Neck and Thoracic spine assessment and pathology

Question 1

What is normal cervical extension?

Answer 1

0-80 degrees

Question 2

What is normal cervical flexion?

Answer 2

0-45-50 degrees

Question 3

What is normal lateral rotation

Answer 3

0-40 degrees

Question 4

Flexing head forward can free up….?

Answer 4

Intervertebral foramen

Question 5

Where does 60% of rotation in the cervical region come from?

Answer 5

Atlantoaxial joints

Question 6

Where does 40% of rotation in the cervical region come from?

Answer 6

The lower cervical vertebrae’s (below C1)

Question 7

What cervical movements happen during neck retraction?

Answer 7

Upper region flexes, lower region extends

Question 8

What cervical movements happen during neck protraction?

Answer 8

Lower region flexes, upper region extends

Question 9

What are the 4 main ligaments in the neck?

Answer 9

Alar
Apical
Tectorial membrane
Cruciform ligament

Question 10

What functions do the
Alar
Apical
Tectorial membrane
Cruciform ligament
do?

Answer 10

Alar - limits ipsilateral head rotation and contralateral side bending
Apical - limits separation of dens from occiput
Tectorial membrane - limits forward flexion
Cruciform - maintains contact between dens and anterior arch of atlas

Question 11

If a patient reports diffuse nonspecific neck pain exacerbated by neck movements, what could it be?

Answer 11

Mechanical neck pain, cervical facet syndrome, cervical muscle strain or sprain

Question 12

If a patient reports pain in certain postures that are alleviated by positional changes, what could it be?

Answer 12

Upper crossed postural syndrome

Question 13

If a patient reports traumatic mechanism of injury with complaint of nonspecific cervical symptoms that are exacerbated in the vertical positions and relieved with the head supported in the supine position, what could it be?

Answer 13

Cervical instability

Question 14

If a patient reports nonspecific neck pain with numbness and tingling into one upper extremity, what could it be?

Answer 14

Cervical radiculopathy

Question 15

If a patient reports neck pain with bilateral upper extremity symptoms with occasional reports of loss of balance or lack or co-ordination of the lower limbs, what could it be?

Answer 15

Cervical myelopathy

Question 16

How can zygapophyseal join pain be described?

Answer 16

Stiffness, pain in extension, pain in rotation, shoulder pain

Question 17

Explain how whiplash causes neck pain? and what structure is affected?

Answer 17

Hyperextension of the neck and head. Stretch and tear longus capitis and colli

Question 18

If a patient is lying down, can lift their head up but can’t tuck their chin. What is the likely cause of this?

Answer 18

Deep neck flexor issue

Question 19

What four categories exist in upper cross syndrome?

Answer 19

Inhibited neck flexors, inhibited rhomboids and serratus anterior, tight pectorals and tight upper traps and levator scapula

Question 20

A protracted position in upper cross syndrome places stress on which muscles?

Answer 20

Levator scapula and semispinalis capitis muscles

Question 21

What is thoracic outlet syndrome?

Answer 21

Compression of the neurovascular structures running from the neck to the arm pit through the thoracic outlet