Evaluating and Treating Chronic Neck Pain

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Evaluating and Treating Chronic Neck Pain

Question 1:

Who first came up with the term Fibrositis?

A) Dr. William Gowers

B) Dr. Kellgren

C) Dr. Travell

D) Dr. Simons

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Evaluating and Treating Chronic Neck Pain

Question 2:

When was the first (recorded) massage school founded in China?

A) 439 AD

B) 581 AD

C) 633 AD

D) 707 AD

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Evaluating and Treating Chronic Neck Pain

Question 3:

At what week of fetal development are the 'proto bones', ligaments, and muscles in place?

A) 5

B) 7

C) 9

D) 12

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Evaluating and Treating Chronic Neck Pain

Question 4:

Which one of these is NOT a characteristic of a Trigger Point?

A) Pain, often exquisite, is present at a discrete point

B) A nodule is embedded within a taut band in the muscle

C) Pressure reproduces the pain symptoms, with radiations in a specific and reproducible distribution (map) - often remote from the pressure point

D) Pain in the distribution of a dermatome

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Evaluating and Treating Chronic Neck Pain

Question 5:

Trigger Points make the host muscle shorter and fatter and reduce its mechanical efficiency

A) True

B) False

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Evaluating and Treating Chronic Neck Pain

Question 6:

What is the 'defining symptom' when a trigger point is pressed?

A) Local Pain

B) Referred Pain Map

C) Tingling

D) Loss of sensation

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Evaluating and Treating Chronic Neck Pain

Question 7:

What is the name of the main chemical that activates the electrical voltage across the 'synaptic cleft' of the nerve synapse?

A) Acetylcholine

B) Noradrenaline

C) Nicotine

D) Sodium

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Evaluating and Treating Chronic Neck Pain

Question 8:

What does the Latin word "Myo-" mean?

A) Bone

B) Hair

C) Tooth

D) Muscle

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Evaluating and Treating Chronic Neck Pain

Question 9:

A multipennate muscle may have several trigger points at the same time.

A) True

B) False

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Evaluating and Treating Chronic Neck Pain

Question 10:

Which of the following possible mechanisms put forward by Dommerholt for trigger point genesis is NOT correct?

A) Low-level muscle contractions

B) Uneven intramuscular pressure distribution

C) Direct trauma

D) Tendon under-loading

E) Unaccustomed eccentric contractions

F) Eccentric contractions in unconditioned muscle

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Evaluating and Treating Chronic Neck Pain

Question 11:

Which of the following chemicals was NOT present in a trigger point milieu as analysed by Shah et al. (2003)?

A) Prostaglandins

B) Substance P

C) Cytokines

D) Bradykinin (BK)

E) Sodium Chloride

F) Hydrogen (H+)

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Evaluating and Treating Chronic Neck Pain

Question 12:

What does LTR stand for?

A) Local Twitch Response

B) Loaded T-Cell receptor

C) Laminated Thoracic Receptor

D) Local Terminal Receptor

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Evaluating and Treating Chronic Neck Pain

Question 13:

Which of the following Autonomic Symptoms is NOT associated with trigger point activity?

A) Hypersalivation—increased saliva production

B) Epiphora—abnormal overflow of tears down the cheek

C) Conjunctivitis—reddening of the eyes

D) Ptosis—drooping of the eyelids

E) Blurring of vision

F) Inability to alter heart rate with exercise (exercise intolerance)

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Evaluating and Treating Chronic Neck Pain

Question 14:

What is the name of the chemical released from nociceptor terminals in Peripheral sensitization?

A) Substance A

B) Substance B

C) Substance P

D) Substance Z

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Evaluating and Treating Chronic Neck Pain

Question 15:

What is the name of the chemical shown to increase the sensitivity of receptors in the spinal cord during Central Sensitization?

A) Dopamine

B) Seratonin

C) N-Methyl-D-Aspirate (NMDA)

D) 5 Hydroxy-Triptamine (5HT)

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Evaluating and Treating Chronic Neck Pain

Question 16:

Which one of these tight muscles is NOT part of the upper crossed pattern (Janda 1996)?

A) Upper Trapezius

B) Levator Scapulae

C) Pectoralis

D) Serratus Anterior

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Evaluating and Treating Chronic Neck Pain

Question 17:

Which of the following postural structures commonly manifests trigger points?

A) Upper Trapezius

B) Levator Scapulae

C) Erector Spinae

D) Musculo-ligamentous apparatus of the lumbar spine

E) Gluteus Medius

F) All of the above

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Evaluating and Treating Chronic Neck Pain

Question 18:

Vitamin D deficiency is implicated in almost 90% of patients with chronic musculoskeletal pain.

A) True

B) False

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Evaluating and Treating Chronic Neck Pain

Question 19:

Iron deficiency may be implicated in chronic myofascial pain syndromes.

A) True

B) False

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Evaluating and Treating Chronic Neck Pain

Question 20:

What is the percentage of golgi tendon organs found in the muscle belly?

A) 10%

B) 50%

C) 70%

D) 90%

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Evaluating and Treating Chronic Neck Pain

Question 21:

What is the name given to the small fiber diameter sensory receptors in muscles (and in fascia)?

A) Interstitial muscle receptors

B) Pacini

C) Ruffini

D) Paciniform

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Evaluating and Treating Chronic Neck Pain

Question 22:

If the patient has ongoing neck pain 4 weeks after trauma - and has no neurological signs - which of the following is typically recommended?

A) No further investigation is recommended

B) X-Ray recommended

C) CT Scan is recommended

D) MRI is recommended

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Evaluating and Treating Chronic Neck Pain

Question 23:

Whiplash may be caused by which of the following?

A) Trauma

B) Infection

C) Age-Related Disc Degeneration

D) Bad Posture

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Evaluating and Treating Chronic Neck Pain

Question 24:

Chronic Neck Pain may often be associated with which of the following?

A) Bad Posture

B) Trigger Points

C) Vitamin Deficiency

D) A & B

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Evaluating and Treating Chronic Neck Pain

Question 25:

Which of the following are considered safe and effective treatments for addressing muscle trigger points related to neck pain?

A) Ischemic Pressure Techniques

B) Torsional Release Techniques

C) Ice and Heat

D) All of the above

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Evaluating and Treating Chronic Neck Pain

Question 26:

Which of the following are muscles of the neck?

A) Splenius Capitis

B) Sternocleidomastoid

C) Tibialis Anterior

D) A & B

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Evaluating and Treating Chronic Neck Pain

Question 27:

Trigger points in which of the following muscles may refer pain to the neck?

A) Trapezius

B) Levator Scapulae

C) Multifidi

D) All of the above

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Evaluating and Treating Chronic Neck Pain

Question 28:

Are neck gliding generally considered a safe and effective way to manipulate neck joints?

A) True

B) False

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Evaluating and Treating Chronic Neck Pain

Question 29:

Trigger points that cause neck pain may also be associated with which of these other symptoms?

A) Stiffness (Limited Range of Movement in the neck and shoulders)

B) Headache

C) Vertigo

D) All of the above

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Evaluating and Treating Chronic Neck Pain

Question 30:

Which of the following can inflammation or a pinched nerve cause?

A) Neck pain

B) Shoulder pain

C) Headaches

D) All of the above

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