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Flashcards in C-Spine Interventions Deck (20)
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1
Q

Generally with MSK conditions think ______ vs ________

A

stability vs mobility

2
Q

When planning interventions what are some general concepts to keep in mind?

A
  1. stability vs mobility
  2. educate the pt
  3. reduce pain
  4. address impairments
  5. improve functional activity performance and participation
3
Q

what is included within Phase 1 interventions pertaining to mobility training?

A
  1. activation/coordination exercises
  2. mobility exercises
  3. inhibitory exercises
  4. soft tissue mobilization
  5. joint mobilization (sustained hold vs oscillations) and manipulations
4
Q

what is included within Phase 2 interventions pertaining to both mobility and stability training?

A

progression to strength/endurance training of stabilizers

must retrain/strengthen motion within newly improved ROM

5
Q

what is included within Phase 3 interventions pertaining to both mobility and stability training?

A

increase challenge of exercise and progress towards activity limitations

6
Q

what is included within Phase 1 interventions pertaining to stability training?

A
  1. exercises aimed at improved physiologic effects
  2. activation/coordination exercises
  3. Joint mobs (sustained holds vs oscillations) and manipulations
7
Q

List things to keep in mind with Craniocervical flexion exercise (CCFEx)

A
  1. begin at target level from testing procedure and progressively increase
  2. in practice, alter positions (quadruped vs. sitting), add resistance
  3. avoid SCM and anterior scalene activation
8
Q

List some interventions that can be used to treat nerve entrapments

A
  1. Gentle Stretching
  2. Nerve mobilizations
    1. active vs passive
    2. gliders (sliders) vs tensioners
9
Q

what is the propsed mechanism for nerve mobilization intervention techniques?

A
  1. these are thought to decrease adhesions and allow improved movement of peripheral nerves
  2. they may increase neural vascualrity, allowing increased oxygenation of the nerve and a resultant decrease in ischemic pain
  3. might disperese noxious fluids
  4. improve axoplasmic flow
10
Q

when documenting manipulations, what 6 things should be included?

A
  1. rate of force application
  2. location in range of available motion
  3. direction of force
  4. target of force
  5. relative structural movement
  6. patient position
11
Q

which proposed mechanism is more widely excepted for joint mobilizations?

A

Neurophysiologic

12
Q

what things are included in manual therapy?

A
  1. Passive movements:
    • mobilizations
    • stretching
    • manually assisted movements
  2. Manipulations
13
Q

List absolute contraindications to passive movements?

A
  1. malignancy of targeted region
  2. Cauda Equina Syndrome
  3. red flag indicators of:
    1. neoplasm
    2. fracture
    3. systemic disturbance
  4. Rheumatoid collagen necrosis
  5. Upper C-spine instability
  6. concern for CAD
14
Q

list relative contraindications to passive movements

A
  1. previously defined relative contraindications
    • active, acute inflammatory conditions
    • sig segmental stiffness
    • systematic disease
    • neuro deterioration
    • irritability
    • Osteoporosis
    • condition is worsening w/present trx
  2. acute nerve root irritation (radiculopathy)
    • when sub and obj symptoms don’t add up
    • any pt condition (handled well) that is worsening
    • use of oral contraceptives (if c-spine)
    • long-term oral corticosteroid use (if C-spine)
  3. immediately postpartum
  4. blood-clotting disorder
15
Q

list absolute contraindications to manipulations

A
  1. previously defined contraindications for passive movements
  2. practioner lack of ability
  3. spondylolisthesis
  4. gross foraminal encroachment
  5. children/teenagers
  6. pregnancy
  7. fusions
  8. psychogenic disorders
  9. immediately post-partum
16
Q

List relative contraindications for manipulations

A

exact same as those defined for passive movements

17
Q

Describe the clinical presentation of neck pain with mobility deficits

A
  1. Common symptoms
    1. generally central or unilateral neck pain (w/possible referral to the shoulder girdle/UE)
    2. symptomatic ROM limitations
  2. Common Physical Exam findings
    1. ROM impairments (symptomatic at end-range)
    2. cervical and thoracic joint hypomobility
    3. symptomatic provocation testing for invovled structures
    4. motor control impairments (subacute and chronic)
18
Q

describe the clinical presentation of neck pain w/movement coordination impairments (WAD

A
  1. Common symptoms
    • Hx related trauma/whiplash
    • associated shoulder girdle/UE pain referral
    • concussive SxS
    • dizziness/nausea; HA; confusion; concentration impairments; hypersenstivity to stimuli; distress
  2. Common Physical Exam findings
    • strength/endurance/coordination/sensory impairments
    • neck pain worsens w/mid-end range ROM
    • tenderness to palpation
    • painful w/provocation testing
19
Q

decribe the clinical presention of neck pain with headache (cervicogenic)

A
  1. common symptoms
    • non-continuous neck pain w/referred HA
      pain provoked w/neck movement/sustained postures
  2. common physical exam findings
      • cervical flexion rotation test
    • HA reproduction w/provocation testing of Upper C-spine segments
    • impaired cervical spine ROM and joint mobility
    • C-spine strength/endurance/coordination impairments
20
Q

describe the clinical presentation of neck pain with radiating pain (radicular pain)

A
  1. common symptoms
    • neck pain w/band-like pain in UE
    • UE dermatomal paresthesia/anesthesia & myotomal weakness
  2. common physical exam findings
    • concordant UE symptoms reproduced/alleviated w/radiculopathy testing procedures
    • LMN impairments w/neurologic testing