Cervical Spine Treatment Protocol Quiz
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Questions and Answers

What is the first step in the treatment of cervical spine posterior derangements?

  • Reduction of the herniation using repeated retraction/extension exercises (correct)
  • Maintenance of herniation reduction with posture correction
  • Prophylaxis and Prevention through patient education
  • Recovery of Function using flexion exercises

    • Step three should begin immediately after the patient experiences pain relief.

    False

    What should be avoided during the first three hours after waking up?

    Flexion exercises

    Step four focuses on __________ and prevention of secondary injury.

    <p>prophylaxis</p> Signup and view all the answers

    Match the treatment steps with their corresponding actions:

    <p>Step One = Reduction of herniation Step Two = Maintenance of herniation reduction Step Three = Recovery of function using flexion exercises Step Four = Prophylaxis and patient education</p> Signup and view all the answers

    How long should steps one and two continue after the patient is symptom-free?

    <p>Two weeks</p> Signup and view all the answers

    Patient education regarding proper posture is essential for the treatment process.

    <p>True</p> Signup and view all the answers

    What combination is emphasized in Step Four for prevention?

    <p>Patient education and modification of activities</p> Signup and view all the answers

    What is the baseline finding for patients with flexion dysfunctions?

    <p>0/10 cervical spine pain</p> Signup and view all the answers

    Patients with extension dysfunctions report peripheralization.

    <p>False</p> Signup and view all the answers

    Which cervical spine special test will be positive for an increase in neck pain?

    <p>Cervical Hyperflexion Test</p> Signup and view all the answers

    Patients with flexion dysfunction report __________ pain without peripheralization.

    <p>neck</p> Signup and view all the answers

    Match the cervical spine dysfunctions to their definitions:

    <p>Flexion Dysfunction = Loss of flexion range of motion Extension Dysfunction = Loss of extension range of motion Anterior Derangement = Condition preceding extension dysfunction Peripheralization = Not reported in flexion or extension dysfunctions</p> Signup and view all the answers

    Which range of motion findings is NOT reported for retraction in patients with flexion dysfunction?

    <p>Nil</p> Signup and view all the answers

    What should be done after flexion exercises for patients experiencing flexion dysfunction?

    <p>Follow with extension exercises</p> Signup and view all the answers

    Cervical spine extension dysfunctions are more common than cervical spine flexion dysfunctions.

    <p>False</p> Signup and view all the answers

    Which of the following situations indicates an adhered nerve root (ANR)?

    <p>Increased symptoms during flexion with ^ P NW ERP</p> Signup and view all the answers

    Cervical spine entrapped nerve roots (ENR) result in the loss of cervical extension range of motion.

    <p>True</p> Signup and view all the answers

    What test is positive for increased symptoms in the presence of an ANR?

    <p>Elvy's Test</p> Signup and view all the answers

    Patients with cervical spine ENR typically report __________ pain along the involved nerve root pattern.

    <p>radiating</p> Signup and view all the answers

    Match the exercise with its description in treating ANR.

    <p>Flexion in sitting with overpressure = 10 repetitions per hour Contralateral side-bending with overpressure = Targeting nerve dynamics Combination flexion, side-bending, and rotation = 10 repetitions per hour Neurodynamics for upper extremity = Any combination of median, radial, and ulnar nerve exercises</p> Signup and view all the answers

    What occurs in the initial few repetitions of retraction for patients with ENR?

    <p>^ P NW</p> Signup and view all the answers

    What type of dysfunctions are cervical spine entrapped nerve roots categorized as?

    <p>Extension dysfunctions</p> Signup and view all the answers

    Patients with ENR will demonstrate symptoms that peripherally centralize as repetitions increase.

    <p>False</p> Signup and view all the answers

    What is a potential result of trauma to the cervical spine?

    <p>Facet dysfunction</p> Signup and view all the answers

    Facet dysfunction can cause pain to radiate into the upper extremities.

    <p>False</p> Signup and view all the answers

    Name one test that would be positive in the presence of cervical spine facet dysfunction.

    <p>Cervical Compression Test</p> Signup and view all the answers

    Facet dysfunction may involve a locked facet or an _________ facet.

    <p>inflamed</p> Signup and view all the answers

    Which motion would NOT contribute to the closure of the lower cervical spine facets?

    <p>Contralateral Rotation</p> Signup and view all the answers

    Match the cervical spine tests with their primary results for facet dysfunction:

    <p>Cervical Compression Test = Positive for increased symptoms Cervical Distraction Test = Temporary pain relief Spurling's Compression Test = Positive for increased symptoms Quadrant Test = Positive for increased symptoms</p> Signup and view all the answers

    Cervical spine facet dysfunction only presents with end-range pain.

    <p>True</p> Signup and view all the answers

    What modifications can help prevent cervical spine facet syndrome in the workplace?

    <p>Headsets or phone modifications</p> Signup and view all the answers

    Which of these techniques is NOT used to unlock a locked facet?

    <p>Therapeutic Modalities</p> Signup and view all the answers

    Manual therapy techniques are necessary before prescribing exercises for a locked facet.

    <p>True</p> Signup and view all the answers

    How long should each stretching exercise be held?

    <p>60 seconds</p> Signup and view all the answers

    ___ is a recommended therapeutic modality to decrease pain and inflammation.

    <p>NSAIDs</p> Signup and view all the answers

    Match the exercises to their description:

    <p>Flexion in sitting = Involves bending forward to open the facet joint Contralateral side-bending = Bending away from the locked facet Contralateral rotation = Rotating the head away from the locked facet Combination exercise = Mix of flexion, side-bending, and rotation</p> Signup and view all the answers

    What is the maximum dosage of traction that can be applied based on a patient's body weight?

    <p>7% of body weight</p> Signup and view all the answers

    Increased flexion of the spine decreases vertebral separation.

    <p>False</p> Signup and view all the answers

    What is the typical duration of mechanical traction treatment for relaxation?

    <p>20-30 minutes</p> Signup and view all the answers

    To achieve increased relaxation during traction, the angle of pull should be __________.

    <p>decreased</p> Signup and view all the answers

    Match the following traction types with their descriptions:

    <p>Over-the-Door Traction = A simple home traction device Pronex Traction = A device that uses pneumatic means for traction Mechanical Traction Machine = A machine that provides controlled traction Saunders Traction = A type of traction using a motorized system</p> Signup and view all the answers

    What is a determining factor influencing the effectiveness of vertebral separation?

    <p>Spinal Position</p> Signup and view all the answers

    Mechanical traction combined with exercise is less effective than exercise alone for reducing neck pain in patients with cervical radiculopathy.

    <p>False</p> Signup and view all the answers

    What type of traction is superior according to the evidence-based practice guidelines?

    <p>Supine mechanical traction combined with exercise</p> Signup and view all the answers

    Study Notes

    Cervical Spine Treatment Research

    • A systematic review of randomized trials regarding therapeutic exercises following cervical spine injury identified 1,268 studies.
    • Only nine studies met the inclusion criteria.
    • Therapeutic exercises included: strength training for the cervical spine, shoulder strengthening (GHJ and STJ), postural education/training, and stretching.
    • Individual study results are presented in summary tables.
    • The summary tables show the number of subjects (N), interventions, and clinically and/or statistically significant findings.
    • One study followed-up on patients beyond 6 months.
    • Clinicians should include therapeutic exercises (including strengthening and stretching) in treatment programs for patients with cervical spine pain and/or disability.

    Systematic Review Results (Details)

    • Several authors (Delive et al. 2011, Hakkinen et al. 2008, etc.) conducted studies with varying participant numbers (N), interventions, and outcomes.
    • Authors report decreased pain and/or decreased disability in their respective studies. (SS=Statistically significant; CS=Clinically significant) Some studies showed no change in pain or disability.
    • Interventions varied, including strength training for upper extremities (UE) with different frequencies and durations, strength training and stretching for the neck and UE, postural exercises, strengthening and stretching, or high-intensity strengthening.

    Cervical Spine Posterior Derangement

    • Posterior derangements of the cervical spine can result from trauma, whiplash, or force-flexion mechanisms, or from poor posture.
    • Posterior derangements present with single and repeated range-of-motion findings similar to the lumbar spine.
    • Examples of positive special tests are the Valsalva Maneuver, Cervical Compression Test, Spurling's Compression Test, and Quadrant Test.
    • Positive tests for decreased pain include the Shoulder Abduction Test and the Cervical Distraction Test.

    Treatment Procedures

    • Treatment for posterior derangements involves repeated retraction/extension exercises to the end-range of motion.
    • These exercises should be coupled with patient education regarding proper posture and body mechanics.

    Recovery of Function

    • Recovery of function involves repeated protraction/flexion exercises to regain motion.
    • This step should begin only after the patient has been pain-free for two weeks and should be discontinued if pain returns.
    • Flexion exercises should be avoided for the first three hours after waking.
    • Patients should undergo prophylactic efforts, including posture correction and avoiding secondary injuries, after the two-week period.

    Cervical Spine Anterior Derangement

    • Anterior derangements are less common than posterior ones.
    • Symptoms often are not referred to the upper extremities.
    • The process is similar to Posterior Derangements, with specific exercises and tests.

    Cervical Spine Postural Syndrome

    • Postural syndrome results from excessive poor posture (e.g., forward head posture during prolonged sitting).
    • Symptoms are typically resolved with posture correction.
    • Special tests are only positive if the patient displays sustained forward-head postures. These tests may worsen the pain, but correcting posture relives the symptoms.

    Computer Ergonomics

    • Modifying computer workstations is crucial for cervical spine and postural syndromes.
    • Recommendations include adjusting chair features, screen position, keyboard, mouse, and work breaks.

    Cervical Spine Flexion Dysfunction

    • Flexion dysfunction is the loss of cervical flexion range of motion, often occurring insidiously after posterior derangement.
    • Usually only reports neck pain, without peripheralization, so there is no referred upper-extremity pain.
    • The Cervical Hyperflexion Test may also be positive.
    • Treatment focuses on exercises to restore flexion along with general care for other conditions.

    Cervical Spine Extension Dysfunction

    • This occurs insidiously, following anterior derangement or facet dysfunction.
    • Symptoms are similar to flexion dysfunction, but typically less common.
    • Treatment utilizes specific exercises, such as retractions and extensions.

    Cervical Spine Adherent Nerve Root (ANR)

    • ANRs are associated with prior surgical procedures or traumatic neck injuries
    • Symptoms include: radiating pain, and loss of flexion range of motion.
    • Neurodynamic exercises (i.e. median nerve, radial nerve, and/or ulnar nerve) are indicated for treating ANRs.

    Cervical Spine Entrapped Nerve Root (ENR)

    • ENRs are insidiously associated with whiplash or facet injuries.
    • Symptoms involve radiating pain along the nerve's dermatome and loss of extension range of motion.
    • Special tests and specific exercises (i.e. flexion exercises, and various side-bending and spinal rotation exercises) are indicated for treating ENRs.

    Cervical Spine Facet Syndrome

    • Facet dysfunction is associated with insidious onset due to poor posture, poor sleeping positions, or repetitive movements (especially in the workplace).
    • Treatment typically uses specific exercises and modalities depending on the type of restriction (e.g., retraction for end-range movements).

    Cervical Spine Stenosis

    • A less common condition than lumbar spine stenosis.

    • Primarily results from repeated traumatic injuries

    • Testing and stretching should be included in the treatment plans for stenosis.

    • More specific testing is part of the diagnosis.

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    Related Documents

    Cervical Spine Treatment Notes PDF

    Description

    Test your knowledge on the treatment steps for cervical spine posterior derangements. This quiz covers key aspects such as the order of treatment actions, patient education, and special tests related to cervical dysfunctions. Ideal for those studying physical therapy or chiropractic care.

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