C/T medical screening

self-report questionnaires

Use ___ for pts w/ neck pain to id baseline status and monitor changes related to pain/func/disability/psychosocial funcing

red flag

warning sign that indicate need for reeval by a medical specialist

yellow flag

warning signs used to assess for pain-associated psychological distress

yellow flag

indicate higher risk for delayed recovery or development of chronic sxs

yellow flag

may require referral for psychological eval/counseling

viscerogenic

type of conditions: neoplasm, inflam or systemic disease, cardiopulm condition, C vascular pathology

neuromoskel

type of conditions: upper C lig instability, C myelopathy

98.6, 160/95, 100, 25

signs of inflam or systemic disease: temp >___°F, bp >___mmHg, resting pulse >___bpm, resting RR >___breaths/min, excessive fatigue

C neoplasm

type of conditions: metastatic lesions (leukemia, hodgkin’s disease), C bone/cord tumors, lung cancer, pancoast’s tumor, esophageal cancer, thyroid cancer

T neoplasm

type of conditions: mediastinal tumor, metastatic lesion, pancreatic cancer, breast cancer, multi myeloma

pulm

types of conditions: tracheobronchial irritation, chronic bronchitis, pneumothorax, pleuritis involving the diaphragm

cardiac

types of conditions: angina, myocardial infarction, aortic aneurysm, occipital migraine, C A ischemia or dissection, arteritis

C vascular pathology

can present w/ neck pain and HA up to 30 days

internal carotid A

vertebral A

recent onset, mod/high severity, 1st and worst, 5D/3N

subjective exam hints for C vascular pathology

C vascular pathology

risk factors: current/past smoker, hypertension, high cholesterol, migraine, vascular anomaly, fam hx of stroke, taking oral contraception, recent infection, recent trauma

dizzy, diplopia, drop attack, dysphagia, dysarthria

5 D’s

numb, nystagmus, nausea

3 N’s

vitals (bp, hr, auscultation), neuro (CN, reflex, strength/sensation, gait), C A/PRoM

objective exam for C vascular pathology

canadian C-spine rules

screening tool for C spine fx; determines the need for C spine X-ray

65+, dangerous mechanism, paresthesia

canadian C-spine rules: high risk factors that mandates radiography

fall 3ft or 5 stairs, axial load to head, MVA w/ high speed or w/ rollover/eject; can’t rot neck 45° L/R

canadian C-spine rules: “dangerous mechanisms”

safe assess of RoM

canadian C-spine rules: simple rear-end MVA, sit/ambulatory, delayed onset of neck pain, no midline C-spine tenderness

5

C images should include ___-view x-ray

major trauma or minor if >50, osteoporosis, long-term corticosteroid use

red flags for T spinal fx

>52, BMI <22, no leg pain, no exercise, female

osteoporotic compression fx of T spine cluster

upper C lig instability

risk factors: recent trauma, throat infection, congenital collagenous compromise (down syndrome, ehlers-danlos), inflam arthritides (RA, ankylosing spondylitis), recent neck/head/dental surgery

C1

w/ lack of stability, ___ can slide forward

upper C lig instability

subjective findings: neck/head pain, feel unstable, constant need for support, sxs worsen, facial/limb paresthesia/overt LoB w/ AROM, lump in throat, metallic taste, limb weakness/coordination loss

sharp purser, alar lig, ant shear

3 tests for upper C lig instability

C myelopathy

UMN disorder where SC is compromised in C spine central canal

cook

name of cluster for C myelopathy

>45, gait deviation, hoffman, inverted supinator, babinski

cook cluster parts

C myelopathy

subjective findings: >45, gait unsteadiness, LoB/coordination, limb weakness/paresthesia, bowel/bladder dysfunc

spondylosis w/ stenosis, disc herniation, spondylolisthesis, tumor

4 ways of SC compression (C myelopathy)