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20 Cards in this Set
- Front
- Back
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Explain how the atlas and axis are atypical cervical segments
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atlas has no vertebral body (rotates around dens)
• vertebral body of C2 extends superiorly to form dens (odontoid process) |
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What is main motion of OA joint?
Explain the motion of the occiput |
flexion and extension,
occiput rotates and sidebends to opposite sides |
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What is the primary motion of the atlantoaxial joint?
Where does it rotate? |
Main motion is rotation,
rotates around the dens |
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Compare paired motion of C2 through C7 to C1
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C2-7 rotates and sidebend to same side some sometimes opposite, whereas C1 is supposed to go opposite sides
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For High velocity low amplitude movement (HVLA) what type of movemtns do you do for the AA joint and OA joint?
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AA- rotate opposite, OA thrust twds eyes
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What type of patints would HVLA of vervical spine be contraindicated?
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1. RA (rheumatoid arthritis)- weak odontoid ligament is susceptible to rupture,
2. Downs Syndrome- different odontoid, 3. Peripheral vascular disease, 4. Osteoporosis, 5. Pts on anticoagulants |
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Name the most frequent serious complications from HVLA to c-spine and most frequent cause
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Most often due to rotation was already extended, movement could occlude and artery-
1. Occipitobasilar strokes (Wallenberg Syndrome), 2. Vertebral artery compression with thrombosis, 3. arterial dissections, 4. cerebral infarctions |
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What is Whiplash and how is it viewed by osteopaths?
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acute hyperflexion-hyperextension injuries in cervical spine with speeds as slow as 7 mph,
These are seen as insult to body (due to resistance of movement of the head vs tendency of body to keep moving forward) |
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What is the main type of neck injury vector associated with whiplash and why?
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hyperextension usually causes greater injuries due to neck tightening and lack of restriction to extension motion
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What are the types of tissues susceptible to injury?
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superficial soft tissues, anterior superficial soft tissues, posterior superficial soft tissues, vertebral complex, peripheral nerves, sympathetic nerves, vascular, cerebrum
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What is often the first muscle to become injured in whiplash and what could it develop into?
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(SCM) sternocleiomastoid and could become torticollis
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At what stage would you use HVLA?
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Early chronic stage (1 week to 1 month) can begin with lumbar and thoracic but no HVLA with the cervical region until late chronic stage (1-3 months)
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What is torticollis?
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aka Loxia, Wryneck- spasm of the sternocleidomastoid muscle causing a rotational tilting of the neck… (can have congenital or adult)
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Klippel-feil syndrome
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• fusion of 2 or more cervical vert
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What is treatment for toricollis?
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Must first image it with c-spine xray to r/o bony problems (such as Klippel-feil syndrome)-
Treatment first stretching with 10 second holds and 15 reps, (in congenital refer to a surgeon if no response in 1-2 months), For adults- 1. OMT- indirect tx and muscle energy, 2. PT, 3. Botox if the above dont work... meds (antichoinergics, benzodiazepines, muscle relaxants) 4. surgery- muscle resection or nerve ablation |
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What should a doctor recommend for a severe injury of whiplast for the first few days?
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1-3 days of bedrest with passive exercises in bed to avoid tissue atrophy
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How might the Sternocleidomastoid feel in congenital torticollis?
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congenital torticollis, SCM may feel ropy, and may feel ‘olive’ type structure within the SCM
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What should first type of treatment be for whiplash?
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Minimize edema development and tissue reaction,
- GENTLE indirect treatment around areas adjacent to the injured tissues, - Treat the cranium and sacrum to restore motion, - Lymphatic drainage |
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What is the OA and AA joint?
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OA- occipital atlantal joint is motion of occipital condyles on atlas (C1). It takes care of 50% of flexion and extension of the C-spine
AA- atlantal-axial joint is motion of C1 on C2 and 50% of C-spine rotation occurs there. |
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If I say "AA is rotated right" what does that mean?
For OA and AA where does side bending and rotation occur? |
atlas (C1) is rotated right on axis (C2)
- occur on opposite sides (usually type 1 but it is modified type one rules) |
