Chapter 014 the Balancing Act: Structural Perspectives of the Head and Neck

Chapter 014 The Balancing Act: Structural Perspectives of the Head and Neck...

True / False Questions

1.The average head weighs about 15-20 pounds.
TrueFalse

2.Bilaterally the trapezius works to perform flexion of the head on the neck.
TrueFalse

3.The semispinalis capitis and cervicis are postural supports for the head.
TrueFalse

4.The suboccipitals are little muscles and not important at all as a group.
TrueFalse

5.The occipitofrontalis muscle is a combination of the occipitalis and the frontalis muscles.
TrueFalse

6.Whiplash is an injury resulting from a sudden impact that causes a violent hyperextension of the head and neck followed by hyperflexion and perhaps an additional hyperextension.
TrueFalse

7.A torticollis is a condition that is another name for a simple stiff neck.
TrueFalse

8.A headache is defined as a diffuse pain in various areas of the head where the pain is not confined to the distribution of a nerve.
TrueFalse

9.All headaches are caused my muscle pain.
TrueFalse

10.The suboccipitals can entrap the brachial plexus.
TrueFalse

Multiple Choice Questions

11.A condition that may cause numbness, pain, and tingling on the back of the head is called ______.
A.temporomandibular joint syndrome
B.occipital nerve entrapment
C.torticollis
D.brachial plexus entrapment

12.If a client presents with a headache and high blood pressure the therapist should
A.give a shorter treatment to the client.
B.have the client fill out many forms.
C.refer the client to the appropriate health professional.
D.give the client a regular supine and prone treatment.

13.When a client has a tension headache, the therapist should start the client in the ______position.
A.supine
B.prone
C.side-lying
D.seated only

14.The trapezius opposes the action of ______bilaterally.
A.lateral flexion
B.rotation
C.extension
D.flexion

15.The trapezius is a prominent superficial muscle and therefore should be treated ______in a protocol of the head and neck.
A.last
B.second
C.first
D.not at all

16.The levator scapulae is usually involved in stiff neck issues and may also be involved in subluxations as it attaches to the ______.
A.spinous processes of C1-3
B.transverse processes of C1-C4
C.atlas
D.the body of the vertebrae of C1-3

17.The splenius capitis and cervicis oppose the sternocleidomastoid in ______.
A.extension
B.lateral flexion
C.flexion
D.rotation

18.The splenius capitis and cervicis work as synergists with the sternocleidomastoid to perform ______.
A.lateral flexion
B.extension
C.flexion
D.hyperextension

19.Muscles that are heavily involved in whiplash injuries are the ______and ______.
A.rhomboids; serratus anterior muscles
B.splenius capitis; cervicis muscles
C.serratus anterior; pectoralis minor muscles
D.quadratus lumborum; rhomboids muscles

20.The three muscles layered at the mastoid process are the splenius capitis, sternocleidomastoid, and the ______.
A.splenius cervicis
B.semispinalis capitis
C.trapezius
D.longissimus capitis

21.The large muscle that supports the trapezius beneath it is called the ______.
A.splenius capitis
B.rectus capitis posterior minor
C.semispinalis capitis
D.splenius cervicis

22.The rotatores and multifidi are deep ______muscles.
A.paraspinal
B.shoulder girdle
C.shoulder joint
D.lumbar

23.The ______lifts the brow and wrinkles the forehead.
A.occipitalis
B.frontalis
C.trapezius
D.temporalis

24.The muscle that is shaped like a shell and is often involved in TMJ syndrome is called the ______.
A.frontalis
B.occipitalis
C.masseter
D.temporalis

25.A little known fact about the sternocleidomastoid is that because it attaches laterally at the mastoid process it is capable of performing ______bilaterally at the atlanto-occipital joint.
A.extension
B.flexion
C.lateral flexion
D.rotation

Fill in the Blank Questions

26.Therapists should ______and ______the head to passively shorten the sternocleidomastoid to treat it.
______

27.Whiplash victims must have emergency care to rule out ______, ______, and ______.
______

28.After medical care for whiplash victims conservative modalities might include ______, ______, ______, and ______.
______

29.Another name for torticollis is ______.
______

30.Torticollis can be caused by infection ______or can be ______.
______

31.The two categories for the 13 classifications for headaches from the International Headache Society are called the ______and ______categories.
______

32.Massage therapy given between headache episodes has been proven by the Touch Research Institute to ______, ______, and ______.
______

33.The term stiff neck is a catchall for ______in neck movements.
______

34.The muscles involved in occipital nerve entrapment would likely be the ______and the ______muscles.
______

35.The scalenes are ______of the cervical spine and anterior neck.
______

36.Clients that complain of nausea, vomiting, and unilateral pain in the head may have a particular type of headache called the ______.
______

37.The upper and lower trapezius performs elevation and depression respectively and are therefore categorized as its own ______and ______.
______

38.The muscles attached to the occipital ridge that the therapist might treat with circular friction could include ______, ______, ______, and ______.
______

39.When the therapist draws his hands superiorly from the mid-thoracic region of the client to the occipital ridge, he is most likely stretching the fibers of the ______.
______

40.The first spinous process that you can palpate on the back of the neck is ______.
______

41.Deep to the trapezius and to the semispinalis capitis is the ______, which spans from the occiput to the spinous process of C1.
______

42.The suboccipital that connects the transverse process of C1 to the spinous process of C2 is the ______.
______

43.The therapist must be really careful when treating the scalenes because of the proximity of the ______.
______

44.Techniques that can be applied to the sternocleidomastoid in a shortened position include ______, ______, and ______.
______

45.The alternating-hands neck stretch ______the fibers of the soft tissue parallel to the cervical spine.
______

46.Treating a client who is experiencing a migraine at the time of treatment is ______.
______

47.A(n) ______is a useful tool for clients who suffer headaches to track them.
______

48.The primary category for headaches includes the classifications of ______, ______, and ______headaches.
______

49.The head actually weighs ______when it is in a head-forward posture.
______

50.Rounded shoulders may lead to a head-forward posture and put a lot of stress on the ______as a result.
______

14-1

Chapter 014 The Balancing Act: Structural Perspectives of the Head and Neck... Key

True / False Questions

1.The average head weighs about 15-20 pounds.
FALSE

The average head weighs between 10 and 13 pounds.

Bloom's: Knowledge
Difficulty: Easy
Learning Outcome: 14-4

2.Bilaterally the trapezius works to perform flexion of the head on the neck.
FALSE

Bilaterally the trapezius works to perform extension of the head on the neck.

Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 14-2
Learning Outcome: 14-3

3.The semispinalis capitis and cervicis are postural supports for the head.
TRUE

Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 14-3
Learning Outcome: 14-4

4.The suboccipitals are little muscles and not important at all as a group.
FALSE

The suboccipitals are superior cervical and occipital postural head supporters that provide extension bilaterally for the head, but also connect to C1 and C2 for rotation and lateral flexion. They are very important base muscles and are very connected to pathologies of the head and neck such as headaches.

Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 14-4
Learning Outcome: 14-5

5.The occipitofrontalis muscle is a combination of the occipitalis and the frontalis muscles.
TRUE

Bloom's: Application
Bloom's: Knowledge
Difficulty: Easy
Learning Outcome: 14-1
Learning Outcome: 14-2

6.Whiplash is an injury resulting from a sudden impact that causes a violent hyperextension of the head and neck followed by hyperflexion and perhaps an additional hyperextension.
TRUE

Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 14-1
Learning Outcome: 14-4

7.A torticollis is a condition that is another name for a simple stiff neck.
FALSE

It is a spasmodic contraction of neck muscles that is more severe than a simple stiff neck.

Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 14-1
Learning Outcome: 14-4

8.A headache is defined as a diffuse pain in various areas of the head where the pain is not confined to the distribution of a nerve.
TRUE

Bloom's: Application
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 14-1
Learning Outcome: 14-4

9.All headaches are caused my muscle pain.
FALSE

There are 13 known classifications for headaches that physicians use for diagnosis and there are many causes of headaches that have nothing to do with muscles or muscle pain.

Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 14-1
Learning Outcome: 14-4

10.The suboccipitals can entrap the brachial plexus.
FALSE

The suboccipitals are not stationed near the brachial plexus; the scalenes are known for entrapping the brachial plexus.

Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 14-1
Learning Outcome: 14-4

Multiple Choice Questions

The occipital nerve can be entrapped by the semispinalis capitis and subsequently the trapezius, which could cause numbness, pain, and tingling on the back of the head.

Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 14-1
Learning Outcome: 14-4

The unknown quantity of high blood pressure presents another undiagnosed condition with a symptom of a headache. The possibilities of complications of a more serious problem are only up to a physician to diagnose.

Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 14-1
Learning Outcome: 14-4
Learning Outcome: 14-5

13.When a client has a tension headache, the therapist should start the client in the ______position.
A.supine
B.prone
C.side-lying
D.seated only

The client should not be placed prone when experiencing a headache. The supine position allows access to the head and neck muscles and maximum relaxation.

Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 14-1
Learning Outcome: 14-4
Learning Outcome: 14-5

14.The trapezius opposes the action of ______bilaterally.
A.lateral flexion
B.rotation
C.extension
D.flexion

The trapezius performs extension bilaterally so would be an antagonist to flexion.

Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 14-3

15.The trapezius is a prominent superficial muscle and therefore should be treated ______in a protocol of the head and neck.
A.last
B.second
C.first
D.not at all

The shoulder girdle muscles should be treated first in a sequence of working the head and neck muscles. The trapezius is particularly superficial and houses much tension.

Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 14-5
Learning Outcome: 14-7
Learning Outcome: 14-9

As the muscle shortens it pulls on the vertebrae and C1 and C2 are the pivot joints, which make them particularly vulnerable.

Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 14-2
Learning Outcome: 14-4

17.The splenius capitis and cervicis oppose the sternocleidomastoid in ______.
A.extension
B.lateral flexion
C.flexion
D.rotation

The splenius capitis and cervicis perform extension bilaterally so oppose the SCM in flexion.

Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 14-3

18.The splenius capitis and cervicis work as synergists with the sternocleidomastoid to perform ______.
A.lateral flexion
B.extension
C.flexion
D.hyperextension

All three muscles do same side lateral flexion and are therefore synergists.

Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 14-3

The splenius capitis and cervicis are unique as they can act bilaterally, unilaterally, and independently of each other. They are prevalent in whiplash injuries.

Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 14-2
Learning Outcome: 14-3
Learning Outcome: 14-4
Learning Outcome: 14-5

20.The three muscles layered at the mastoid process are the splenius capitis, sternocleidomastoid, and the ______.
A.splenius cervicis
B.semispinalis capitis
C.trapezius
D.longissimus capitis

The longissimus capitis is deep to the splenius capitis and SCM.

Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 14-2
Learning Outcome: 14-7

21.The large muscle that supports the trapezius beneath it is called the ______.
A.splenius capitis
B.rectus capitis posterior minor
C.semispinalis capitis
D.splenius cervicis

Deep to the trapezius is the semispinalis capitis that provides a cushioning support for the trapezius.

Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 14-2
Learning Outcome: 14-3

22.The rotatores and multifidi are deep ______muscles.
A.paraspinal
B.shoulder girdle
C.shoulder joint
D.lumbar

These muscles are nestled deep next to the spine located on the full length of the spinal column.

Bloom's: Knowledge
Difficulty: Easy
Learning Outcome: 14-2
Learning Outcome: 14-3

23.The ______lifts the brow and wrinkles the forehead.
A.occipitalis
B.frontalis
C.trapezius
D.temporalis

The frontalis lifts the brow and wrinkles the forehead. No other muscle in the list is in the line of pull to perform the action.

Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 14-2
Learning Outcome: 14-3

24.The muscle that is shaped like a shell and is often involved in TMJ syndrome is called the ______.
A.frontalis
B.occipitalis
C.masseter
D.temporalis

The temporalis is shaped like a shell and strategically placed on the side of the head to attach to the mandible making it often involved in TMJ syndrome.

Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 14-2
Learning Outcome: 14-4
Learning Outcome: 14-5

The position of the muscle bilaterally gives it this ability and adds to the dimensional quality of the muscle.

Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Hard
Difficulty: Medium
Learning Outcome: 14-2
Learning Outcome: 14-3

Fill in the Blank Questions

26.Therapists should ______and ______the head to passively shorten the sternocleidomastoid to treat it.
flex; laterally flex

Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 14-5
Learning Outcome: 14-7

27.Whiplash victims must have emergency care to rule out ______, ______, and ______.
fractures; concussions; damage to the spinal cord

Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 14-4

28.After medical care for whiplash victims conservative modalities might include ______, ______, ______, and ______.
massage therapy; physical therapy; chiropractic; acupuncture

Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 14-4

29.Another name for torticollis is ______.
wry neck

Bloom's: Knowledge
Difficulty: Easy
Learning Outcome: 14-4

30.Torticollis can be caused by infection ______or can be ______.
central nervous system disorder; congenital

Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 14-4

31.The two categories for the 13 classifications for headaches from the International Headache Society are called the ______and ______categories.
primary; secondary

Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 14-4

32.Massage therapy given between headache episodes has been proven by the Touch Research Institute to ______, ______, and ______.
(Give three.) reduce the number of headaches; decrease pain intensity; lower stress hormone levels; increase regular sleep patterns; increase serotonin levels

Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 14-4

33.The term stiff neck is a catchall for ______in neck movements.
limitations

Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 14-4

34.The muscles involved in occipital nerve entrapment would likely be the ______and the ______muscles.
trapezius; semispinalis capitis

Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 14-4
Learning Outcome: 14-5

35.The scalenes are ______of the cervical spine and anterior neck.
stabilizers

Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 14-3
Learning Outcome: 14-4

36.Clients that complain of nausea, vomiting, and unilateral pain in the head may have a particular type of headache called the ______.
migraine

Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 14-4

37.The upper and lower trapezius performs elevation and depression respectively and are therefore categorized as its own ______and ______.
agonist; antagonist

Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 14-2
Learning Outcome: 14-3

38.The muscles attached to the occipital ridge that the therapist might treat with circular friction could include ______, ______, ______, and ______.
the trapezius; splenius capitis; longissimus capitis; sternocleidomastoid; semispinalis capitis; some suboccipitals; the occipitalis

Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Hard
Difficulty: Medium
Learning Outcome: 14-2
Learning Outcome: 14-7

39.When the therapist draws his hands superiorly from the mid-thoracic region of the client to the occipital ridge, he is most likely stretching the fibers of the ______.
trapezius.

Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Hard
Difficulty: Medium
Learning Outcome: 14-2
Learning Outcome: 14-7

40.The first spinous process that you can palpate on the back of the neck is ______.
C2

Bloom's: Application
Bloom's: Comprehension
Bloom's: Knowledge
Difficulty: Medium
Learning Outcome: 14-2
Learning Outcome: 14-7