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Tch 6508 midterms
| Question | Answer |
|---|---|
| what is the proportion of the nucleus to the entire disc in the c-spine vs lspine? | nucleus is smaller in proportion to the entire disc in the cspine than in the lspine |
| in ___years the mucoid tissue of nucleus is replaced with ___ which arises from ____ of the ____ | in TEEN years the mucoid tissue of the nucleus is rplaced with FIRBOCARTILAGE arising from the HYALINE CARTILAGE of the VERTEBRAL END PLATE |
| by age 40 the nucleus is ___ & ___ and composed of what? with little or no what? | by age 40 the nucleus is dry and ligamentous, and composed of fibrocartilage, islands of hylanine cartialge, and tendon-like materials, with little or no proteoglycans |
| What may cause radicular-like sx in the cspine? | after loss of disc ht, unicnate processes approximate & result in degen which can form osteophytes which project into the disc space or ivf |
| What do uncinate processes limit and guide? | they limit pure lat flexion they are guides to couple lat flexion with rotation |
| from c3-c7, what is the coupling? | lat flex and ipsi rotation |
| true synovial joints are richly innervated with what./ | nociceptive nerve fibers |
| what has been the main source of pain in pts with chronic neck pain? | the facet joints |
| what is the causal theory of acute torticollis? | from a meniscoid entrapments, together with acute mm spasm |
| What is the best way to adjust acute torticollis and why? | adjsuting into the direction of fixation bc it may gap the joint and release the meniscoid without jamming the joint. |
| disc protrusion is with nuc pulpsos penetrating ____, but ____ | disc protrusion with nuc pulposus penetrating asymmetrically thru annular fibers, but confined within the annular margin |
| with disc extrusion, nuc,. pulposus goes? | goes beyond the annular margin |
| radiculopathy is not the same as what? | as pain radiating into the extremities |
| what is radiculopathy defined as? | presence of sensory, motor, or reflex abnormalities in the affected nerve root |
| what is myelopathy? | spinal cord dysfunction |
| what complications are typically seen with myelopathies? | finger numbness, clumsiness, difficulty walking due to spasticity and loss of position sense |
| in more severe cases of myelopathy what may occur? | bowel and bladder control dysfunction |
| upon examination what do pts with myelopathy present with? | long-tract signs such as hyperreflexos and clonus |
| what can cause myelopathy? | severe stenosis of spinal canal due to bony encroachment |
| When a patient presents with signs and symptoms of significant and/or progressive myelopathy what must happen? | urgent surgical decompression of the spinal cord or nerve roots may be indicated. |
| A chronic degenerative condition of the cervical spine that can affect the vertebral bodies, the IVD, the facet joints, longitudinal ligaments, and/or ligamentum flavum | cervical spondylosis |
| Degenerative arthritis (osteoarthritis) of the vertebrae and related tissues | Spondylosis def |
| Inflammation of vertebrae (ex.-spinal tuberculos | Spondylitis def |
| Breaking down of a vertebral structure (ex. pars interarticularis). | Spondylolysis |
| Forward slippage of a vertebra due to a spondylolysis. | Spondylolisthesis |
| clay shovelers fx mechanism? and type of fx | hyperflexion injury, usually oblique or vertical |
| Cervical Hyperflexion Compression Fracture with dislocation can lead to? | Can damage the spinal cord at that level, and lead to paralysis or death |
| C0 articulations (condyles) are ___? | convex |
| C1 superior facets are _____? | concave |
| Both articular surfaces between C1-C2 are ____allowing for considerable mobility in rotation | convex |
| what are the mms of the suboccipital triangle | obliques capitis inferior obliques capitis superior rectus capitis posterior major |
| what is the princple movt of c0/c1? | ext and flex |
| During flexion occipital condyles move _____, and c0/c1 ___ | the occipital condyles glide postreior and superior and c0/c1 separate |
| c0/c1 axial rotation and lat flexion is @ end range @ _____ degrees to each side | 4-8 degrees |
| c0/c1 rottation is couple with? | with small amount of OPPOSITE side lat flexion |
| Lat flex of c0/c1 is associated with ___ (___ direction of LF) and ____ (___ direction of LF) | lat flex of c0/c1 is associated with roll (same direction as LF) and slide (opp direction LF) |
| what is the primary movt of c1/c2? | rotation 40 degrees to each side |
| rotation @ c1/c2 accounts for ___% of all cerv rotation | 50 |
| @ c1/c2 flex/ext occurs as a ___ movement due to ____facet surfaces, and is associated with forward and backward translation of __mm in adult | occurs as a rocker movement due to bioconvex facet surfaces, associated with forward and backward trasnlation of 2mm in adult |
| C1/C2 lat flexion is __ degrees each side and is coupled with ___ to the same side | 5 degrees each side and is coupled with translation to the same side |
| AS occiput | bilat. extension malposition bilat. flexion restriction |
| PS occiput | bilat flex malpos biltat extension restriction |
| AS-RS occiput | ext malpositon, left lat flex malposition flex restriction, right lat flex restriction |
| AS-RS-RP | ext malpositon, left lat flex malposition, right rotation malposition flex restriction, right lat flex restriction, left rotation restriction |
| AS-RS-RA | ext malpositon, left lat flex malpositon, left rotation malposition flex restriction, right lat flex restriction, right rot restriction |
| PS-LS | flex malposition, right lat flex malposition ext restriction, left lat flex restriction |
| PS-LS-LP | flex malpositon, rt lat flex malposition, left rotation malposition extension restriction, left lat flex restriction, right rotation restriction |
| PS-LS-LA | flex malposition, right lat flex malposition, rt rot malposition ext restriction, right lat flex restriction, left rot restriction |
| static model for C1/C2 is used in? | HIO or Toggle Recoil technique, HVLA thrusting done on an “unloaded” joint in side posture |
| static c1/c2 listings always start with __ for ? | A for atlas |
| ASR | left lat. flexion malp. right lat. flex. restriction |
| ASL | right lat. flex. malp. left lat. flex. restriction |
| ASRP | left lat. flex. malp. right rotation malp right lateral flexion rest. left rotation restriction |
| ASLA | right lat. flex. malp. right rotation malp. left lat. flexion restriction left rotation restriction |
| define dissetion | partial tearing of the inner artery wall (the intima). |
| what can a dissection cause? | expanding hematoma or thrombus in the vessel wall of the vertebral artery. |
| What can a hematoma do? | The hematoma may seal off The hematoma may expand to completely occlude The hematoma may disrupt blood flow and form emboli |
| what may a subadvential dissection do? | may rupture through the adventitia, resulting in subarachnoid hemorrhage |
| what ct disorders put ppl @ a risk for vba? | Vascular-Type Ehlers-Danlos syndrome (EDS type IV) Marfan’s Syndrome Osteogenesis Imperfecta Type I |
| what are two other risks for vbas? | Possible Infectious Cause (Recent URI) Elevated Homocystine Levels |
| Mech of VBA: ____stress, with lack of association of ___ stress therefore it is a _____ | trivial stress, with a lack of significant stress, therefore it is a multifactoral etiology |
| inheritable disorder characterized by weakened linings of the walls of blood vessels and the intestine. | ehlers danlos type IV |
| EDS tpye IV is assoicated with minimal what? | minimal skin and joint hyperextensibility, but is associated with a notable tendency toward easy bruising. |
| what can lead to death in EDS IV? | Spontaneous rupture of arteries and bowel can lead |
| describe the skin in eds IV? and where is it most apparent? | The skin is usually thin and translucent with veins being seen through the skin. This is most apparent over the chest and abdomen. |
| Joint hypermobility is usually limited to the ? in eds IV | digits |
| what rupture can happen in eds Iv? | Tendon and muscle rupture can occur |
| facial features of EDS IV? | including large eyes, thin nose, lobeless ears, short stature and thin scalp hair. Also evident is a decrease in subcutaneous tissue, particularly in the face and extremities. |
| minor trauma in eds iv can lead to? | extensive briusing |
| how is eds IV inherited? | autosomnal dominant or recessive |
| Generalized disorder of connective tissue with skeletal, ocular and cardiovascular manifestations | marfans |
| marfans fingers? | long, thin and hyperextensible fingers |
| OI face? | triangular |
| OI has tendency towards? | spinal curvature |
| what happens in OI in 20s-30s | possible hearing loss |
| OI and collagen? | strcture normal, but decreased |
| what else is a possible risk of vbas? | infectious trigger, some resp tract infections in 1 case study was a risk factors |
| have vbas increased or decreased over the yrs? | increased |
| vba strokes usually present as ____ injuries such as? | brainstem, such as severe naseau and vomiting, vis problems and vertigo |
| what syndrome can strokes of posterior circulation result in and what are sx? | Wallenberg’s syndrome, where there is loss of pain and temperature of the face on the ipsilateral side of the lesion, and of the body on the contralateral side. |
| what is the worst case of vba | locked in syndrome, aka the corpse with living eyes |
| Every reliable published study estimating the incidence of stroke from cervical manipulation agrees that the risk is? | < 1-3 incidents per million treatments, and about one incident per 100,000 patients who are being treated with a course of care of cervical CMT |
| a potenital warning sign is the sudden onset of what? | pain in the side of neck, head, occipitals, esp if different than any pain had before, and absence of musculoskel pain source |
| with dizziness what can be done to potentially see if you should adjust the pt or not | if neck rotation and extension aggravate the dizziness, maybe a vasc problem, or if any other red flags are present, but there is no definitive test |
| when in doubt to adjust a pt with dizziness what can be done? | treat the neck with other non-manipulative conservative methods such as soft tissue massage, physiological therapeutics, or non-force chiropractic techniques |
| defintion of malpractice | An act or continuing conduct of a professional which does not meet the standard of professional competence and results in provable damages to his/her client or patient. |
| malpractice is a tort, what does tort mean? | a legal claim between two or more individuals |
| malpractice is not a ____ act | not a criminal act, tried under criminal law |
| criminal law def | beyond a resonable doubt |
| civil law def | A preponderance of evidence |
| To have a successful malpractice claim, the patient (plaintiff) must prove the following were present at the time of an injury?? and if any mssing? | 1. Doctor-Patient relationship 2. Duty 3. Dereliction of Duty 4. Direct Causation 5. Damage If any one of these elements is absent, the doctor (defendant) will prevail in litigation |
| doc-pt refers to the fact that what arrangement has been made bw doc and pt? | a contractual arrangement |
| elements needed to form a contract | 1. both parties are competent 2. offer made by one of parties 3.ACCEPTANCE by other 4.MEETINGS OF THE MINDS of the 2 parties 5. each party must pay CONSIDERATION, something of VALUE is exchanged ( not always $) |
Created by:
margaretrhager
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