WAD

Question 1

Sudden hyperextension followed by hyperflexion of the neck describes

Answer 1

whiplash

Question 2

Lack of info labeling

Answer 2

diagnosis
injury
prognosis
treatment

Question 3

definition of whiplash

Answer 3

Acceleration-deceleration mechanism of energy transfer to the neck

Question 4

Whiplash impacts result in what type of injury?

Answer 4

bony of soft tissue injuries

Question 5

Who is a typical patient with WAD?

Answer 5

middle aged

women

Question 6

(women/men) have increased head and neck mass and slower recovery time from whiplash injury

Answer 6

women

Question 7

What symptoms are present with WAD?

Answer 7

neck pain/stiffness
headache
shoulder pain
back pain 
focus
concentration
memory
blurred vision
dizziness
sleep disturbance 
fatigue
depression 
buzzing in the ears

Question 8

There is a link between chronicity and litigation/compensation claims (true/false)

Answer 8

false

Question 9

What is the biggest indicator of chronicity in WAD?

a. compensation claims
b. impact of MVA
c. nerve damage
d. amount and severity of acute pain

Answer 9

amount and severity of acute pain

Question 10

The direction of the hit from an MVA matters to injury (true/false)

Answer 10

false

Question 11

What type of injury is the worst in terms of damage?

Answer 11

extension

Question 12

What forces occur with hyperextension injury?

Answer 12

extension
posterior shear
posterior compression
anterior distraction
traction 
torsion if hit off center

Question 13

Speed is relevant to injury (true/false)

Answer 13

false

Question 14

Intra-discal pressure (increases/decreases) with flexion

Answer 14

increases

Question 15

intra-discal pressure (increases/decreases) with extension

Answer 15

decreases

Question 16

(higher/lower) inter-vertebral disc pressure in C-spine compared to t-spine

Answer 16

higher

Question 17

Which muscle is the most at risk with extension during a whiplash?

a. rectus capitis posterior minor
b. scalenes
c. longus coli
d. longus capitus

Answer 17

longus coli

Question 18

Which muscle is the most at risk with lateral impact?

a. rectus capitis posterior minor
b. scalenes
c. longus coli
d. longus capitus

Answer 18

longus capitus

Question 19

_ is delayed in muscle contraction in response to sudden movement of head and neck

Answer 19

reaction time

Question 20

What are the symptoms of VAI?

Answer 20

5 Ds
A
3 Ns

Question 21

Which muscles are commonly injured?

a. anterior
b. posterior
c. lateral
d. back muscles

Answer 21

posterior

Question 22

WAD patients do not have trigger points (true/false)

Answer 22

false

Question 23

Trigger points in WAD patients are due to

Answer 23

damaged tissue

not the originator of pain

Question 24

Trigger points are _

Answer 24

latent

Question 25

a forward head effects improvement in WAD (true/false)

Answer 25

true

Question 26

Neural injury with WAD can cause

Answer 26

injury to brain spinal cord nerve roots

Question 27

What neural injury can happen with WAD?

Answer 27

DRG refractory period and not fire for 2 weeks following MVC

Question 28

This is defined as the DRG not firing for 2 weeks after the injury and suddenly being flared up

Answer 28

refractory period

Question 29

What injury can occur soon after the crash?

Answer 29

central sensitization

Question 30

Anxiety disorder that can develop after a person is exposed to one or more traumatic events, such as major stress, sexual assault, warefare, or other threats on a persons life describes

Answer 30

PTSD

Question 31

What symptoms are indicative of PTSD?

Answer 31

disturbing recurring flashbacks avoidance or numbing of memories of the event hyperarousal symptoms not present before exposure to event inability to sleep

Question 32

symptoms of _ may result in an overactive adrenaline response

Answer 32

PTSD

Question 33

Which ligaments can be torn or injured with WAD? a. longitudinal ligament b. alar and transverse ligament c. ALL d. PLL

Answer 33

alar and transverse ligament

Question 34

A patient has a stiff, rigid neck and multi level symptoms, which type of injury potentially resulted from WAD? a. facet joint injury b. disc lesion c. ligament injury d. muscle tear

Answer 34

disc lesion

Question 35

Rim lesion includes

Answer 35

``` annulus tearing off the VB anterior > posterior bleeding from VB and ALL hemarthroses stiff, rigid neck multi-level symptoms ```

Question 36

Which area of the c-spine is unstable?

Answer 36

occiput/atlas/axis

Question 37

scalenes refer to what area a. shoulder blades b. front of neck c. occiput d. around eye and back of ear

Answer 37

around eye and back of ear

Question 38

What can a headache from WAD be caused by?

Answer 38

``` facet joints atlanto-occipital joints and ligaments ligaments of c-spine annulus of IVD periosteum of the VB cervical muscles ```

Question 39

Which tissues are primarily damaged with WAD? a. muscles and facet joints b. disc, facet joint, neural tissue c. muscles and ligaments d. facets and neural tissue

Answer 39

disc, facet joint, neural tissue

Question 40

Which tissues are secondary damage with WAD? a. muscles and facet joints b. disc, facet joint, neural tissue c. muscles and ligaments d. facets and neural tissue

Answer 40

muscle and ligament

Question 41

What treatment is the most effective for WAD short term? a. manipulation and collars b. traction and exericse c. collars and rest d. manip/mobs, and active exercise

Answer 41

manip/mobs, and active exercise

Question 42

Collars help neurobehavioral issues with WAD (true/false)

Answer 42

false

Question 43

There is evidence that rest improves neurobehavioral component of WAD (true/false)

Answer 43

false

Question 44

Spinal manipulation gives a _ effect

Answer 44

placebo

Question 45

What is the most powerful treatment for addressing neurobehavioral component? a. rest and spinal mobs b. exercise, advice and info c. posture and education d. spinal manip and rest

Answer 45

exercise, advice and info

Question 46

What is the purpose in doing a short period of no therapy?

Answer 46

allow tissue to heal with inflammatory process to slow down

Question 47

Patients should wean use of collar based on a. pain b. psychological fear c. disability d. time or function

Answer 47

time or function dependent

Question 48

Patients should engage in frequent _

Answer 48

movement

Question 49

What position is the most beneficial for exercise? a. prone b. supine c. sidelying d. seated

Answer 49

supine

Question 50

symptom exam cluster for tissue issues

Answer 50

proportionate pain aggs/eases intermittent sharp, dull ache or throb at rest no night pain, dysesthesia, burning, shooting or electric

Question 51

Patients injured in stressful environments are _

Answer 51

adreno-sensitive

Question 52

Abnormal nociceptive processing occurs a. immediately, < 7 days b. after 3 months c. after 2 weeks d. when it becomes chronic

Answer 52

<7 days

Question 53

What predicts chronic whiplash?

Answer 53

abnormal nociceptive processing

Question 54

What changes are seen in ROM?

Answer 54

less ROM

Question 55

How does a slump test change symptoms?

Answer 55

increase intensity of cervical symptoms

Question 56

Peripheral neurogenic symptom cluster

Answer 56

pain in dermatomal or cutaneous distribution positive neurodynamic and palpation history of nerve pathology or compromise

Question 57

Pain in dermatomal or cutaneous distribution, positive neurodynamic and palpation history of nerve pathology or compromise shows a. central sensitization b. peripheral neurogenic c. nociceptive

Answer 57

peripheral neurogenic

Question 58

``` Proportionate pain, aggs/eases intermittent sharp, dull ache or throb at rest, no night pain, dysesthesia, burning, shooting or electric suggest a. central sensitization b. peripheral neurogenic c. nociceptive ```

Answer 58

nociceptive

Question 59

Patients show sensitivity to _ and _ _

Answer 59

adrenaline | mechancial pressure

Question 60

symptom and sign cluster for central sensitization

Answer 60

disproportionate pain diffuse palpation tenderness psychosocial issues disproportionate aggs/eases

Question 61

disproportionate pain, diffuse palpation tenderness, psychosocial issues, disproportionate aggs/eases suggest a. central sensitization b. peripheral neurogenic c. nociceptive

Answer 61

central sensitization

Question 62

central sensitization affects

Answer 62

pain experience smudging left/right discrimination

Question 63

Patients experience a. central sensitization b. peripheral neurogenic c. nociceptive d. all of the above

Answer 63

ALL

Question 64

Anterior > posterior lesion, bleeding from VB and ALL, stiff and rigid neck, multi level symptoms and hemathroses suggest which type of injury occurred with WAD a. VA b. neural c. ligament d. disc

Answer 64

disc