\documentclass[10pt,a4paper]{article}

% Packages
\usepackage{fancyhdr}           % For header and footer
\usepackage{multicol}           % Allows multicols in tables
\usepackage{tabularx}           % Intelligent column widths
\usepackage{tabulary}           % Used in header and footer
\usepackage{hhline}             % Border under tables
\usepackage{graphicx}           % For images
\usepackage{xcolor}             % For hex colours
%\usepackage[utf8x]{inputenc}    % For unicode character support
\usepackage[T1]{fontenc}        % Without this we get weird character replacements
\usepackage{colortbl}           % For coloured tables
\usepackage{setspace}           % For line height
\usepackage{lastpage}           % Needed for total page number
\usepackage{seqsplit}           % Splits long words.
%\usepackage{opensans}          % Can't make this work so far. Shame. Would be lovely.
\usepackage[normalem]{ulem}     % For underlining links
% Most of the following are not required for the majority
% of cheat sheets but are needed for some symbol support.
\usepackage{amsmath}            % Symbols
\usepackage{MnSymbol}           % Symbols
\usepackage{wasysym}            % Symbols
%\usepackage[english,german,french,spanish,italian]{babel}              % Languages

% Document Info
\author{bee.f (bee.f)}
\pdfinfo{
  /Title (5002-case-4.pdf)
  /Creator (Cheatography)
  /Author (bee.f (bee.f))
  /Subject (5002 Case 4 Cheat Sheet)
}

% Lengths and widths
\addtolength{\textwidth}{6cm}
\addtolength{\textheight}{-1cm}
\addtolength{\hoffset}{-3cm}
\addtolength{\voffset}{-2cm}
\setlength{\tabcolsep}{0.2cm} % Space between columns
\setlength{\headsep}{-12pt} % Reduce space between header and content
\setlength{\headheight}{85pt} % If less, LaTeX automatically increases it
\renewcommand{\footrulewidth}{0pt} % Remove footer line
\renewcommand{\headrulewidth}{0pt} % Remove header line
\renewcommand{\seqinsert}{\ifmmode\allowbreak\else\-\fi} % Hyphens in seqsplit
% This two commands together give roughly
% the right line height in the tables
\renewcommand{\arraystretch}{1.3}
\onehalfspacing

% Commands
\newcommand{\SetRowColor}[1]{\noalign{\gdef\RowColorName{#1}}\rowcolor{\RowColorName}} % Shortcut for row colour
\newcommand{\mymulticolumn}[3]{\multicolumn{#1}{>{\columncolor{\RowColorName}}#2}{#3}} % For coloured multi-cols
\newcolumntype{x}[1]{>{\raggedright}p{#1}} % New column types for ragged-right paragraph columns
\newcommand{\tn}{\tabularnewline} % Required as custom column type in use

% Font and Colours
\definecolor{HeadBackground}{HTML}{333333}
\definecolor{FootBackground}{HTML}{666666}
\definecolor{TextColor}{HTML}{333333}
\definecolor{DarkBackground}{HTML}{017075}
\definecolor{LightBackground}{HTML}{EFF6F6}
\renewcommand{\familydefault}{\sfdefault}
\color{TextColor}

% Header and Footer
\pagestyle{fancy}
\fancyhead{} % Set header to blank
\fancyfoot{} % Set footer to blank
\fancyhead[L]{
\noindent
\begin{multicols}{3}
\begin{tabulary}{5.8cm}{C}
    \SetRowColor{DarkBackground}
    \vspace{-7pt}
    {\parbox{\dimexpr\textwidth-2\fboxsep\relax}{\noindent
        \hspace*{-6pt}\includegraphics[width=5.8cm]{/web/www.cheatography.com/public/images/cheatography_logo.pdf}}
    }
\end{tabulary}
\columnbreak
\begin{tabulary}{11cm}{L}
    \vspace{-2pt}\large{\bf{\textcolor{DarkBackground}{\textrm{5002 Case 4 Cheat Sheet}}}} \\
    \normalsize{by \textcolor{DarkBackground}{bee.f (bee.f)} via \textcolor{DarkBackground}{\uline{cheatography.com/180201/cs/38539/}}}
\end{tabulary}
\end{multicols}}

\fancyfoot[L]{ \footnotesize
\noindent
\begin{multicols}{3}
\begin{tabulary}{5.8cm}{LL}
  \SetRowColor{FootBackground}
  \mymulticolumn{2}{p{5.377cm}}{\bf\textcolor{white}{Cheatographer}}  \\
  \vspace{-2pt}bee.f (bee.f) \\
  \uline{cheatography.com/bee-f} \\
  \end{tabulary}
\vfill
\columnbreak
\begin{tabulary}{5.8cm}{L}
  \SetRowColor{FootBackground}
  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Cheat Sheet}}  \\
   \vspace{-2pt}Published 23rd February, 2024.\\
   Updated 11th May, 2023.\\
   Page {\thepage} of \pageref{LastPage}.
\end{tabulary}
\vfill
\columnbreak
\begin{tabulary}{5.8cm}{L}
  \SetRowColor{FootBackground}
  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Sponsor}}  \\
  \SetRowColor{white}
  \vspace{-5pt}
  %\includegraphics[width=48px,height=48px]{dave.jpeg}
  Measure your website readability!\\
  www.readability-score.com
\end{tabulary}
\end{multicols}}




\begin{document}
\raggedright
\raggedcolumns

% Set font size to small. Switch to any value
% from this page to resize cheat sheet text:
% www.emerson.emory.edu/services/latex/latex_169.html
\footnotesize % Small font.


\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Case Hx}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{- 48 y.o.\{\{nl\}\}- Stiff neck \& upper back pain\{\{nl\}\}- Painful R jaw} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Jaw}}\{\{nl\}\}- 0/10 at rest\{\{nl\}\}- 7/10 when chewing\{\{nl\}\}- 4/10 after chewing\{\{nl\}\}- Onset after tooth removal 12 years ago\{\{nl\}\}- Has OA of jaw (fears this will worsen)\{\{nl\}\}- {\bf{RF:}} massaging jaw when it locks\{\{nl\}\}- {\bf{AF:}} grinding teeth \& chewing} \tn 
% Row Count 8 (+ 6)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Neck \& upper Tx}}\{\{nl\}\}- 0/10 - 5/10\{\{nl\}\}- 10-12 years ago\{\{nl\}\}- {\bf{AF:}} running, standing too long \& neck extension} \tn 
% Row Count 11 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Physical Exam Findings}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Upper crossed syndrome:}} muscle imbalance in two sets of opposing muscles\{\{nl\}\}- {\bf{Tight:}} upper traps, elevator scapulae, \& pectoralis major \& minor → responsible for elevating \& protracting the shoulders \& rounding the upper back\{\{nl\}\}- {\bf{Weak:}} lower traps, serratus anterior, \& the deep Cx flexors → responsible for stabilising the shoulder blades \& supporting the neck \& upper back} \tn 
% Row Count 8 (+ 8)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{ROM}}\{\{nl\}\}- Can fit 2 fingers between teeth\{\{nl\}\}- Palpable click-over R TMJ\{\{nl\}\}- Centric relation test is painful on R\{\{nl\}\}- Masseter, temporals, digastric, lateral pterygoid {\emph{tight bilaterally}}\{\{nl\}\}- Cx PROM all directions moderately restricted + flexion caused L upper traps pain} \tn 
% Row Count 14 (+ 6)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Deep neck flexor endurance:}} shacking after 5 seconds} \tn 
% Row Count 16 (+ 2)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Wall angel:}} unable to flatten back against wall or stretch arms towards wall} \tn 
% Row Count 18 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Clinical tests}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Wall angel:}}\{\{nl\}\}- {\bf{Purpose:}} assess Tx mobility\{\{nl\}\}- {\bf{Findings:}} Unable to flatten back against wall or stretch arms towards wall} \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Beighton score:}}\{\{nl\}\}- {\bf{Purpose:}} screen for hyper-mobility\{\{nl\}\}- {\bf{Findings:}} 0} \tn 
% Row Count 5 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{TOS tests:}}\{\{nl\}\}- {\bf{Purpose:}} Identifies compression of neuromuscular structures as they exit through the Tx outlet\{\{nl\}\}- {\bf{Findings:}} Didn't reproduce any pain aka. -ve} \tn 
% Row Count 9 (+ 4)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Name 4 TOS tests:}}\{\{nl\}\}- Adson's\{\{nl\}\}- Reversed Adson's\{\{nl\}\}- Roo's\{\{nl\}\}- Hyperabduction} \tn 
% Row Count 11 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Discussion}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Working diagnosis:}}\{\{nl\}\}- Chronic TMD (temporomandibular dysfunction) w/ knownTMJ OA\{\{nl\}\}- Chronic non-specific mechanical neck \& Tx pain w/ associated upper crossed posture} \tn 
% Row Count 4 (+ 4)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Subdivisions of pain-related TMDs:}}\{\{nl\}\}1. Myalgia / myofascial pain\{\{nl\}\}2. Arthralgia (joint pain)\{\{nl\}\}3. Intra-articular disorders (within joint)\{\{nl\}\}4. Headache (typically confines to the temporal region)} \tn 
% Row Count 9 (+ 5)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Correlation:}}\{\{nl\}\}- Some neck muscle pain has been found to be correlated with TMD, {\bf{doesn't}} completely account for rest of pt's presentations\{\{nl\}\}- Non-specific mechanical neck \& thoracic spine pain is very common (∴ high probability), links w/ the pt's posture \& explains some of the other examination findings in the Tx \& upper quarter\{\{nl\}\}- {\emph{Poor neck flexor endurance}}has been linked w/ chronic TMD \& chronic neck pain \& poor posture (especially a forward head posture)} \tn 
% Row Count 19 (+ 10)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{What's the pt trying to tell me:}}\{\{nl\}\}- Pt has identified stress (grinding teeth, unhappy at home, use of the Headspace app) → will aggravate both the TMD \& neck/upper Tx symptoms\{\{nl\}\}→ Pt should try to identify sources of stress \& DC can offer to help them access further support} \tn 
% Row Count 25 (+ 6)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{Address the pt's expectations for having tech x-rays → they're not indicated, \& would need to explain theist the pt} \tn 
% Row Count 28 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Learning outcomes}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Temporomandibular disorder (TMD) diagnosis \& management:}}\{\{nl\}\}⏺ {\bf{{\emph{Signs \& symptoms:}}}}\{\{nl\}\}- {\bf{Jaw pain:}} located in jaw joint, surrounding muscles or both\{\{nl\}\}- {\bf{Jaw clicking or popping:}} may be duet the displacement of the jaw joint or the movement of the cartilage disc within the joint\{\{nl\}\}- {\bf{Jaw stiffness:}} may make it difficult to eat, speak, or jawn\{\{nl\}\}- {\bf{Headaches:}} especially in the temples or behind the eyes\{\{nl\}\}- {\bf{Ear pain or fullness:}} feeling of fullness in the ear, even though there's no infection\{\{nl\}\}- {\bf{Neck \& shoulder pain:}} may become sore or painful as a result of compensating for the jaw\{\{nl\}\}- {\bf{Teeth grinding or clenching:}} (especially during sleep), can lead to tooth damage, headaches, \& jaw pain\{\{nl\}\}⏺ {\bf{{\emph{Imaging:}}}}\{\{nl\}\}- {\bf{X-rays:}} help identify any bony abnormalities or damage to the jaw joint\{\{nl\}\}- {\bf{MRI:}} jaw joint, surrounding tissues, muscle, ligaments, \& cartilage\{\{nl\}\}- {\bf{CT:}} Jaw joint, surrounding structures, including bones \& soft tissues\{\{nl\}\}- {\bf{Cone beam CT:}} 3D images of the jaw joint\{\{nl\}\}⏺ {\bf{{\emph{Management:}}}}\{\{nl\}\}- {\bf{Lifestyle changes:}} soft foods, not gum chewing, stress management to reduce jaw tension\{\{nl\}\}- {\bf{Medications}}\{\{nl\}\}- {\bf{Manual therapy}}\{\{nl\}\}- {\bf{Oral appliances:}} (e.g. splint or mouthguard) to relieve jaw pain \& reduce teeth grinding \& clenching\{\{nl\}\}- {\bf{Injections}}\{\{nl\}\}- {\bf{Surgery}}} \tn 
% Row Count 28 (+ 28)
% Row 1
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Consider the impact of stress on the pt's prognosis:}}\{\{nl\}\}- Can have significant impact on prognosis, especially for pts w/ chronic illnesses or conditions; {\bf{{\emph{chronic stress}}}} is linked to a range of -ve health outcomes (↑ inflammation, impaired immune function, \& heightened risk of heart disease, diabetes, etc)\{\{nl\}\}- {\bf{Impaired immune function:}} can lead to a longer recovery time \& more severe symptoms for pts with chronic illnesses\{\{nl\}\}- {\bf{Increased inflammation:}} can exacerbate symptoms of chronic illnesses \& lead to further damage to organs \& tissues\{\{nl\}\}- {\bf{Worsening of symptoms:}} (e.g. pain, fatigue, \& digestive issues), can impact a pt's quality of life \& ability to manage their condition\{\{nl\}\}- {\bf{Delayed healing:}} can lead to longer recovery \& ↑ risk of complications\{\{nl\}\}- {\bf{Poor treatment adherence:}} pts may have harder time following treatment plans, can lead to poorer outcomes \& slower recovery} \tn 
% Row Count 47 (+ 19)
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{X}
\SetRowColor{DarkBackground}
\mymulticolumn{1}{x{17.67cm}}{\bf\textcolor{white}{Learning outcomes (cont)}}  \tn
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Indications for Cx spine x-rays:}}\{\{nl\}\}⏺ {\emph{SEE DIAGRAM BELOW}}\{\{nl\}\}- Pt has no HIGH RSIK factors to warrant Cx x-ray immediately\{\{nl\}\}- Pt has NO LOW risk factors + ROM rotation is not below 45° (PROM tested only, no AROM detailed {[}preffered{]})} \tn 
% Row Count 5 (+ 5)
% Row 3
\SetRowColor{white}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Management of chronic non-specific neck \& Tx pain:}}\{\{nl\}\}- Chronic pain: consider referral to psych-management / pain clinic\{\{nl\}\}- Home exercises to maintain movement between treatments\{\{nl\}\}- {\bf{Non-specific neck pain:}}\{\{nl\}\}- Short term: Tx manipulation w/electrothermal therapy\{\{nl\}\}- Long term: Cx manipulation, exercises ± manual therapies\{\{nl\}\}- Encourage activity \& ADLs\{\{nl\}\}- NSAIDs\{\{nl\}\}- Stretching \& strengthening exercises, ROM exercises, manual therapy\{\{nl\}\}- {\bf{Non-specific Tx pain:}}\{\{nl\}\}- Tx manual therapy: massage, trigger point therapy (TPT), stretches, traction, manipulation \& mobilisation} \tn 
% Row Count 18 (+ 13)
% Row 4
\SetRowColor{LightBackground}
\mymulticolumn{1}{x{17.67cm}}{{\bf{Functional management for this pt:}}\{\{nl\}\}⏺ {\bf{{\emph{Jaw:}}}}\{\{nl\}\}- Stabilisation exercises\{\{nl\}\}⏺ {\bf{{\emph{Neck / upper Tx:}}}}\{\{nl\}\}- Wall angel\{\{nl\}\}- Prayer stretch\{\{nl\}\}- Upper traps stretch\{\{nl\}\}- Lev. scap. stretch\{\{nl\}\}- Wall chin tucks} \tn 
% Row Count 23 (+ 5)
\hhline{>{\arrayrulecolor{DarkBackground}}-}
\end{tabularx}
\par\addvspace{1.3em}



\end{document}