| What is a whiplash injury?
What is a common way to get such an injury?
What body part is usually the most common place to recieve such an injury? | A __________ injury is an acceleration-decceleration injury.
These injuries frequently happen in motor vehicle accidents, or in contact sports.
Typically, this injury happens in the neck, and can effect any structure therein. Other common areas are the jaw, or anywhere on the spine or back muscles. |
| Describe the 5 grades of Whiplash injury, to the best of your ability. This is to check understanding. Answers in brackets are bonus. | Whiplash Classifications (very simplified; only DIFFERENCES will be listed):
Grade 1: Nearly zero issues (categories: motion, ligamentous, neurological)
Grade 2: Slight limitation only.
Grade 3: Slight-moderate (hematomas might be present from this grade upward)
Grade 4: Moderate-severe. Fracture or disc derangement is present (ligamenous rutpure from this grade onward is possible)
Grade 5: Severe. Requires surgical management or stabilization |
| What are the 3 types of Whiplash collisions, and what kind of impact does each indicate? | Type 1 collision; rear impact
Type 2 collision; side impact
Type 3 collision; front impact |
| What are the 4 PHASES of Whiplash recovery, plus their time periods? | • Stage 1; acute injury, inflammation phase, upto 72 hrs post accident
• Stage 2; subacute, repair phase, 72 hrs – 14 weeks
• Stage 3; remodelling phase, 14 weeks – 12 months or more
• Stage 4 chronic permanent |
| What is the name of the classification used in Canada (except Quebec) to classify Whiplash injuries?
If you are in the Province of Quebec, what classification does Quebec use? | Canada: Foreman & Croft Classification (F/C)
Quebec: Quebec task force classification (QTF)
Q: What are these classifications for? |
| True or false:
Deafness, TMJ Pain, Tinnitus, nausea are symptoms that can only develop *during* the "less subacute" stage of healing in a whipplash injury. | False. These symptoms can happen immediately with whiplash injury (usually developed within 72 hours of injury). This can be due to brain trauma, nerve damage and/or ligamentous damage, among other things. |
| True or false, nerve atrophy takes more than 72 hours to develop, after whiplash injury, if it's going to happen. | False. Nerve atrophy, if it will develop, will develop during acute stages of whiplash recovery (within 72 hours). |
| True or false: Neurological signs such as numbness & tingling are present with TOS or nerve root tractioning, during the first 2 weeks of whiplash injury healing. | True. |
| True or false:
In the late remodelling phase (near completely healed) of a whiplash, the longus capitus is likely in chronic spasm. Over time this spasm will flatten the
cervical spine lordosis, destabilising the vertebrae & exerting compression
on the cervical discs. | FALSE (trick question).
It is the Longus Coli that is more likely to flatten the lordotic curve, due to its insertion on more than twice as many spots on the cervical vertebra. |
| If the longus coli is in chronic spasm (tightness), and it is going to flatten the lordotic curve of the neck, what should you do about it? This is causing them cervical disc pain, and weakened their vertebra.
Currently, the patient is in the remodelling phase of their healing, OR this is an old injury that is causing them chronic issues. | You should work on gently increasing their range of motion, and strengthening the other muscles in the neck, to help the neck right itself. If it is indeed an old injury, also increase bloodflow to the area.
This will likely cause your patient to feel a little stiff or sore the next day. This is normal. If they have no edema during treatment, have them ice, then heat the sore area, if they feel discomfort the next day.
CONTRADICTION: Do not advise this if the patient has screws or wires in their neck. |
| Joint injuries from whiplash can over time lead to what kinds of joint conditions? | Degenerative disc disease or osteoarthritis of the cervical spine. |
| True or false:
Medical assistance should be sought with a grade 2 or higher whiplash, or if
neurological testing is positive. | True. |
| True or flase:
Medical assistance should be sought with a grade 3 or higher whiplash, but not needed for less severity. | False: Almost all grade +3 whiplash injuries have some neurological injury, and MUST RECIEVE OTHER MEDICAL ASSISTANCE. Neurological injury can also happen in Grade 2 whiplashes, meaning the question was false in more ways than one. |
| How do you test ligaments and muscles in a whiplash injury? | Stretches on the cardinal planes of motion, with the range that stretches the affected muscle tested LAST. |
| True or False:
When testing a whiplash injury, you shoud check the ROM on the effected muscle first. | False. The mainly affected muscle should be checked LAST. |
| Name 3 special whiplash tests/test types (these tests do not test "typical" damage sites, like your spine, but test for additional complications). For example, the "vertebral artery test". Name 3. | •The swallow test is used to differentiate between SCM trigger points and
other cervical pathologies.
• Deep tendon reflexes of bicep C5, brachioradialis C6 & tricep C7
• Dermatomes & myotomes tested C4-C8
• Upper limb tension tests
• Spurlings, cervical compression & distraction tests.
• Thoracic Outlet Syndrom (TOS) testing
• Temporomandibular Tests |
| What is the first test one should do before any whiplash test that tests the cervical spine via rotation, flexion or rotation?? | The "Vertebral artery test" is used to rule out any vertebral artery insufficiency
before performing any test that extends, sidebends & rotates the cervical spine. |
