-patient has cervical pain
-patient has cervical spine tenderness
-no evidence of ossification
-abnormal level of alertness and no focal neurological deficits
If a patient is in an MVA is important to acquire details such as.
Angle of collision,
damage to the veichle
Other necessary information is needed from post mva patient include the following excepct .
Whether the radio was on at the time of the collision.
Lateral flexión injury to the neck is common in force in MVA.
When describing a technical sequence of events following a rear collision the following are true excepct
the torso will slump down as the air inflates and the steering will cause a concussion.
Low speed rear impact collision result from the following sequence of cervical spine excepct.
compression forces DO NOT usually affect c3-4
they usually affect C5-6
________is an invasive intervention for non specific neck pain
There is evidence that low belt radiation therapy intervention was associated with in pain and function in the short term of patient with subacute or chronic neck or shoulder pain
Reclamation’s regarding actions of short term relieve for those with neck pain after a collusion include :
Exercise training and Mobilization.
The mercy guideline and other sources suggests _____________ home care is only what is needed for uncomplicated cases.
2 weeks of
Initial high frequency treatments ranging from 3- 5 treatments or adjustments for ______ is aprópiate for most uncomplicated cases
It is recomend that________ be use as a baseline measurement as for patient status.
questions like the neck stability
All of the following were associated for poor prognosis of neck pain disorders except
less need to socialize
Patient in an MVA trauma may experience a possible pain management fracture if the head was
TOS is often considered a differential diagnosis for patients with arm complaints
TOS testing are designed to compress the brachial plexus by specific structure to:
reproduce the patient complain.
When TOS testing were a diminished pulse as positive ________ are false probability to occur
Which of the following TOS test attempts to isolate the anterior or middle scalene muscles
Adsons and halstead
ROS tets is a functional assessments
Which of the following test attempt to isolate the pectoral is minor or corachoid process
Many TOS patients present at a chiropractic office with diffuse arm pain
TOS patient will describe arm symptoms that level path down the inside arm to the
4th and 5th digits
he brachial plexus and or subclavian arteries could be compress at all the following sites excepct
It is always important to perform a neurological examination in an attempt to differentiate TOS from all of the following excepct:
Which of the following is not considerate conservative management for TOS.
40% of TOS cases are due to trauma.
Patient presenting with positionaly related arm numbness or tingling and secondary neck complains should be tested for stability and TOS
Consevative management for TOS should include:
-Trigger point therapy,
-cervical thoracic adjustment,
-stretching of pectorals stregthening of the mid scapula
If a patients complains of numbness the chiropractor should start differentiating between subjective and objective numbness with a sensory examination
Patient presenting with subjective numbness is or may.
-suggest a referal,
-demonstrate no sensory overall,
-motor findings often diffuse,
-non following a secondary dermatology pattern
Numbness cause by _________ is ussually accompanied by history of overuse or direct trauma and exams may reveal motor weakness and involve central cord.
Central nervous system
TOS with pressure on the neurovascular Illness of the brachial plexus is a practical example of numbness cause by the brachial plexus
Most cases of isolated peripheral nerve or nerve root problem can be maneged condition by a chiropractor
Patient with bilateral symptoms clumsiness of the hand difficulty walking posible urinary dis function and shoting pain into the arms is a classic presentation of core myelopathy
Cervical myelopathy occurs in _____ of individuals over 70 years of age
Myelopathy is the most common spinal cord disfunction in individuals older than ______ years of age and more common in ______.
common in males
All of the following are cause of spinal cord compression or myelopathy exepct
Spinal myelopathy that is caused by direct pressure on the posterior column may produce :
disturbance and vibration perception and propioseption disturbances
Myelopathy producing Lower motor neuron problems is due to:
compresion of the nerves roots.
Patient with myelopathy due to anterior cord compresion may have all of the following symptoms excepct :
Deep tendon hyporefexia.
Patient with myelopathy due to posterior cord compresion may have all of the following except
Babinsky sing may be present in cases of myelopathy.
Overlap of myelopathy symptoms probably will not include which of the following :
Based on the subjects of myelopathy which of the following could be a good differential diagnosis :
Neck findings of upper motor neuron lesions and lower motor neuron lesions may occur with myelopathy.
Hoffman’s Test is performed by:
flicking the index finger into extension.
Most test for cervical myelopathy are specific but no sensitive Which means finding a positive is good for
ruling in myelopthy but not finding positive does not rule out myelopathy.
Radiographic measurements of the spinal canal diameter maybe accomplish on the ______
lateral view of the spinal canal
If the spinal canal measurements are less than 13 mm and mri should be order
13 mm and mri should be order
Surgery is the recommended management for cervical myelopathy were there are hard lesions.
Subject prognosis or ossification of the posterior longitudinal ligament
If they are Mild myelopathy symptoms or mri evidence of compresion with no t2 changes.
Should be managed using high velocity low amplitude adjustment.
____% of patients with early onset and mild myelopathy improve with manage chiropractic adjustment.
Internal medication and emergency doctors rank dizziness amoung the top 3 patients complains
izziness may occur in as many as __% of the elderly.
In elderly population Myelopathy due to spinal stenosis is a common cause of a sense of imbalance.
Dizzie patient may complain of
-complain that the room moves,
-complain that he is spinning,
-has a sense of motion while not moving
Vértigo indicates a peripheral or central disfunction
In older patients weight loss ussually results from
When vertigo has a peripheral cause the patient history remain all of the following except :
Constant diseases (dizziness?. )
If tinitis is only audible to the patient is considered
When a patient complain of local air pain what should the examiner look for :
All of the above
-otitis media and oto sclerosis
Bening paroximal positional vertigo usually last at the most 1-2 minutes in a patient with a history of trauma
An overlap of a cervicogenic vertical symptoms probably would not include which of the following:
Cervical rom thats it’s within normal limits
Which of the following presentations is not observed in meineirs disease.
Vertigo thats is reproduce by body rotation
Loss of speech discrimination ability is highly suggested of a
central cause of hearing loss.
Which of the following pathology are associated with hearing loss.
Meiniers disease and labyrinthitis.
Patient experiencing subhearing loss after a trauma with neurological findings should receive a neurological examination to determine.
possible vascular defects
Patient complain about hearing or rhythmic or pulse sound should be:
All of the above
-Checking for hypertension,
-bruits or murmurs evaluated for cardiovascular conditions
Slow onset of continuous or progressive tinitis with possible mild vertigo or hearing loss should be evaluated for
Referal to a neurologist or otorhinolaryngologist is aprópiate for all complications for hearing loss excepct a:
Perilymphatic fistula that does not affect adls
Habituation exercise is a conservative approach for managing
Dizziness associated with a history of bieromethic pressure changes like diving or air fight is probably due to: perilymphatic history.
Migrane headaches has a price tag of 13 to 17 billion annually
__% of men and __% women report at least one significant headaches for month.
In a chiropractic office one of the most common headache presentation is associated with
Vascular neurological headache include:
all of the above.
Patient with cervicogenic headache present with pain localize to the neck and subocipital region and is provoked by specific neck movements
A headache patient with a history of head trauma should be:.
referred for medical consultation
The following are secondary causes for headache except:
SI joint pathology.
(metabolic disease, trauma and intracranial pathology were the other options)
History of hypo or hyperthyroid diseases or diabetes could indicate:
A headache associated with exercise indicates is categorize as:
Which of the following will not trigger an migrane with aura :
Which of the following presentations is not observed in a cluster headache :
They are described as non-pulsating tightening headaches.
A constant progressive headache with associated symptoms such as ________ could indicate a tumor.
All of the above
Chiropractic manipulative therapy adjustments is recommended for Migranes, cervicogenic and tension type headaches.
Tension type and cervicogenic type headache should include the following except:
Avoidance of alcohol
Cluster headaches Should be :
All of the above.
A cluster headache is ussually unilateral accompanied by a
lacrimation and a runny nose on the same side.
All the following headache presentations are red flags except :
A headache associated with exercise.
Conservative management for Migranes do not include:
Patients taking nsaids or aspirin longer than 3 days may experience a :
A concusion is considered a subcet of:
mild traumatic brain injury.
The definition of concusion does not include :
Loss of consciousness.
The most common signs/symptoms of concussions headaches, dizziness, difficulty concentrating, irritability and other emotional and behavior manifestations
There are ____million concussions in the USA annually but only 50% are actually reported.
The sport concussion assessment tool is a comprehensive approach to additional asses concussions
Return to play (RTP) clearance involve gradual step by step increased in physical demands and sports contact.
The following individuals most be educated about the dangers of concussions except:
SIS stand for :
Second Injury Symptoms
SIS patients experience rapid :
Tests for neuropsychological function to Evaluate cognitive function include the following expect :
Concussion evaluation test.
The most common symptoms of a VBA is :
The following may cause a VBA exepct
Possible risk factors for a VBA include :
Ligamentous hyper mobility and Giant Cells arteritis.
Standard in office testing cannot detect arterial anomalies or pathology That predispose patients to be VBA
Symptoms of VBA occur in the practitioners office_____ of the time.
A pathoneumonic device for remembering VBA symptoms or signs is by :
5D and 3N
The prognosis for patient suffering VBA is :
All of the above
A patient displaying Dizziness, diplopia, dysarthria, dysphagia, nystagmus, numbness and nausea after there adjustments should
have there Vitals monitor and an ambulance call.
A chiropractic having a patient displaying symptoms of VBA before being adjusted should document that no adjustment was perform in their records.