S200B&C Operator Certification Examination Lumbar & Cervical

Transcription

1 Please record your answers, on the Answer Sheet provided, at end of the exam. 1. How do you determine the amount of force needed to distract the lumbar herniated disc? Choose the one best answer. A. Based on patient s height B. Based on patient s weight C. Always a little more than the previous day D. Every patient starts at the same weight 2. Which patients should start a lumbar session pounds below one quarter their body weight. Choose ALL that apply. A. Elderly B. Acute injury and spasm C. Previous Surgery D. Nervous and anxious patients E. Sciatica patients 3. At what weight do we find lumbar mobilization of the joint space to occur? Choose the one best answer. A. One Quarter the body weight plus pounds for most patients. Exceptions are made for very thin and very large patients. B. Over 100 pounds for all patients. C. When the patient reports that they feel movement in the disc space. D. One quarter the body weight plus 25 pounds is a fixed rule for every patient. E. Keep raising the Maximum Tension until the patient reports feeling a good stretch. 4. What is the typical amount of increase, to the Maximum tension, for each lumbar session until the upper limit is attained? Choose the one best answer. A. 4-7 pounds B. 3-5 pounds C pounds D pounds 5. With regard to female patients: Choose the one best answer. A. Need less tension based on gender. B. Usually need less tension based on size and body mass. C. Are more nervous. D. Come more regularly for a session. 6. What conditions are contra-indicated for SpineMED? Choose ALL that apply. A. Recent surgery. B. Sciatica. C. Severe osteoporosis. D. Unstable skeletal conditions such as multiple surgeries and movement in fusions. E. Infection or tumor. F. Disc prolapse. 7. What statement best describes the action of the SpineMED? Choose the one best answer. A. The secret is in the computer inside the control Console. B. The SpineMED can pull harder than other conventional devices and give greater movement in the spine. C. Through patient positioning, degree and amount of applied force, the SpineMED gives greater mobilization of a spinal level with minimal stress and discomfort. D. The SpineMED is stretching the spine and pulling disc herniations back into place. E. The SpineMED gives the patient comfort and relaxation during the procedure. *Spinal Decompression that is, unloading due to non-surgical distraction and positioning. Page 1 of 7

2 8. Which two answers apply for the patient s first visit? A. Explain each step of the procedure fully to the patient. B. After the first few cycles, the patient is now experienced, and you do not need to be so attentive. C. We target a Maximum tension, but the first visit is always lower than this target tension. D. Have the patient remove their shoes. E. The first session should be half the session time (15-20 minutes). 9. How do you know the patient is getting a good distraction? Choose the one best answer. A. You do not know until after all the sessions are completed. B. The Maximum Tension must be one quarter the body weight plus 25 pounds. C. Observe the patient for comfort and relaxation while at an appropriate Maximum Tension. D. The angle of distraction must be set to the level of injury. 10. What is the most important factor for success? Choose the one best answer. A. The patient needs to be relaxed throughout each session. B. Keep increasing the Maximum Tension with each session. C. The patient must get as much bed rest as possible. D. Alter the session if no response is noted in the first 5 days of starting the procedure. 11. Why is patient relaxation so important? Choose the one best answer. A. They will not return if the procedure hurts. B. Relaxing the paraspinal muscles is key to good mobilization and the ensuing decompression* of the disc space. C. It allows you to distract with a higher Maximum Tension. D. The SpineMED is a placebo when in fact the problem is psychological. 12. The SpineMED is primarily a procedure for. Choose the one best answer. A. Post-surgical patients. B. Patients who cannot benefit with any other modality. C. Patients who complain of severe pain. D. Any lumbar or thoracic disc herniations. E. Lumbar pain related particularly to herniated and degenerated discs. 13. What is the purpose of the Infrared Heat Pad in the lumbar section of the SpineMED System? Choose the one best answer. A. To keep the patient warm on cool days. B. To heat the annulus of the disc, which promotes repair and patching of the fissures. C. To heat the paraspinal muscles and ligaments, to provide a more relaxed distraction. D. To heat and relax the patient to promote sleep during a session. 14. How many sessions are generally required before the patient improves? Choose the one best answer. A B C. It depends whether the patient is undergoing daily or weekly sessions. D. Every patient will vary depending on their injury. 15. How long is the duration of the decompression* phase of each cycle? Choose the one best answer. A. 30 seconds B. 60 seconds C. 45 seconds D. ½ of the total time of one cycle *Spinal Decompression that is, unloading due to non-surgical distraction and positioning. Page 2 of 7

3 16. How long is the duration of the relaxation phase of each cycle? Choose the one best answer. A. 60 seconds B. 45 seconds C. 30 seconds D. ½ of the total time of one cycle. 17. What is the total length of a session? Choose the one best answer. A. 45 minutes B. It depends on the time necessary for mobilization of the lumbar segment C. 60 minutes D. 30 minutes 18. What is the proper positioning of the patient on the Table prior to a session? Choose the one best answer. A. Patient should be in the prone position. B. Patient should be in the supine position. C. The patient s hips should be positioned over the split in the Table. D. The patient s abdomen should be over the upper Table section. 19. What are the most important steps in positioning the Pelvic Restraints? Choose the one best answer. A. The restraints should capture the buttocks and be tightened so that the patient will not slip through. B. The restraints should be positioned immediately above the Iliac Crests to secure the Pelvis. C. With the abdomen across the split in the Table, tighten the Pelvic Restraints to a comfortable fit. 20. How is the Upper Harness, properly positioned? Choose the one best answer. A. The Upper Harness should be positioned around the chest and tightened snugly. B. To secure the upper body, the Upper Harness should rest snugly under the armpits. C. Positioning should be just below the lower margin of the ribcage and tightened to prevent slipping. 21. What is the purpose of the Knee Support Cushion? Choose the one best answer. A. Provides minimal rotation of the hips for more efficient distraction and relaxation of the spine. B. To lift the weight of the legs from the Table surface and allow unrestricted movement of the lower Table section. C. It helps the patient relax. D. To stabilize the lower extremities. 22. Which two statements are true about patient positioning? A. The lower restraints should be snug against the Pelvis, positioned over the Iliac Crest. B. The Upper Harness should be comfortably positioned just below the lower rib margin. C. The patient should lift their legs to help you place the Knee Support Cushion. D. The positioning of the lower restraint is more important than the Upper Harness. 23. As you raise and bend the knees to position the Knee Support Cushion, what action is happening? Choose the one best answer. A. Increases lumbar scoliosis B. Rotates the hips to flatten the spine. C. Relaxes the hamstrings. D. Stretches the paraspinal muscles. 24. Where should the Patient Safety Switch, be placed during a session? Choose the one best answer. A. Across the patient s abdomen. B. In the patient s hand. C. Clip it to the Upper Harness. D. Wherever it can easily be accessed by the patient. *Spinal Decompression that is, unloading due to non-surgical distraction and positioning. Page 3 of 7

4 25. What is the purpose of the Patient Safety Switch? Choose ALL that apply. A. For any discomfort or pain experienced by the patient at anytime. B. For safety if you leave the room and the patient is left unattended. C. If the patient feels that the force is too high. D. It is only used when the therapist is busy. 26. What are the correct sequential steps for lumbar setup of a patient once they are lying on the SpineMED System? Choose the one best answer. A. 1. Adjust the patient s position on the Table to allow for proper Iliac Crests capture. 2. Insert the Pelvic Restraints into receivers and position patient so the Pelvic Restraints capture the Iliac Crests. 3. Tighten the Pelvic Restraints against the patient to comfortably secure the Pelvis to the Table. 4. Position and tighten Upper Harness Straps. 5. Position the Head Pillow beneath the patient s head. 6. Assist the patient with lifting their knees, and insert the Knee Support Cushion. 7. Inflate Air Bladder beneath patient s lumbar spine. 8. Place Patient Safety Switch in the patient s hand and instruct on use. 9. Set Pelvic Tilt treatment angle. 10. After the Pelvic Tilt has been set to the specific treatment angle, re-tighten both the Pelvic Restraints and the Upper Harness. B. 1. Adjust the patient s position on the Table to allow for proper Iliac Crests capture. 2. Position and tighten Upper Harness Straps. 3. Insert the Pelvic Restraints into receivers and position patient so the Pelvic Restraints capture the Iliac Crests. 4. Tighten the Pelvic Restraints against the patient to comfortably secure the Pelvis to the Table. 5. Assist the patient with lifting their knees, and insert the Knee Support Cushion. 6. Inflate Air Bladder beneath patient s lumbar spine. 7. Place Patient Safety Switch in the patient s hand and instruct on use. 8. Set Pelvic Tilt treatment angle. 9. After the Pelvic Tilt has been set to the specific treatment angle, re-tighten both the Pelvic Restraints and the Upper Harness. 10. Position the Head Pillow beneath the patient s head. C. 1. Adjust the patient s position on the Table to allow for proper Iliac Crests capture. 2. Position the Head Pillow beneath the patient s head. 3. Insert the Pelvic Restraints into receivers and position patient so the Pelvic Restraints capture the Iliac Crests. 4. Tighten the Pelvic Restraints against the patient to comfortably secure the Pelvis to the Table. 5. Position and tighten Upper Harness Straps. 6. Place Patient Safety Switch in the patient s hand and instruct on use. 7. Set Pelvic Tilt treatment angle. 8. Assist the patient with lifting their knees, and insert the Knee Support Cushion. 9. Inflate Air Bladder beneath patient s lumbar spine. 10. After the Pelvic Tilt has been set to the specific treatment angle, re-tighten both the Pelvic Restraints and the Upper Harness. 27. When do you set the lumbar angle of distraction? Choose the one best answer. A. Before positioning the patient. B. After positioning the patient, but before beginning a session. C. During a session when needed. D. Anytime. *Spinal Decompression that is, unloading due to non-surgical distraction and positioning. Page 4 of 7

5 28. If the Uninterruptible Power Supply/Battery Backup Unit (UPS) inside the Console is emitting an audible beep, this indicates: Choose ALL that apply. A. The SpineMED session has finished. B. The batteries are fully charged. C. The power to the Console has been interrupted and SpineMED is operating on battery power. D. The patient has pressed the Patient Safety Switch to stop the SpineMED session. E. The batteries inside the UPS/Battery Backup are defective or damaged. 29. During the session, with 15 minutes remaining, you notice that the Pelvic Restraints have moved down to the patient s upper thighs. You should. Choose the one best answer. A. Tighten the Pelvic Restraints against the patient to prevent any further slipping during a session. B. Stop the session, reposition the patient, and secure the Pelvic Restraints above the Iliac Crests more firmly. Resume the session with the remaining number of cycles before the interruption. C. Discontinue the session and resume on the next scheduled session. D. Stop session, reposition the patient, and resume the session with the Maximum Tension set 5 pounds lower. 30. What is the purpose of the ice therapy and interferential current? Choose the one best answer. A. To speed the healing of the annular fissures. B. To increase patient comfort after distraction. C. To cool spinal nerves. D. To reduce incidence of muscle spasm. 31. When should the patient wear an orthopedic lumbar support belt? Choose the one best answer. A. All through the complete program. B. Traveling to and from each session and also at work. C. When they experience increased pain. D. At night during sleep. 32. A patient reports that they experienced an ache in their lower back immediately above the sacrum for four hours after their last session. You should. Choose the one best answer. A. Leave the Maximum tension at the same value as the previous session. B. Increase the Maximum tension by only 3 pounds from the previous session. C. Lower the Maximum tension by at least 3 pounds from the previous session. D. Adjust the Maximum tension to the value administered on the most recent session that did not cause this particular discomfort for an extended period of time. 33. The starting tensions for a cervical patient s first session should be set at? Choose the one best answer. A. Ten pounds for women, and twelve pounds for males B. Eighteen pounds for men, and fourteen pounds for women. C. Four pounds for women, and five pounds for men. D. Eight pounds for men, and six pounds for women. 34. Tensions for cervical patients should be increased from the starting tension each day by? Choose the one best answer. A. Three to five pounds. B. Six to eight pounds. C. Three pounds for men, and two pounds for women. D. One to two pounds. *Spinal Decompression that is, unloading due to non-surgical distraction and positioning. Page 5 of 7

6 35. A cervical patient reports their neck has been sore for the past 24 hours since their last session. You should. Choose the one best answer. A. Increase the tensions by only 1 pound for this session. B. Maintain the same tensions as the previous session. C. Reduce the tensions by 1-3 pounds. 36. When do you set the cervical angle of distraction? Choose the one best answer. A. Before positioning the patient. B. After positioning the patient, but before beginning the session. C. During a session when needed. D. Anytime. 37. The normal course of the protocol for a cervical patient is typically. Choose the one best answer. A. Twenty to twenty-five sessions. B. At least five sessions past the point where their improvement plateaus once the recommended course has been completed. C. Fifteen sessions for men, and eighteen sessions for women. D. When their pain is abated. 38. The cervical angle is adjusted to. Choose the one best answer. A. Improve the comfort for the patient during the session. B. To target specific disc segments. C. To ensure that the disc pathology is exacerbated. D. So that they can more easily see the LCD screen. *Spinal Decompression that is, unloading due to non-surgical distraction and positioning. Page 6 of 7

7 Complete information below. Answer Sheet NOTE: Print clearly, the Clinician Name information is used to prepare your certificate, so record information as you would like it to appear on your certificate. Remember to include any titles, designations or other information you want displayed. Clinician Name: Signature: Date: Clinic Name: Street/Mailing Address: City: Zip: Telephone: Fax completed Answer Sheet to: # Ogilvie St. South Prince George, BC V2N 1W9 Phone: / *Spinal Decompression that is, unloading due to non-surgical distraction and positioning. Page 7 of 7