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Test Bank for Williams' Basic Nutrition and Diet Therapy 16th Edition By Staci Nix McIntosh
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Test Bank for Williams' Basic Nutrition and Diet Therapy 16th Edition By Staci Nix McIntosh
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Test Bank for Williams' Basic Nutrition and DietTherapy 16th Edition By Staci Nix McIntosh
What is the main aim of doing a high velocity thrust? - ANSWER cause joint
cavitation that is accompanied by a crack sound
Will a high velocity thrust always produce a cracking sound? - ANSWER no - need
to educate pt on this
What does a high velocity thrust require for it to work? Why? - ANSWER spinal
locking in order to localize the forces and achieve cavitation at a specific level
How is spinal locking achieved? - ANSWER -facet apposition
-ligamentous myofascial tension
-combo of both
Principle of spinal locking - ANSWER position spine to localize the leverage or
force moment to one joint without placing undue strain on adjacent segments
What movements are coupled in spinal thrust? - ANSWER side bending and
rotation
Relationship of coupled motions and muscular activity - ANSWER coupled motion
occurs independently of muscular activity, but muscular activity might influence the
direction and magnitude of couple movement
What can influence coupled motion? - ANSWER -pain
-vertebral motion
-posture
-facet tropism (R and L facets shaped in different planes of motion, often L5-S1)
Type I movement coupled motion - ANSWER side bending and rotation occur in
opposite directions
Type 2 movement coupled motion - ANSWER side bending and rotation occur in
the same directions
How do you lock via facet apposition? - ANSWER spine placed in a position
opposite to that of normal coupling behavior
What is the facet apposition locking type at Co-C1? - ANSWER type 2 - same
direction
What is the facet apposition locking type at C1-C2? - ANSWER not applicable -
complex rotation
,What is the facet apposition locking type at C2-T4? - ANSWER type 1 - opposite
directions
What is the facet apposition locking type from T4-L5 in flexion? - ANSWER type 1 -
opposite
What is the facet apposition locking type from T4-L5 in neutral or extension? -
ANSWER type 2 - same
Most frequent injury associated with high velocity thrust - ANSWER -arterial
dissection or spasm
-lesions of brain stem
*no deaths attributed to manip by PT
3 classifications of complications via thrust - ANSWER -serious non reversible
impairment
-substantive reversible impairment
-transient impairment
What is included in serious non reversible impairment category? - ANSWER -death
-CVA
-spinal cord compression
-cauda equina syndrome
What is included in substantive reversible impairment category? - ANSWER -disc
herniation
-disc prolapse
-nerve root compression
-fracture
What is included in transient impairment category? - ANSWER -local
pain/discomfort
-headache
-tiredness
-radiating pain or discomfort
-paresthesia
-dizziness
-nausea
-hot skin
-fainting
Causes of complications from thrusts - ANSWER -incorrect patient selection
-poor technique
What would lead to incorrect patient selection for a thrust? - ANSWER -lack of dx
-lack of awareness of possible complications
-inadequate palpation assessment
-inappropriate/inadequate progression of forces through mob grades
-lack of patient consent
,What could constitute poor technique for a thrust? - ANSWER -excessive force
-excessive amplitude
-excessive leverage
-inappropriate combo of leverage
-incorrect plane of thrust
-poor pt positioning
-poor therapist positioning
-lack of pt feedback
Contraindications to spinal thrust - ANSWER -bony issues --> that can lead to bone
compromise
-neurological issues
-vascular --> VBI, aortic aneurysm, bleeding diseases
-lack of dx
-lack of pt consent
Precautions to spinal thrust - ANSWER -adverse reaction to previous manual
therapy
-disc herniation or prolapse
-pregnancy
-spondylolisthesis
-psych dependence upon manip techniques
-ligamentous laxity
How to make doing a spinal thrust safer - ANSWER -appropriate training
-thorough pt history
-thorough physical exam
-clinical reasoning skills
-use graded mobs prior to application of manip
Factors related to lack of improvement from spinal thrust - ANSWER -longer
duration of sx
-no stiffness in L spine ROM
-negative Gaenslen's sign
-radiating sx
-little discrepancy in L/R hip IR
-generally reduced hip IR ROM
Clinical prediction rule for LBP spinal thrust short term improvement - ANSWER -
FABQ < 19
-duration of LBP <16 days
-no radiating sx
-at least 1 hypomobile segment
-at least 1 hip with > 35 deg IR
*need at least 4/5 criteria
Clinical prediction rule for thoracic spinal thrust for improvement in neck pain and
CAUTION - ANSWER -symptoms < 30 days
-no sx distal to shoulder
-looking up does not increase sx
, -FABQ < 12
-decreased upper thoracic kyphosis (T3-5)
-cervical extension < 30 deg
***not proven***
Evidence for cervical high velocity thrust compared to thoracic high velocity thrust -
ANSWER pt with neck pain who met CPR for thoracic thrust did better with cervical
thrust, and had fewer side effects
CPR for cervical spinal thrust for improvement in neck pain - ANSWER -sx <38
days
-low FABQ
-side to side difference in cervical rotation ROM of 10 deg or greater
-pain with PA testing of middle c spine
*at least 3/4
3 pathways of the peripheral nervous system - ANSWER -outflow/efferent = motor
-inflow/afferent = sensory
-regulatory = combo
What is the predominant motor sign of a lower motor neuron injury? - ANSWER
weakness
Other signs of LMN injury - ANSWER -dyskinesia (one or a pattern, distal vs.
proximal)
-decrease or absent DTR
-myalgias
Positive signs of issues with a sensory pathway - ANSWER -tingling
-burning
-temperature sensitivity
-allodynia (hyperalgesia)
-pain
Negative signs of issues with a sensory pathway - ANSWER -numbness
-proprioceptive loss
-ataxia
Signs of issues with a regulatory pathway - ANSWER -aberrations in vascular flow
-aberrations in skin moisture
-aberrations in hair growth
-trophic changes
-nail loss
-delayed wound healing
UMN injury: tone, DTR, muscle wasting, clonus, Babinski, sensory loss,
fasciculations, regulatory - ANSWER -increased or decreased tone
-increased or decreased DTR
-yes or no mm wasting
-possible clonus
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