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WorksheetsSSP517 - week six - Cx and Tx spine injury and pathology 2.
Total questions: 28
Worksheet time: 15mins
Which of the following nerve roots is most commonly the source of neck-related shoulder pain and cervical radiculopathy?
C2
C4
C6
C7
According to Dwyer et al (1990), to which area would a C5-6 cervical radiculopathy refer pain?
The green section
The blue section
The yellow section
The red section
The purple section
Which of the following applies to a potential aetiology for cervical radiculopathy? (Select ALL correct answers)
Cervical disc herniation
Intervertebral foramen stenosis
Tightening of the Scalene Triangle
Tightening of the Quadrilateral space
'Piriformis syndrome'
Which special test could be used to assist in the diagnosis of a cervical radiculopathy?
Spurling's test
The Stalk test
The CAD test
The Joint Position Error Sense test
The Sharp/blunt test
Which part of the intervertebral disc is gelatinous in texture?
The nucleus pulpsosus
The annulus fibrosus
Which of the following stages of disc-related injury is most serious?
Irritation of the annulus fibrosus
Disc bulge
Disc prolapse/herniation
Sequestrated nucleus pulposus
Which is the most commonly injured disc in the cervical spine?
C1-2
C3-4
C5-6
C6-7
According to Nakashima et al (2015), 'Disc bulging’ is present in what % of asymptomatic patients (n=1,211 age 20-70)?
87%
17%
37%
57%
According to Iyer (2016), most people with cervical disc herniation with radiculopathy experience substantial improvements within what time frame?
Within 4-6 months
Within 4-6 days
Within 4-6 weeks
Within 4-6 years
What word is given to headaches that stem from the cervical spine?
Cervicogenic headaches
Migraine headaches
Caffeine headaches
Cluster headaches
What word is given to the loss of height within the vertebral column?
Scoliosis
Stenosis
Spondylosis
Spondylolisthesis
Stenosis of which cervical vertebral foramen is likely to result in symptoms of Cervical Myelopathy?
Central Foramen
Intervertebral Forament
Transverse Foramen
Sacral Foramen
Which special tests could be used to detect a possible Cervical Myelopathy? (Select ALL correct answers)
Hoffman's
Babinski
CAD
JPSE
Gaze stabilisation
If an athlete or patient presents with clumsiness of the hands, bi-lateral worsening neurological symptoms, urinary retention, and an ataxic gait, which cervical injury or pathology might you suspect?
Non-specific idiopathic neck pain
Cervical radiculopathy
Cervical myelopathy
Cervical artery dysfunction
Cervicogenic headaches
Dizzyness, dysphagia, dysarthria, diplopia, and drop attacks are likely to be indicative of stenosis of which cervical foramen?
Central foramen
Transverse foramen
Intervertebral foramen
Foramen Magnum
A blood clot within the vertebral artery could result in symptoms of which red flag condition?
Cervical Myelopathy
Cauda Equina Syndrome
Upper cervical instability
Cervical Artery Dysfunction
Which red flag sign and symptom is missing from this table?
(a)
When would you NOT perform the CAD test in clinical practice?
On a Tuesday
When the patient or athlete reports subjective DNA symptoms
When the patient presents with neurogenic symptoms
When the patient or athlete reports a reduction in cervical range of motion
When you intend to perform cervical manual therapy into end of range rotation and/or extension
What stage is missing from this CAD testing procedure?
o Patient counts down out loud from ‘10-0’
o Patient closes their eyes
o Patient sits 90cm away from the wall
o Patient tells you when they can feel light touch
In which two medical conditions is the prevalence of upper cervical instability increased? (Select TWO correct answers)
Rheumatoid Arthritis
Multiple Sclerosis
Downs Syndrome
Parkinson's Disease
Diabetes
Upper cervical instability is the result of a rupture (traumatic, degenerative, or genetic) of which ligament?
The Transverse ligament
The Anterior Longitudinal ligament
The Ligamentum Llavum
The Supraspinous ligament
Fracture of which bony landmark could result in upper cervical instability?
The transverse process
The spinous process
The odontoid process
The coracoid process
The olecranon process
What would be your action plan if a patient or athlete presents with a combination of red flag signs and symptoms?
Send for urgent medical assessment
Trial some manual therapy
Perform the CAD test
Review in two weeks time
What are 'drop attacks'?
Fainting episodes
Mini heart attacks
A bout of clumsiness
A cause of neck pain
Which red flag symptom are you screening for if you ask;
"Has your walking been unbalanced or unsteady?"
Ataxia
Dysphagia
Nystagmus
Facial numbness
Nausea
Which red flag symptom are you screening for if you ask;
"Do you have any trouble with finding your words?"
Ataxia
Dysphagia
Nystagmus
Facial numbness
Dysarthria
Which red flag symptom are you screening for if you ask;
"Have you noticed any rapid flickering of your eyes?"
Ataxia
Dysphagia
Nystagmus
Facial numbness
Dysarthria
What treatment is an absolute contraindication if your suspect upper cervical instability?
Manual therapy (especially traction)
Soft tissue massage
Reassurance
Exercise advice
Retraining proprioception
