Prac Viva

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Author:
jessiekate22
ID:
156454
Filename:
Prac Viva
Updated:
2012-05-30 20:55:14
Tags:
Cervical Spine
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2020
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  1. What kind of history do pts with cervical spine problems present with?
    • - area of pain- occipital- C1-C2
    • - arm pain, paraesthesia, numbness
    • - headache- type
    • - facial pain, paraesthesia (where and what fingers), numbness
    • - diziness
    • - trauma
  2. What are the aggravating factors for cervical spine issues?
    • -turning head to reverse car
    • - reading- flexion problems
    • - computer use- using mouse- forward movement
    • - holding phone (with ear and shoulder) (LF), hanging washing (ext)
    • - sports- swimming
    • - sleeping position- pillows sleep on- edge of pillow
  3. What are some easing factors for the cervical spine?
    • - lie down
    • - get up, move around, walk
    • - night position
    • - pillows
  4. What are the 5 ds for special questions?
    • - dizziness
    • - dysphagia (swallow)
    • - dysarthria (speech)
    • - diplopia (double vision)
    • - drop attacks (like fainting)
  5. What are the special questions that need to be asked for a pt with cervical spine problems?
    • - 5 ds
    • - nausea/vomiting
    • - spinal cord (tingling hands/ feet), bilateral limb paraesthesia, unsteadiness on feet (ataxia- wide BOS)
    • - medication (long term, steriods)
    • - medical history- RA- ligs unstable
    • - weight loss
  6. What observations do you make when assess a cervical spine pt?
    • - lordosis (FHP- forward head posture)
    • - lateral tilt
    • - arm supported (nerve root compromise)
    • - dowager's hump (senile osteoporosis- kyphosis)
    • - mm spasm
    • - is the posture correct?
  7. What functional movements would you conduct with your patient?
    • - flex
    • - ext
    • - rot
    • - lat flex
    • etc
  8. What active movements would you conduct for a pt with cervical spine problems?
    • All done in sitting:
    • - flex- OP for just cervical flexion cross hands over
    • - flex + rotation test_ FRT-can differentiate
    • - ext- hold jaw to OP
    • - Rot- look left, then right OP- one hand behind head with elbow on shoulder
    • - lateral- low/mid/upper- using hand to block level and OP
  9. What are we looking for with active movements?
    • range
    • rhythm
    • pain reproduction
    • local restrictions
    • - effect of correcting deviations
    • - OP, repeated, quick, sustained
  10. What are the active movements of the upper cervical spine?
    • -flexion- chin tuck
    • - ext- stick chin out
  11. What are the quadrants for the upper cervical spine and what are they used for?
    • - used to clear the neck
    • - upper Csp
    • - lower Csp
  12. How to do a quadrant of the Lower Csp?
    • look up to the roof- ext
    • lateral flex to the same side
    • rot to the same side turn head towards to side u laterally flexed
    • then compress
  13. How do perform a quadrant for the upper Csp?
    • Ext- bring chin forward
    • - rot same side
    • - lateral flex- chin goes away
    • O1, C2, C3
  14. What is the spurling's sign?
    • - it is to reproduce nerve root problems
    • - compression to reproduce pain in the arm (sustained sl E/ sl LF)
    • - distraction- (to relieve arm symptoms)
    • Stages 1- compression in neutral
    • 2- compression in ext
    • 3- compression in both ext ad lateral felx to side effected
  15. What jts would you ensure to clear?
    • - TMJ- open mouth, side to side, clearing scalenes, traps, SCM
    • - shoulder- flex, ext, abd- OP
    • - elbow- flex, ext- OP
  16. What is the neurodynamic test ULTT 1 for and conduct it?
    • - median nerve test
    • - can tell if the P is from shoulder or neck
    • - no pillow- person needs to be flat
    • - lateral flex of neck and taking arm in ext pulls the nerve more
    • - any tightness or pain reproduced
    • - sh dep, sh abd, wrist ext, ER, elb ext, Csp LF
    • Once pain is brought on pt laterlly flexes away and towards, if P isbrought on and relieve it is a +ve test.
    • Way to know is to compare to the other side.
  17. What physical examinations do you conduct on a Csp pt?
    • - clear jts
    • - neurodynamic test
    • - neurological examination
    • - vertebral artery testing
  18. Conduct a neurological examination on you Csp pt
    • - sensation- reproduced- pin prick
    • - motor power (C5-T1)
    • - reflexes
    • - +/- clonus/ babinski- shows an UMNL
  19. Conduct the apropriate vertebral artery testing on ur Csp pt
    • Need to see pts eyes at all times
    • Hold 10 sec one side, rest for 10 sec, hold 10 sec other side
    • Do in sitting because the heart has to work against gravity
    • - sustained bilateral rotation- both sides
    • - additional tests as indicated- eg going to put pt in ext u conduct the test in ext
    • - differentiate between VA and vestibular. Done by pt in standing and getting them to rotate there body holding there head still
  20. Conduct a general palpation of a Csp pts neck
    • arms by side- want pts head and mm relaxed
    • - temp, sweating- use back of hands
    • - spinal body alignment
    • - spasm
    • - tenderness
    • - soft tissue thickening
    • - A/C jt (C7- T1)
  21. what other areas will you palapate on a Csp pt?
    • - spinous process (C2, C7 prominent)- ensure u angle at the curve of the lordosis
    • - Zjts- will feel the ridge- use dom thum and reinforce with the other
    • - Transverse process of C1- much further out near jaw
    • - cervical rib- sit at 45 degrees
    • - arch of C1- angle fingers towards pts eyes
  22. Spinous process of Csp
    • C2- big
    • C3- small
    • C6- should be big but disappear when pt ext
    • C7- sticks out
  23. What are the PAIVMS- passive accessory intervertebral movments for Csp?
    • - Central PA- in line with lordosis- on spinous processes
    • - Unilateral PA- Z jts
    • - transverse- only on C1 C6, C7
    • Looking at range, P reproduction, vary angle pressure
  24. What are PPIVMS and PAIVMS?
    • PPIVMS- passive physiological movements
    • PAIVMS- passive accessory movements
  25. Conduct the PPIVMS for Csp
    • - flexion- for C6/7 hold the pt in more flex, pt head off end of bed, you support with belly, trying to feel the gap of the spinous processes
    • - Ext same as above- using legs, can hold head as a Basket ball
    • - Rot- hands on side of head- rot away from side palpating
    • - lateral flexion- hands either side of head, using side of fingers to feel the movement

    Support head with belly- have bed at the right height, bend knees more to make the movements- alows you to concentrate on what you are feeling.

    • C0-C1- can feel transverse process move away from the skull
    • ALWAYS COMPARE TO THE OTHER SIDE
  26. If pt has decrease ext how would you treat them?
    • - accessory
    • - central PA grade as you go
    • - central due to central pain
  27. Pt has pain on the posterior of neck, left side
    Rot and lateral flex to left decrease ROM, palpate find level- use unilateral on level of pain and side of pain
  28. Treatment
    • - 30 sec - look at problems eg rot then do 3 x 30
    • - in reassessment can look at PIVMS
    • - if pt is irritable- open jt via lateral flex away from side. if close MUST be low grades
    • NOTE/ if PNS down arm as well as neck pain- always do an open tech
  29. What are some openning techniques for nerve root compression?
    • - lateral glide
    • - lateral flex away
    • - distraction- pull up
    • - rot away
    • - transverse- push towards side
    • - take pressure off nerve with pillows under arm

    Traction for C6 neck in flexion- hold chin and occiput, one leg in front of the other and lean back for 30 sec/ min support head on tummy
  30. Treatments
    • - traction
    • - manipulation- to get afew degrees of movement, where oscillating tech might aggravate
    • - pillows
  31. What are some additional treatments you can conduct on a pt?
    • - local heat, ice
    • - EPA
    • - Isometric exercise
    • - Postural advice/ correction
    • - deep cervical flexor strengthening
    • - Scap control
  32. When do you use a central PA?
    - bilateral symptoms
  33. When do you use a unilateral or transverse PA?
    unilateral symptoms
  34. When do you use rotation?
    - unilateral pain/ movt abilities
  35. When do you use lateral flexion
    - unilateral pain/ movt abnormalities
  36. LOOK AT MY NOtES IN MY BOOK FOR SOME PRACTICE QU

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