Comp 8

Question 1

Describe brachioradialis reflex and neuro level

Answer 1

Tap tendon at distal radius

C6

Question 2

Describe triceps reflex and level

Answer 2

Tap tendon where it crosses olecranon fossa

C7

Question 3

Describe Spurling’s manuever

Answer 3

Doc behind seated patient
1. Compression of head in neutral
2. Compression of head with head in extension
3. Sidebend away from affected side then toward affected side and add compression
Positive test is indicated by pain down arm in distribution of nerve root indicating nerve root compression

Question 4

Describe ME for OA somatic dysfunction

Answer 4

Modified type 1
Pt supine
Student at head of table
Contact occiput and extend/flex head through occiput
Rotate left/right through occiput
Side bend left/right through occiput
Have pt pull chin toward chest (for flexion dysfunction) or toward table (for extension dysfunction)
Increase factors to engage feather edge of new restrictive barrier

Question 5

Describe ME for AA somatic dysfunction

Answer 5

pt supine
Student at head of table, contacting AA with fingertips
Fully flex head and neck to lock out rotation of typical cervical vertebra and isolate atlas on axis
Rotate AA joint into restrictive rotational barrier
Have pt rotate head towards side of ease

Question 6

Describe ME for typical cervical (C2-7) somatic dysfunction

Answer 6

type 2 mechanics
Pt supine
Doc at head of table
Contact transverse processes of segment and extend/flex, rotate, and side-bend head through segment
Have pt move head and neck toward neutral positions

Question 7

Describe HVLA for OA

Answer 7

Pt supine
Doc at head of table on same side of posterior occiput
Contact occiput with 2nd MCP joint of caudal hand while cradling head/neck with other hand
Extend/flex, rotate, sidebend through occiput
Have pt inhale and exhale. During exhalation, further engage barrier
At end of another exhalation, apply thrust in direction of top of head with hand in contact with occiput
Other hand does not pull on mandible

Question 8

Describe HVLA for AA

Answer 8

Pt supine
Doc at head of table contacting AA with fingertips
Fully flex head/neck to lock out rotation of typical cervical vertebra to isolate atlas on axis
Rotate AA into restrictive barrier
Have pt rotate towards side of ease
Engage new barriers until no new barriers
Have pt inhale and exhale. During exhalation, further engage barrier
At end of exhalation, apply rotational thrust through barrier

Question 9

Describe rotational focused HVLA for typical cervical (C2-7)

Answer 9

Pt supine
Doc at head of table on same side of posterior transverse process
Contact posterior aspect of PTP with 2nd MCP of hand on side of rotational PTP while cradling head/neck with other hand
Engage rotational restrictive barrier THROUGH segment
Side bend towards EASE of motion TO segment
Engage sagittal plane barrier (flex/extend)
Apply HVLA thrust to named segment through barrier in rotational manner
Thrust is following facet anatomical positioning. Towards eyes for upper and towards opposite axilla for lower (rays of sun)

Question 10

Describe translational focused HVLA for typical cervical C2-7

Answer 10

Pt supine
Doc at head of table opposite PTP
Contact lateral aspect of segment in midcoronal line using 2nd MCP joint of hand on side of translational hard end feel while cradling head/neck with other hand
Side bend to restrictive barrier THROUGH segment
Rotate to EASE of motion TO segment
Flex/extend
Apply thrust to named segment through barrier in a side bending manner towards sternal notch

Question 11

Describe where to tap for biceps reflex and what level

Answer 11

Tap thumb with reflex hammer, while thumb is on pt’s biceps tendon
Tests primarily C5