Spinal Cervical Orthotic Management Flashcards
(30 cards)
Evaluation of cervical injury (4)
Position of head prior to injury
Expectation of impact
Direction of impact
Intensity of impact
Whiplash (2)
Hyperextension and flexion injuries
Acceleration / deceleration force to unrestrained head/neck
Whiplash syndrome (15)
Soft tissue injury
-disc
-nerve root
-muscles/ligaments
-elongate
-microscopic tears
-haemmorage
-oedema
Fractures
-avulsion of spinous process
-chip vertebral body
Dislocation
-of atlas
-spondylosisthesis
(X ray necessary)Whiplash symptoms (10)
Neck ache Headache Shoulder pain (interscapular) Neck tenderness Spasm Blurred vision Light headed Restriction of motion Swallowing problem Difficult to lift head from pillow
Whiolash symptoms must consider trauma to spinal cord (3)
Numbness of trunk and/or extremities
No involuntary movement
If movement coordination impaired
Csm management (2)
Surgical (if spinal cord involvement) Conservative management (depending on symptoms)
Csm conservative management (10)
Medication Immobilisation -orthosis Mobilisation -manipulation -exercise Reeducation -posture -adl Psychological intervention
Ra cervical spine changes (5)
Ligamentous distension rupture Synovitis Destruction of articular cartilage Osteoporosis Bone erosion
Ra results of pathological changes (6)
Pain
Dislocation of c4,5; c5,6
Transverse lig rupture will result in flexion instability
-extension limited by dens
Once dens no longer intact unstable in all planes
Spinal cord can be damaged
Ra cervical management aims (3)
Reduce pain
Minimise joint destruction
Enhance cervical stability
Ra cervical management options (7)
Therapy -education -heat/ice -exercise regime Orthoses Medication Surgery
Torticollis (2)
Twisted neck typically caused by contracted sternocleidomastoid muscle (scm)
Head to affected side, rotation of chin to opposite side
Congenital torticollis (5)
Grisels syndrome
Positioning in utero results in ischaemic injury
During birth
Palpable enlargement of muscle
Facial deformity due to sleeping position
Acquired torticollis (9)
Trauma -atlantoaxial subluxation -birth complications Disease Idiopathic (25-55) ist Unilateral stiffness of muscles Pressure on accessory nerve Twitching (spasm) Head/neck pain
Congenital torticollis management (4)
Exercise
Heat
Orthoses for serial positioning
Surgery
Acquired torticollis management (5)
Must address underlying cause Therapy Orthosis Surgery (if due to subluxation) Medication
Orthotic treatment for torticollis (1)
Fillauer?
Muscle trauma of cervical spine (6)
Vascular pain
-sustained contraction occludes arterial flow
-tms/ tension myositis syndrome (sarno)
Sprain (lig) / strain (muscle/tendon)
-elongation resulting in tears
-forceful contraction resulting in tear at origin/insertion
Whiplash management ( soft tissue injury) within hours (7)
Immediate rest -orthosis Ice -decreases acute inflammation -decreases bv dilation -decreases pain -decreases haemmorhage/oedema
Whiplash management (13)
Heat -commence after 1 day -removes accumulated nociceptors -prevents collagen binding -causes vasodilation -wash out toxins Discontinue orthosis -after several days Gentle mobilisation -ultrasound/massage Traction Exercises Medication
Cervical fractures (8)
Jeffersons fracture -ring of atlas Hangmans fracture -axis (hyperextension) Teardrop fracture -extreme flexion with compression Fracture of dens Fracture of the spinous process (clay shovelers fracture)
Pathologies of cervical spine (6)
Cervical spondylosis -disc herniation Inflammatory arthritis Torticollis Neoplasm Congenital
Spondylosis (6)
Degenerative disc disease Pathological changes (c3-c7) -narrowing of disc height -osteophytes at disc margins -sensory root irritation more common -oa changes in posterior joints
Spondylosis associated problems (3(
Spinal stenosis
Spondylolisthesis
Symptoms of these include pain, altered sensation and muscular weakness
