Term
| difference between examining acute vs chronic injury to the neck |
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Definition
| potential for exam to be harmful in the acute condition |
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Term
| 1st steps of cervical exam where possible (3) |
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Definition
central/peripheral neurlogical deficit
neurovascular compromise
skeletal injury (fx, ligamentous instability) |
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Term
| importance of doing a cervical screen prior to the exam |
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Definition
| stop the exam early if there is evidence of serious pathology |
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Term
| sypmtoms that do not respond to mechanical stimuli should alert the clnician to the posibbility of what (4) |
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Definition
| sinister nature or of central initation, autonomic, or affective nature |
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Term
| Fx assessment tests for the C spine (2) |
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Definition
| Neck Disability Index, Northwick Park Neck Pain Questionnaire |
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Term
| which functional assessment tool of the C spine has good short term reliabilty and internal consistency |
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Definition
| norhtwick parck neck pain questionnaire |
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Term
|
Definition
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Term
|
Definition
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Term
|
Definition
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Term
|
Definition
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Term
|
Definition
|
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Term
|
Definition
| pain intensity, personal care, lifitng, work, headaches, concentration, sleeping, driving, reading, recreation |
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|
Term
| 10 sections of northwick park neck pain questionnaire |
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Definition
| pain intensity, pain and sleeping, pins needles or numbness at night, duration fo sypmtoms, carrying, reading and watching tv, working/homework etc, social activities, driving, previous episode of neck pain |
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Term
| major contributor to cervicogenic pain |
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Definition
| lack of postural control due to poor neuromuscular function |
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Term
| restriction of cervical extension, sidebending, and rotaito to the same side as the pain is referred to as what |
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Definition
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|
Term
| which restriction is the most common pattern producing distal symptoms |
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Definition
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|
Term
| restriction of cervical flexion, sidebending, and rotaiton to the opposite side of the pain |
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Definition
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|
Term
| 10 steps of the cervical spine exam |
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Definition
Initial observations
history/subjective info
structural exam
arom/goniometry
rptd movements/muscle control
PROM/SSMT/PIVM/PAIVM
resisted testing
neuro assessment
palpation
special tests |
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Term
| Classifications: Stabilization/immobilizatoin (6) |
|
Definition
hyper paivm
3+ episodes
increased AROM/PROM
9 point test (+)
self manipulation |
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Term
| Classifications: manipulation/mobilization (4) |
|
Definition
facet pattern
A and P limited same direction
asymmetric pain pattern
+ PIVM/PAIVM |
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Term
| Classifications: specific exercise (2) |
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Definition
directional preference with repeated movements (centralize/peripheralize)
hx suggets movement/pattern bias |
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Term
| Classifications: traction (3) |
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Definition
signs of nerve root compression
no directional preference
relieved/decreased with manual traction |
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Term
| Classifications: upper cervical (6) |
|
Definition
headache (frontal, tempral)
limited rotation
suboccipital mm tightness/pain
possible dizziness
(+) PIVM
facet tenderness (C2-C3) |
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|
Term
| 6 goals of the acute phase |
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Definition
encourage pt involvement
provide mechanoreceptor stimulation
control pain and inflammation
promote healing
maitain newly attained ranges
provide neuromuscular feedback |
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Term
| 4 goals of teh funcitonal phase |
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Definition
correction of imbalances of strength and flexibility
incorporte neuromuscular re-educaiton
strengthening of the entire kinetic chain
postural correciton and retraining |
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|
Term
| purpose of cervical thrust and non thrust manipulation |
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Definition
decrease neck and headache pain
if combined with exercise more effective than manipulation alone |
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Term
| purpose of thoracic thrust and non thrust manipulation |
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Definition
| reduction of pain and disbility in pts with neck pain and neck and arm pain |
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Term
| purpose of stretching exercises |
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Definition
| decreasing neck pain specifically anterior/medial/posterior scalenes, upper trap, levator scapulae, pec minor, pec major |
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Term
| purpose of coordination, strengthening and endurance exercises |
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Definition
| reduce neck pain and headache |
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Term
| puprose of upper quarter nerve mobilizaiotn |
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Definition
| reduce pain and disability in patients with neck and arm pain |
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Term
| 2 pieces of pt education for whiplash associated disorder |
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Definition
early return to normal, non-provocative pre accident activities is important
provide reassurance to the pt that good prognosis and full recovery commonly occurs |
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Term
| DJD, cervical spondylosis, osteoarthritis chronic: effects on various tissues |
|
Definition
bone hypertrophy
capsular fiborsis
hyper/hypomobility
proliferation of synovium |
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Term
| s/s of DJD, cervical spondylosis, osteoarthritis chronic: |
|
Definition
reduced mobility (capsular pattern)
pain
possible nerve root impingement |
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|
Term
| dx of DJD, cervical spondylosis, osteoarthritis chronic: |
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Definition
|
|
Term
| clinical dx of DJD, cervical spondylosis, osteoarthritis chronic: |
|
Definition
quadrant test/foraminal closure
movement restriciton (A and P same directions, SSMT (+)
hx |
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Term
|
Definition
mobilizaiton/manipulation
stabilization
address mm imbalances |
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Term
| mgmt of djd for pt's that PT's cant do |
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Definition
| medications (NSAIDS, mm relaxants, trigger pt injections, oral/injectio of steroids) |
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Term
|
Definition
| facet entrapment (acute locked facet or acute wry neck) |
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|
Term
| facet entrapmemt: what is it caused by |
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Definition
| entrapment of fatty meniscoid in moving from flexion to extension |
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|
Term
| facet entrapmemt: which movement feels most comfortable |
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Definition
|
|
Term
| facet entrapmemt: which movement is painful |
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Definition
|
|
Term
| facet entrapmemt: clinical exam |
|
Definition
quadrant test
movement restrictions
hx |
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|
Term
| facet entrapmemt: mgmt on PT end (3) |
|
Definition
facet gapping
mobilizaiton with traction
manipulation techniques |
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|
Term
| Acc/Deceleration Injuries Whiplash Associated Disorders: dysfunction of what tissues |
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Definition
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|
Term
| Acc/Deceleration Injuries Whiplash Associated Disorders: related to what injuries |
|
Definition
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|
Term
| Acc/Deceleration Injuries Whiplash Associated Disorders: s/s are related to what (8) |
|
Definition
direction of impact
position of head
speed of impact
seat position
vehicle design
vehicle size
seat belts/head rest position
sex |
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|
Term
| Acc/Deceleration Injuries Whiplash Associated Disorders: possible s/s to alert PT include (7) |
|
Definition
central nervous system signs
periodic loss of conciousness
patient does not move neck at all (dens fx)
painful weakness of neck mm (fx)
gentral traction and compression painful (fx)
severe muscle spasm (fx)
complaints of dizziness |
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Term
| Acc/Deceleration Injuries Whiplash Associated Disorders: typical s/s (5) |
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Definition
headache
pain
stiffness
loss of ROM
mm guarding |
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Term
| Acc/Deceleration Injuries Whiplash Associated Disorders: sources of symptoms (general tissue) |
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Definition
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|
Term
| Acc/Deceleration Injuries Whiplash Associated Disorders: connective tissues (2) |
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Definition
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|
Term
| Acc/Deceleration Injuries Whiplash Associated Disorders: sources of sypmtoms include teh joint capsule and ligaments specifically which ligaments/capsules? (4) |
|
Definition
transcetion of anterior annulus
bruising of uncinate region (rim lesion)
rupture of alar ligament
avulsion of vertebral end plate |
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|
Term
| Acc/Deceleration Injuries Whiplash Associated Disorders: soruces of symptoms: vertebra specific |
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Definition
| zygapophyseal injries (25-65% of neck pain pts) |
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Term
| Acc/Deceleration Injuries Whiplash Associated Disorders: sources of symptoms: system |
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Definition
| central/peripheral neurologic systems |
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Term
| Acc/Deceleration Injuries Whiplash Associated Disorders: source of sypmtoms: force absorbing structure |
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Definition
| IVD (slow healing, up to 18 months to heal) |
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Term
| Acc/Deceleration Injuries Whiplash Associated Disorders: sources of symptoms: non mechanical sources |
|
Definition
VBI
dorsal root ganglia
visceral structures |
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Term
| Acc/Deceleration Injuries Whiplash Associated Disorders: how quickly do they resolve |
|
Definition
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|
Term
| Acc/Deceleration Injuries Whiplash Associated Disorders: if pain persists more than 6-8 weeks what may help to r/o instability |
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Definition
|
|
Term
| Degenerative Spinal Stenosis: what is it |
|
Definition
| narrowing of spinal canal, nerve root canal (lateral recess), interveretbral foramina) |
|
|
Term
| Degenerative Spinal Stenosis: primarily associated with what population? |
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Definition
|
|
Term
| Degenerative Spinal Stenosis: causes (4) |
|
Definition
facet hypertrophy
loss of IVD height
IVD bulging
spondylolisthesis |
|
|
Term
| Degenerative Spinal Stenosis: caludication/pseudoclaudication can be caused by what |
|
Definition
| nerve compression with compromise of arterial supply or venous return |
|
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Term
| Degenerative Spinal Stenosis: mgmt |
|
Definition
| flexion exercises, stabilization, traction |
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|
Term
| cervical disc lesions: rare before the age of what |
|
Definition
|
|
Term
| cervical disc lesions: most common age range |
|
Definition
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|
Term
| cervical disc lesions: often assoicated with what changes |
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Definition
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|
Term
| cervical disc lesions: most common spinal levels |
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Definition
|
|
Term
| cervical disc lesions: asymptomatic disc injury incidence |
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Definition
|
|
Term
| cervical disc lesions: mechanism |
|
Definition
| acute injuries, cervical extension, sidebending, or rotation and axial loading |
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|
Term
| cervical disc lesions: assoicated symptoms |
|
Definition
| limb pain (radiculopathy, neck and medial scapular pain, mm spasm, (+) ULTT) |
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|
Term
| cervical disc lesions: exam findings: what does the head do |
|
Definition
| lists away from painful side and stiff |
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|
Term
| cervical disc lesions: exam findings: increased pain with what? |
|
Definition
|
|
Term
| cervical disc lesions: exam findings: AROM |
|
Definition
| decreased toward pain typically ext, rot, and SB away or toward the affected nerve root |
|
|
Term
| cervical disc lesions: exam findings: neurlogical findings |
|
Definition
|
|
Term
| cervical disc lesions: exam findings: (+) tests (4) |
|
Definition
spurlings
distraction
neuromeningeal/neurodynamic testing
bakody's sign (pt places arm on top of head, (+) if reduction in pain) |
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|
Term
| cervical disc lesions: mgmt: general (3) |
|
Definition
modified rest
cervical collar
oral corticosteroids or NSAIDS |
|
|
Term
| cervical disc lesions: mgmt: PT side |
|
Definition
ID directional preference (sepcific ex)
Correct deformities if present (kyphosis)
Traction
neuromobs |
|
|
Term
| cervical disc lesions: mgmt: when is surgery indicated |
|
Definition
| if failed PT intervention x 2-6 months |
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|
Term
| Instability/Immobilization exam findings |
|
Definition
recurrent episodes
pain with prologned position
feel better in sititng
increased AROM/PROM SSMT, PAIVM
Holding neck with hands
Younger age
(+) instability tests |
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|
Term
| Instability/Immobilization Tx considerations |
|
Definition
stabilization ex
posture education
strenthen longus colli and upper thoracic mm |
|
|
Term
| trauma/inflammation exam findings |
|
Definition
constant pain
no directional preference
mm inhibitoin/weakness d/t pain |
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|
Term
| trauma/inflammation exam findings |
|
Definition
constant pain
no directional preference
mm inhibitoin/weakness d/t pain |
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|
Term
| trauma/inflammation tx consideraitons |
|
Definition
NSAIDS
modalities
reassess
walking to increase circulation
continuously reassess |
|
|
Term
|
Definition
no directional preference
neuro signs
radicular symptoms |
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|
Term
| traction tx considerations |
|
Definition
reassess
modalities
gentle neuromob
thoracic mob
deep cervical strengthening
incorporate ex |
|
|
Term
| muscle lesion exam findings |
|
Definition
arom/prom painful in opposite directiosn
isolation palpation
inital inflammatory response |
|
|
Term
| muscle lesion tx considerations |
|
Definition
| rest, educate, reassess, gentle stretching and isometric training, decrease inflammation |
|
|
Term
|
Definition
move shoulder (should hurt shoulder not neck)
upper quarter exam
shouldn't have big neuro signs
if neck mvmt hurts the shoulder indicates a neck condition |
|
|
Term
|
Definition
brachial plexus invovlment (C8-T1)
artery involvement
vascualr
cold hand
color of skin changes
low pulse
capillary refill
changes in hair growth |
|
|
Term
| differential dx for the C spine (2) |
|
Definition
TMJ dysfunciton
Cervicogenic headaches |
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|
