Cervical Spine - Examination & Interventions

Question 1

Where in the C spine is the normal lordotic curve?

Answer 1

C4-5 interspace

Question 2

What does an __ amount of lordosis cause in the c-spine?
- Increased
- Decreased

Answer 2

• Inc: more load on facet joints
• Dec: more load on the vertebral bodies and discs

Question 3

When should you consider doing vertebral artery testing?

Answer 3

• Hx of trauma
• Nausea w/neck motion
• dizziness
• syncope

Question 4

What is the main supporting ligament of the AA & what does it restrict?

Answer 4

Transverse ligament & excessive flexion

Question 5

What is the alar ligament?

Answer 5

Connects C2 to occiput & limits SB and rotation of the occiput

Question 6

What tests are for the transverse ligament?

Answer 6

• Transverse Ligament Test
• Sharp Pursers

Question 7

Which symptoms may indicate it is more Vertebral Artery than Vestibular?

Answer 7

• double vision
• slurred speech
• chagnes in mental status, including confusion or anxiety
• loss of vision in one or both eyes
• sudden, severe weakness throughout the body

Question 8

For cervical vs thoracic, after stabilization if pain remains for all motions, where is it coming from?

Answer 8

Thoracic

Question 9

What is the muscle action of the anterior/middle scalenes

Answer 9

Flexion, IPSI SB, CL rot

Question 10

What does the craniocervical flexion test measure?

Answer 10

• the strategy to perform upper cervical flexion (MC)
• Isometric endurance of deep cervical flexors

Question 11

What does the neck flexor endurance test test?

Answer 11

• superficial cervical muscles and control of deep cervical flexors

Question 12

What is the craniocervical flexion test?

Answer 12

Use of a stabilizer (starting at 20 mmHg) under the neck to assess deep cervical flexors

Question 13

How do you grade reflexes?

Answer 13

0 - absent
1- diminished
2 - normal
3 - brisk
4 - clonus

Question 14

What is the TIC for cervical radiculopathy?

Answer 14

• Spurlings Test
• Upper Limb Neural Tension Test 1
• Distraction Test
• 60 degrees of rotation

Question 15

What is the purpose of the active intervertebral closure test?

Answer 15

• Rule out or confirm nerve root compression in the cervical spine

Question 16

What other tests, besides the TIC, are used to rule in/out nerve compression/radiculopathy

Answer 16

• Active Intervertebral Closure Test
• Shoulder Abduction Test
• Doorbell test

Question 17

What is a positive test results for the Shoulder Abduction Test?

Answer 17

• reduction of symptoms in that position

Question 18

What test is done for 1st rib mobility?

Answer 18

Cervical Rotation lateral Flexion Test (CRLF)

Question 19

What tests are done for thoracic outlet testing?

Answer 19

• Roos Test
• Costoclavicular Syndrome Test
• Modified Wright Test (allen maneuver)
• Adson Maneuver

Question 20

What PROM/Jt play exams are for the upper cervical spine?

Answer 20

• OA Motion screen
• OA Coupled rotation screen
• OA Coupled rotation joint play
• AA Joint motion screen –> Cervical Flexion Rotation Test
• AA Joint play

Question 21

With an AA Joint Restriction, what happens to the axis of motion? What does this mean?

Answer 21

• It moves to the restricted facet joint
• You have to push and pull at the same time to properly mobilize it

Question 22

What does segmental side bending tell you?

Answer 22

It demonstrates where a restriction may be in the lower cervical spine