CAD Quiz Number 4

It has been over two years since we had one of these quizzes, so here we go. This one reflects much of the changes in our thinking in the last two years. For those of you who regularly read my column, this quiz should be passable. It should also pose no threat to those claiming to be "experts" in whiplash (CAD or cervical acceleration/deceleration) traumatology. Give it a whirl.

Quiz Questions

1. The latest model of CAD trauma describes a temporary change in cervical spine alignment and is characterized by:

1. A straightened cervical curve.
   
2. A reversed cervical curve.
   
3. An s-shaped curve.
   
4. A c-shaped curve.

2. Critical to how injury occurs at this point is a vertical shift in the lower cervical spine of the vertebral body's:

1. Central locus of control.
   
2. Instantaneous axis of rotation (IAR).
   
3. Bending moment.
   
4. Internal pressure.

3. Of the various generators of pain in people suffering from the effects of late (i.e., chronic) whiplash, which is most prominent?

1. The zygapophyseal joint.
   
2. The joints of Luschka.
   
3. The intervertebral disc.
   
4. The muscles and fascia.

4. During the temporary spinal configuration change mentioned in question #1, what are the effects on the motion segments themselves?

1. The upper segments extend while the lower segments hyperflex.
   
2. Both upper and lower segments hyperextend.
   
3. Both remain within the normal intervertebral ranges of motion.
   
4. The upper segments flex while the lower segments hyperextend.

5. What does the SCL-90R stand for?

1. Serial counting logic 90, refereed.
   
2. Subset of clinical logic 90, revised.
   
3. System checklist 90, revised.
   
4. Seven-count learning 90, remedial.

6. What did Dr. Nick Bogduk and cohorts discover about the SCL-90R profiles in late whiplash patients vs. control subjects asked to deliberately attempt to fake a profile?

1. There were no significant differences between the scores of people with late whiplash and controls.
   
2. Control subjects could not successfully fake the SCL-90R profiles of the late whiplash patient.
   
3. Late whiplash patients tend to overrate their problems with mathematics.
   
4. Control subjects could success fully fake a late whiplash profile.

7. Of the following simple disability questionnaires, which is useful in CAD patients with primary complaints in the neck?

1. Vernon and Mior's NDI.
   
2. The Roland-Morris questionnaire.
   
3. The Revised Oswestry questionnaire.
   
4. None of these lend themselves to primary neck disorders.

8. Of these questionnaires, which is the most sensitive to temporal change?

1. Vernon and Mior's NDI.
   
2. The Roland-Morris questionnaire.
   
3. The Revised Oswestry questionnaire.
   
4. None of them are sensitive to changes in disability over time.

9. Which statement is most correct regarding the healing time of CAD injuries?

1. Less than half will have recovered by 12 weeks postinjury.
   
2. About 75% will have recovered by 12 weeks postinjury.
   
3. Nearly all will have recovered by 12 weeks postinjury.
   
4. None of these statements are even remotely correct.

10. The term "backset" refers to:

1. The degree of extension of the head/neck during rear impact.
   
2. The rearward motion of the head (a.k.a., "head lag") as it approaches the head restraint.
   
3. The horizontal distance between the back of the head and the front of the head restraint before impact.
   
4. The relative positions of the occupant's torso and the car's seat back.

Answer Key:

1. C
2. B
3. A
4. D
5. C
6. B
7. A
8. B
9. A
10. C

How Do You Stack up?

• If you scored 9-10: You're an expert. We need more like you.
• If you scored 7-8: You're still above average. You're well read (or taught).
• If you scored 5-6: Average. And you call yourself an expert? Probably undeserved self-praise. You need to brush up.
• If you scored 3-4: Poor. You're not even a good guesser.
• Chance alone nearly guarantees you a score of 2-3! If you're treating these people, you definitely need to get current.