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% Packages
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\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{Siffi (Siffi)}
\pdfinfo{
  /Title (whiplash.pdf)
  /Creator (Cheatography)
  /Author (Siffi (Siffi))
  /Subject (Whiplash Cheat Sheet)
}

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% Commands
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% Header and Footer
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\fancyhead{} % Set header to blank
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\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{Whiplash Cheat Sheet}}}} \\
    \normalsize{by \textcolor{DarkBackground}{Siffi (Siffi)} via \textcolor{DarkBackground}{\uline{cheatography.com/122609/cs/22981/}}}
\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}Siffi (Siffi) \\
  \uline{cheatography.com/siffi} \\
  \end{tabulary}
\vfill
\columnbreak
\begin{tabulary}{5.8cm}{L}
  \SetRowColor{FootBackground}
  \mymulticolumn{1}{p{5.377cm}}{\bf\textcolor{white}{Cheat Sheet}}  \\
   \vspace{-2pt}Not Yet Published.\\
   Updated 1st January, 2021.\\
   Page {\thepage} of \pageref{LastPage}.
\end{tabulary}
\vfill
\columnbreak
\begin{tabulary}{5.8cm}{L}
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  \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{7.5988 cm} x{9.6712 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Biomechanics}}  \tn
% Row 0
\SetRowColor{LightBackground}
- Hyperextension + Hyperflexion & - SCM most affected \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
- Myofascial damage & - Head rotates into hyperextension, anterior cx muscles stretched - muscles at their tension limit - remaining forces put into the ALL and anterior fibres of the annulus fibrosis \tn 
% Row Count 11 (+ 9)
% Row 2
\SetRowColor{LightBackground}
- CN affected - 2nd & - Flexion - Damage in suboccipital region of the spine - muscles subocciptal and occipitofrontalis are more traumatised \tn 
% Row Count 17 (+ 6)
% Row 3
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{- PTSD occurs} \tn 
% Row Count 18 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{8.635 cm} x{8.635 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Mechanisms of Injury}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Rear end collisions mainly - linear + angular rearward motion of the head to the torso} \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
{\bf{Shear, compression, tension and torque}} & - Shearing is vertical in vertebral column + horizontally on the spine, more likely to occur during the head extension and torso accelerating forward stage, more likely at C5-C7 \tn 
% Row Count 11 (+ 9)
% Row 2
\SetRowColor{LightBackground}
 & - Compression - head is accelerated downward towards the spine/tissues are compression during extension phase. Forced extension - applies compressive forces to posterior structures and tensile forces to anterior structures \tn 
% Row Count 23 (+ 12)
% Row 3
\SetRowColor{white}
 & - Tension - Extension phase, anterior neck muscles, compression of posterior neck structures \tn 
% Row Count 28 (+ 5)
% Row 4
\SetRowColor{LightBackground}
 & - Torque Small force at the end can create a larger force at the base - rotational acceleration of the head on the fulcrum at the top of the cx spine \tn 
% Row Count 36 (+ 8)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{8.635 cm} x{8.635 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Classfications - WAD}}  \tn
% Row 0
\SetRowColor{LightBackground}
0 - No Neck complaints and NO physical signs & Rarely presents to clinicians \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
I - Neck complaints of stiffness, pain or tenderness but with no physical signs & Very minor muscular damage \tn 
% Row Count 7 (+ 4)
% Row 2
\SetRowColor{LightBackground}
II - Neck complaints AND MSK signs & Limited ROM and point tenderness \tn 
% Row Count 9 (+ 2)
% Row 3
\SetRowColor{white}
III - Neck complaints AND Neuro signs & Decreased/absent DTR, weakness and sensory loss \tn 
% Row Count 12 (+ 3)
% Row 4
\SetRowColor{LightBackground}
IV - Neck complains AND \seqsplit{fracture/Dislocation} & {\bf{REFER IMMEDIATELY}} \tn 
% Row Count 15 (+ 3)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{{\bf{most patients are Grade II WAD}}}  \tn 
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{8.635 cm} x{8.635 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Injury Severity}}  \tn
% Row 0
\SetRowColor{LightBackground}
- There are factors and variables that could make people susceptible to severe injury: & - Angle of the collision - More of an angle = more susceptible \tn 
% Row Count 5 (+ 5)
% Row 1
\SetRowColor{white}
- Speed \& Size of vehicles - Moving rear end collision & - Road conditions - wet/icy roads \tn 
% Row Count 8 (+ 3)
% Row 2
\SetRowColor{LightBackground}
- Occupant Head position - pt looking straight forward? Head turned? - Head turn = more severe & - Gender - women more than men, anatomy/seating position \tn 
% Row Count 13 (+ 5)
% Row 3
\SetRowColor{white}
- Occupant awareness of impact - bracing & - Head Restraints - should be at back of the head touches anterior part, low restraints can act as a pivot during hyperextension \tn 
% Row Count 20 (+ 7)
% Row 4
\SetRowColor{LightBackground}
- Seat Belts - Body held in place, momentum transferred to head and neck, head twists during flexion phase due to one shoulder being restrained & - Direct body impact - Head or other parts of the body hitting object during collision \tn 
% Row Count 28 (+ 8)
% Row 5
\SetRowColor{white}
- Loss of consciousness - Severe G forces & - Medical Hx - cx spine degeneration, history of HA/chronic soft tissue pain can worse injury \tn 
% Row Count 33 (+ 5)
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{8.635 cm} x{8.635 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Injury Severity (cont)}}  \tn
% Row 6
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{- Pain onset - immediate onset of pain, more likely to have pain post injury} \tn 
% Row Count 2 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{8.635 cm} x{8.635 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{History}}  \tn
% Row 0
\SetRowColor{LightBackground}
- Neck Pain - myofascial damage & TMD \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
Dysphagia & Dizziness \tn 
% Row Count 3 (+ 1)
% Row 2
\SetRowColor{LightBackground}
Deafness & Tinnitus \tn 
% Row Count 4 (+ 1)
% Row 3
\SetRowColor{white}
Nausea & Fatigue \tn 
% Row Count 5 (+ 1)
% Row 4
\SetRowColor{LightBackground}
Visual symptoms & Memory Loss \tn 
% Row Count 6 (+ 1)
% Row 5
\SetRowColor{white}
Poor Concentration & Superficial tenderness of the scalp \tn 
% Row Count 8 (+ 2)
% Row 6
\SetRowColor{LightBackground}
Pyschological symptoms - anxiety, depression, anger & PTSD- PTSD questionnaire - 4 or more on a seven point scale, refer to a mental health professional \tn 
% Row Count 13 (+ 5)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{8.8077 cm} x{8.4623 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Examination}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{- MAKE SURE IT IS SAFE}} & Cx spine orthopaedic exam \tn 
% Row Count 2 (+ 2)
% Row 1
\SetRowColor{white}
Neurological involvement & Signs of myelopathy \tn 
% Row Count 4 (+ 2)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{Potential causes of other symptoms} \tn 
% Row Count 5 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
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\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{p{1.727 cm} p{1.727 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Prognosis}}  \tn
% Row 0
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{{\bf{Higher probability of prolonged disability:}} Women, Multiple injuries, Older People, Rear end collisions} \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{{\bf{Delayed functional recovery:}} High initial pain intensity, More symptoms, Greater initial disability} \tn 
% Row Count 6 (+ 3)
% Row 2
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{{\bf{Psychological S\&S Slower recovery}} - Passive coping style, Depressed mood, fear of movement} \tn 
% Row Count 8 (+ 2)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{8.1169 cm} x{9.1531 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Management}}  \tn
% Row 0
\SetRowColor{LightBackground}
{\bf{Acute Phase (2wks after injury)}} & Education - explain, reassure, coping strats \tn 
% Row Count 3 (+ 3)
% Row 1
\SetRowColor{white}
 & Rest with mild, gentle ROM \tn 
% Row Count 5 (+ 2)
% Row 2
\SetRowColor{LightBackground}
 & Exercises should start within 4 days of injury \tn 
% Row Count 8 (+ 3)
% Row 3
\SetRowColor{white}
 & Cryotherapy \tn 
% Row Count 9 (+ 1)
% Row 4
\SetRowColor{LightBackground}
 & NSAIDs - 400-600mg 4 times a day for first 4 days \tn 
% Row Count 12 (+ 3)
% Row 5
\SetRowColor{white}
 & Gentle mobilisation (away from painful \& restricted ROM) \tn 
% Row Count 15 (+ 3)
% Row 6
\SetRowColor{LightBackground}
 & Soft Tissue Techniques \tn 
% Row Count 17 (+ 2)
% Row 7
\SetRowColor{white}
 & Encourage return to normal activities when possible \tn 
% Row Count 20 (+ 3)
% Row 8
\SetRowColor{LightBackground}
 & TENS \tn 
% Row Count 21 (+ 1)
% Row 9
\SetRowColor{white}
\mymulticolumn{2}{x{17.67cm}}{} \tn 
% Row Count 21 (+ 0)
% Row 10
\SetRowColor{LightBackground}
{\bf{Subacute phase (\textgreater{}2-12 weeks)}} & Pain control - 1g Paracetamol four times a day \tn 
% Row Count 24 (+ 3)
% Row 11
\SetRowColor{white}
 & Active exercise - DNF + posture training , Isotonic, Isometrc, Ice + Heat after exercise \tn 
% Row Count 29 (+ 5)
% Row 12
\SetRowColor{LightBackground}
 & Mobilisation - traction/ gentle manipulation \tn 
% Row Count 32 (+ 3)
\end{tabularx}
\par\addvspace{1.3em}

\begin{tabularx}{17.67cm}{x{8.1169 cm} x{9.1531 cm} }
\SetRowColor{DarkBackground}
\mymulticolumn{2}{x{17.67cm}}{\bf\textcolor{white}{Management (cont)}}  \tn
% Row 13
\SetRowColor{LightBackground}
 & Modalities (US, TENs) \tn 
% Row Count 1 (+ 1)
% Row 14
\SetRowColor{white}
 & Soft Tissue Techniques \tn 
% Row Count 3 (+ 2)
% Row 15
\SetRowColor{LightBackground}
 & Nutritional Support \tn 
% Row Count 4 (+ 1)
% Row 16
\SetRowColor{white}
 & Advice and coping strats \tn 
% Row Count 6 (+ 2)
% Row 17
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{} \tn 
% Row Count 6 (+ 0)
% Row 18
\SetRowColor{white}
{\bf{Chronic (\textgreater{}12 weeks)}} & \seqsplit{Manipulation/mobilisation} + active Exercise \tn 
% Row Count 9 (+ 3)
% Row 19
\SetRowColor{LightBackground}
 & Proprioceptive retraining \tn 
% Row Count 11 (+ 2)
% Row 20
\SetRowColor{white}
 & Advice and coping strats \tn 
% Row Count 13 (+ 2)
% Row 21
\SetRowColor{LightBackground}
 & Strengthening exercises \tn 
% Row Count 15 (+ 2)
% Row 22
\SetRowColor{white}
 & Extension retraction exercises for cx spine \tn 
% Row Count 18 (+ 3)
% Row 23
\SetRowColor{LightBackground}
\mymulticolumn{2}{x{17.67cm}}{} \tn 
% Row Count 18 (+ 0)
% Row 24
\SetRowColor{white}
{\bf{Late Whiplash}} & Resist pressure to over treat and over investigate \tn 
% Row Count 21 (+ 3)
% Row 25
\SetRowColor{LightBackground}
 & Encourage return to normal activities \tn 
% Row Count 23 (+ 2)
% Row 26
\SetRowColor{white}
 & Motivational interviewing \tn 
% Row Count 25 (+ 2)
% Row 27
\SetRowColor{LightBackground}
 & Reduce influence of compensation claims \tn 
% Row Count 27 (+ 2)
% Row 28
\SetRowColor{white}
 & CBT \tn 
% Row Count 28 (+ 1)
\hhline{>{\arrayrulecolor{DarkBackground}}--}
\end{tabularx}
\par\addvspace{1.3em}



\end{document}