Cervical, Thoracic, and Lumbar Spine Review

Flashcards reviewing key concepts from the Cervical, Thoracic, and Lumbar Spine lecture notes.

List 5 risk factors for CAD according to Rushton et al. and IFOMPT

Hypertension, Hyperlipidemia, Cardiac disease, Diabetes, History of smoking

According to Sizer et al. (2007), what is the next step after identifying red flags during the screening process?

Categorization

What is a key consideration when a patient has a history of trauma to the cervical spine?

Risk of dissecting issue

In forward head posture, where is the trachea positioned in relation to the shoulder?

Over the shoulder

In forward head posture, what is the typical position of the upper and lower cervical segments?

Upper segments in extension, lower segments in flexion

During palpation, what finding might suggest CGH?

Tenderness of upper cervical segments

What is expected during AROM/PROM assessment if headache symptoms are reproduced with protraction?

Headache symptoms reproduced with protraction held for longer duration

What does reduced ROM and symptom reproduction during the AO joint (nod) test suggest?

AO joint stiffness and involvement in CGH

What ROM loss during the AA joint test suggests CGH?

Loss of 32 degrees rotation

What is the gold standard test for CGH diagnoses, according to Hall et al., 2008?

Cervical flexion rotation test

What is a defining feature of CGH regarding the DCNF?

Impairments in muscle strength and DCNF

Describe the ideal work pattern to avoid static postures, according to Hedges 3SSS.

Moving around every 20 minutes

What is the purpose of NAGs in cervical spine manipulation?

To promote/improve flexion

According to Reid et al 2015, SNAGs can decrease what for CGH?

Pain and disability

According to Reid et al 2014, what is the most effective treatment for dizziness associated with neck pain/stiffness?

C1/C2 mulligan SNAG

List 3 contraindications that mean NO manipulation of Cx spine.

Osteoporosis, spondylosis, RA

List 3 red flags that mean NO manipulation of Cx spine

Recent trauma, dislocation, ligament rupture

What muscle group is commonly weakened due to forward head positioning?

Deep Neck Flexors (DCNF)

What is an effective exercise to strengthen the DCNF?

Craniocervical deep neck flexor endurance (DCNF) test with towel feedback

What does Jull et al., 2002 suggest is the most effective treatment combination for CGH?

Manual therapy (MT) + exercise

What spinal region promotes regional interdependence within the cervical spine?

Thoracic Spine

What ROM improvement was shown with Tx HVT due to regional interdependence?

7-8 degrees in cervical ROM improvement

List 3 "ABC" DO NOT USE for HVT -Tx?

Pregnancy, drugs, non mechanical

List 3 "ABC" DO NOT USE for HVT -Tx?

Cancer, hypermobility, scoliosis

Contraindications include foggy feeling" what red flags should you screen for?

transverse > ligament test (IFOMPT framework) - CAD - questionnaire (major red flag) - traumatic event, foggy feeling, young = dissecting (Rushton et al., 2022) - VBI Q’s - feeling foggy

What is the significance of Alanto-dens interval of grater than 5 mm?

Laxity of ligament

In the alar ligament test, what finding indicates a ligament tear or rupture?

Lack of movement and pain, and no clunk to increased movement

According to Hoving et al. (2002), when do patients benefit most from MT for cervical stiffness?

When they present with recently acute stiffness within 2-3 weeks

According to Lee and Kim (2016), what combination is more effective for improving ROM, strength, and pain?

Tx Manip + DCF training

According to Blanpied et al., 2017, what patient group benefitted the most from MT?

Subacute (with neck pain deficits)

According to Rushton et al, what framework should be used for CAD and VBI?

IFOMPT framework

List CAT 3 conditions.

Radiculopathy

List 3 red flags for C-spine

neural deficits, symptoms progressively getting worse, MOI = MVA

What ROM in the Cx is considered normal after trauma?

45 degrees

List 3 special tests to asses nerve root compression

Spurlings, Distraction, wainner cluster test

what special test should you use to asses radiculopathy, OR CRPAL TUNNEL

ULTT Blinded

What test has 85%, a specificity of 96%, and a sensitivity of 88%?

Transverse ligament test

When does an atlantoaxial subluxation indicate instability?

When it is greater than 4 mm

What type of action should be used when in acute stage of whiplash mangement?

Reassurance and self exervise

What type of dysfunction does a slider promote?

nerve excursion

What type of HVT should be used in Radiculopathy?

Regional interdependence

Which classification is QTF guidelines?

Sterling man Therm 2004

According to young et al 2019, one session of what manipulation results in pain improvement?

Tx manip

What score is medical screening questionnaire consider as radiculopathy?

CAT 3

Specific screening questions for Tx, what factors need to be included?

Spondylosisi, Osteoporosis, OA

3 Signs of red flags that are specific to Tx.

Spondylosis ,Osteoporosis, OA

When assesing breathing patterns what anatomical part needs to be observed/palpated?

Ribs

What does PAIVMS tests for?

To differentiate CVJ/CTJ from facet/IVJ

Is there any tenderness of rhomboids in pt that has Tx spain or tear?

No, there there should be no to rule out rhomboids tear.

When does one consider pain has PILL response?

Indication pain and loss of ROM - MWM

What is the purpose to use swivel chair?

to avoid rotation

What is the goal of MT during Tx?

grades 1-2 on facet

What type of MT should one use in later stages of MT?

MWM/SNAG for rotation

What finding indicates for HVT for ROM?

Plateaued rom

What type of Soft tissue approach would one use during TX sprain?

Soft tissue for guarding and tension

If hypomobility is present as condition, which intervention need to be focused and implement?

Stretching/exercise with combination of soft tissue.

during Derangement cases, what is important during rotation stages?

Progress increase duration rotation stretching into pain then through pain

After weeks of phase 2 - 3x8 what are the next steps?

3x12

For aerobics, what is type of approach would used and RPE value?

Walking flat surface RPE 11-14

After pt has shown walking 30 mins, what is the next progression for strength?

progress to inclines

Score 4 of medium risk based on what tool?

Psychological approach/ start back tool

Medical screening questionnaire helps rule OUT what conditions?

Sizer et al., 2007 red flags

Why test Quadrant test?

Rule out facet joint sprain with quadrant test

Repeat movement with WB, what are you assessing?

Assessing for centralisation or peripheralisati on indicating good prognosis

What type of DP is used in flex and extension

EXTENSION

Overall, what you expect based on the spring test with LBP?

Expect no rule out facet sprain and stiffness

Whats is the purpose RME and what is the focus?

Lam et al., favoring MDT compared t o exercise alone

What type of postural cue to give for pt with LBP?

Posture correction, Avoid prolonged postures

In patients after assessment and use start back what type of number/score is required for this conditions?

Score of 3 on start back (hill et al., ) s u g g e s t e d a p p r o a c h f r o m NIC E g uid elin e s ( o s ulliv a n ) - e x e r cis e, M T, p s y c h olo gic al response

Pt has facet, will the get centralisation or peripheralizer in repeat mov?

No they dont

With lumbar SNAGS, pt restored, what is goal/purpose?

Restores mobility and reduced mechanical pain

To get the best outcome for improvement what is more usable mobilization or SNGS?

that Mulligans SNAG is more useful than neural mobilization at improving disability

Lumbar radiculopathy should not be use in ABC, what does this stand for

Should not be use when: Sheurmans and ak spond, Cancer, Osteoporosis due to disuse, Drugs, Haemophillia, Worsening function Non mehcanical/uremitting

With sizer, what catagory is possibe for PNS (peripheral dysfunction)

3 cat

Pt has myotomal/Sens weakness what is the next steps

Assessment/Treat with radiculars

Why perform gait assesement ?

foot slap, hip hitch

Posutral tests for SIJ would likey be.

SIJ pain provocation tests

Where is L5 Dermatome during the Neuro Assesment - Somatsenory( sensation Test?

Medial border L4 and anterior shin

what does SLR test assess?

Assess sensitivity of nerve sliding against mechanical interface

What type of dysfunction is considered after you detmerine comression vs tension in L5

Comrpession dysfunction

After early stages control, what should you traget

tibialis anterior, gluteus med, extensor hallucis longus

During neural mobilization exercises what postion will patient use?

One ended

Pregnancy, what structure and ABC will one use?

Lumbar SNGS

SIj dysfunction are they going to have red flags?

No, they should have NO red flag

Which spinal conditions need 3 positive tests to confirm?

SIJ pain provocation

What does ASLR stand for and asses?

Active stabalisation to assess stabalisation aspect of SIJ

For SIJ, What needs to be increased or load to the psoas to improve function closure?

Force closure

In SIJ cases, what needs to be activated in core?

(thoracolum bar fascia)