Evaluation of the Patient with Neck Pain - Part I Flashcards Preview

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Flashcards in Evaluation of the Patient with Neck Pain - Part I Deck (28)
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1
Q

State the percent prevalence of neck pain for the following groups:

25-74 y/o

45-64 y/o

A

8.2%; 10.1%

2
Q

What percent of patients with neck pain had/have had it for more than 6 months?

A

13.8%

3
Q

What is the annual incidence of cervical dic herniation?

A

5.5 per 100,000

4
Q

What is the prevalence of whiplash?

A

2.8% of all police-reported MVAs

5
Q

What are the long-term outcomes of neck pain after 10 years?

A

79% had decreased neck pain

43% had no neck pain

32% had moderate or severe neck pain

6
Q

What are red flags for possible fracture?

A

History - major trauma

History - Fall from a height

Physical Exam - severely restricted ROM (active)

7
Q

What are red flags for possible infection?

A

Age: under 20, over 50

Fever or chills

Pain worse supine

Recent UTI

IV drug abuse

Immune suppression

Physical exam - temperature, percussive pain at C7 & T1

8
Q

What are red flags for possible tumor?

A

Age: under 20, over 50

Unexplained weight loss

Pain worse when supine

Sever nocturnal pain

9
Q

What are red flags for vertebrobasilar artery compromise?

What test do you perform to discover them?

A

Patient is positive for Wallenberg’s Test:

Dizziness

Visual changes

Lightheadedness

Nystagmus

10
Q

How do you perform Wallenberg’s Test?

A

While supine, patient flexes neck, holds for 10 seconds, then extends neck, again holding for 10 seconds, followed by rotation to the right, then left.

11
Q

What is the red flag for cerebral ischemia?

A

Any sense of acute anxiety or panic on the part of the patient during any part of the examination or treatment.

12
Q

How is the head normally held during inspection?

How should it move?

A

Erect

It should move in smooth coordination with the rest of the body.

13
Q

How far should the patient disrobe for neck examination? Why?

A

To the level of the waist due to possibility of reflected pathology.

14
Q

When inspecting the patient’s skin, what should you look for?

A

Blisters

Discoloration

Scars - Surgical: anterior (thyroid), posterior (spine)

15
Q

When palpating the supraclavicular fossa, what are you looking for?

A

Lumps, swelling, bone

16
Q

What pathology might you find when palpating the supraclavicular fossa?

A

Lumps - lymph nodes, apical lung tumor

Swelling - clavicular fracture, lymphatic obstruction

Bone - cervical rib

17
Q

What should you palpate for if your patient has sustained a whiplash injury?

A

Avulsion fractures

C2

T1

18
Q

What is being performed?

A

C4-C5 Palpation

19
Q

What is being performed?

A

C6 Palpation

20
Q

What is being performed?

A

Carotid pulse palpation and auscultation

21
Q

What is being performed?

A

Greater occipital nerves palpation

22
Q

What is being performed?

A

Lymph node palpation

23
Q

What is being performed?

A

Lymph node palpation

24
Q

What is being performed?

A

Nuchal ligament palpation

25
Q

What is being performed?

A

Parotid gland palpation

26
Q

What is being performed?

A

Sternocleidomastoid palpation

27
Q

What is being performed?

A

Thyroid palpation

28
Q

What is being performed?

A

Trapezius muscle palpation