Musculoskeletal Physiotherapy 2 Lecture Practice Flashcards

These flashcards define key terms and clinical conditions related to the cervical spine, thoracic spine, shoulder, and temporomandibular joint (TMJ) as presented in the lecture notes.

Atlas

The $1^{st}$ cervical vertebra ($C1$) which supports the weight of the head through the atlanto-occipital joint ($C0-C1$) and has no vertebral body or true spinous process.

Axis

The $2^{nd}$ cervical vertebra ($C2$) characterized by a superior projection called the Dens (Odontoid process), which facilitates rotation of the skull.

Dens (Odontoid) Fracture Type II

A fracture at the base of the odontoid peg; it is classified as unstable and carries a high risk of non-union.

Hangman's Fracture

A colloquial name for a fracture involving both pedicles or pars interarticularis of the axis vertebra ($C2$).

Cervical Radiculopathy

Compression of a nerve root as it exits the cervical spine, resulting in neurological loss such as myotomal weakness, dermatomal sensory changes, and reflex loss.

Cervical Myelopathy

Injury to the spinal cord due to severe compression from trauma or stenosis, characterized by bilateral symptoms, ataxia, and bladder/bowel dysfunction.

Myelomalacia

A lack of fluid signal on MRI indicating spinal cord compression and softening, often associated with cervical myelopathy.

5 D’s and 3 N’s

Specifically: Dizziness, Diplopia, Dysarthria, Dysphagia, Drop attacks (5 D's); and Nausea, Numbness, Nystagmus (3 N's), which are screened to identify Vertebrobasilar Insufficiency (VBI).

Cervical Artery Dissection (CAD)

A tear in the wall of the vertebral or internal carotid artery that can lead to a stroke; it often presents as sudden, unfamiliar, severe neck pain or headache.

Whiplash Associated Disorders (WAD)

Clinical manifestations resulting from an acceleration-deceleration mechanism of energy transfer to the neck, commonly seen in motor vehicle collisions.

Acute Wry Neck

Sudden onset of sharp neck pain with protective deformity and ROM limitation, categorized as either zygapophyseal (high cervical) or discogenic (lower cervical/upper thoracic).

Migraine

A disabling primary headache disorder typically of vascular origin, often unilateral and frontotemporal, occurring in four phases: Prodrome, Aura, Migraine, and Postdrome.

Tension-type Headache (TTH)

A very common primary headache described as a bilateral, featureless 'band around the head' with a pressing or tightening quality.

Trigeminocervical Nucleus

The brain region where afferents from the $C1-C3$ nerve roots converge with trigeminal nerve afferents, providing the pathophysiological basis for cervicogenic headaches.

Cervicogenic Headache (CGH)

A secondary headache caused by non-traumatic disorders of the upper cervical spine, typically perceived as unilateral pain spreading from the neck to the head.

Stomatognathic System

A functional system composed of the skull, mandible, hyoid, teeth, TMJs, and associated muscles, vessels, and nerves.

Retrodiscal Pad

A bilaminar, highly vascular, and richly innervated structure located posterior to the TMJ articular disc; it is a potential source of pain.

Anterior Disc Displacement with Reduction (ADDwR)

A TMJ disorder characterized by a joint click during opening (when the disc repositioned onto the condyle) but no permanent locking.

Anterior Disc Displacement without Reduction (ADDwoR)

Also known as 'closed lock,' where the TMJ disc is permanently displaced, limiting mouth opening to approximately $25-30\,mm$ without a click.

Myofascial Pain with Referral (TMD)

A subtype of myalgia where pain extends beyond the immediate boundary of the masticatory muscles during palpation.

Symptom Modification Procedure (SMP)

A clinical test used during the assessment phase to determine if a specific movement or posture can immediately change a patient's symptoms.

Treatment Direction Technique (TDT)

A specific movement strategy chosen for treatment based on its positive impact on the patient's symptoms during testing.

External Subacromial Impingement

Mechanical encroachment of soft tissue in the subacromial space, often resulting in a 'painful arc' during $60-120\,deg$ of shoulder abduction.

Internal Posterosuperior Impingement

Encroachment of the rotator cuff tendons between the humeral head and glenoid rim, common in overhead athletes at maximum external rotation.

GIRD (Glenohumeral Internal Rotation Deficit)

A loss or asymmetry in passive internal rotation range of motion of the shoulder joint.

Bankart Lesion

Damage to the labral attachment with the glenoid rim, often occurring during a traumatic anterior shoulder dislocation.

SLAP Lesion

A 'Superior Labrum Anterior to Posterior' tear, frequently involving the attachment point of the long head of the biceps brachii.

TUBS

An acronym for 'Traumatic Unidirectional Bankart Surgery,' describing a clinical classification of shoulder instability.

AMBRI

An acronym for 'Atraumatic Multidirectional Bilateral Rehab Inferior capsular shift,' describing a category of non-traumatic shoulder instability.

Scheuermann’s Disease

Juvenile osteochondrosis of the spine leading to structural thoracic kyphosis, characterized by wedge-shaped vertebral bodies and Schmorl’s nodes.

Ankylosing Spondylitis (AS)

An inflammatory spondyloarthropathy linked to the $HLA-B27$ gene, causing insidious spinal stiffness, limited chest excursion ($<2.5\,cm$), and 'bamboo spine' appearance.

T4 Syndrome

A clinical pattern involving upper extremity paraesthesia and pain, hypothesized to arise from autonomic nervous system dysfunction linked to upper thoracic hypomobility.

Thoracic Outlet Syndrome (TOS)

Neurovascular compression of the brachial plexus or subclavian vessels within the scalene triangle, subclavicular space, or subpectoral space.

Stinger and Burner Syndrome

A transient brachial plexopathy resulting from a traction injury, commonly occurring in contact sports and causing radicular burning or stinging pain down the arm.

Tietze’s Syndrome

Idiopathic swelling and local pain of the costochondral junction, often affecting the $2^{nd}$ or $3^{rd}$ ribs.