Head And Neck

Question 1

Flexion

Answer 1

60

Question 2

Extention

Answer 2

60

Question 3

Lateral flexion

Answer 3

45

Question 4

Rotation

Answer 4

80

Question 5

Flexion mm

Answer 5

Scm ( Bilaterally)
Longus Cervicis , Capitus (Bilaterally)
Anterior Scalene ( bilaterally)

Question 6

Extention mm

Answer 6

Upper Traps ( bi)
splenius Cervicis&Capitus (bi)
Levator scapulae ( bi)
Suboccipitals 
Longissimus cap, cervicis ( assisits)
Illiocostalis cervicis ( assist) 
Multifidi( bi)

Question 7

Lateral Flexion

Answer 7

(Unilaterally to same side )
Upper traps
Levator scap
Scm
All threee scalenes ( ribs fixed)
Splenius cervicis, capitus
(Assist )
Longussimus cervicis, capitus 
Illiocostalis cervicis
Oblique cap superior

Question 8

Rotation mm

Answer 8

(On the right/ same side )
Levator scap 
Splenius cap/ Cervicis 
Rectus cap post mj
Oblique cap inferior
Longus colli/cap
(Assist on the right/ same side)
Longisimus cervicis , Capitus
Illiocostalis cervicis 
( on the left/ opposite side) 
Scm
All3 scalenes 
Multifidi rotatores

Question 9

Vertebral artery test

Answer 9

P: circulation deficiency of vertebral artery at tranverse foramen
Clt:
1 . seat or supine
2 .Fully Rotate head to 1 side & Extend
3.hold 30 secs
4. Repeat the other side
+ clt complain feeling of dizyness or nytagmus

Question 10

Tmj joint AF ROM

Answer 10

P: asses motion of mandible at tmj
Clt:
1 . Clt seat. Stand behind clt
2. Index finger pads both hands , posterior portion of mandible condyles
3 instruct clt to open and close jaw slowly and fully
4. Asses qaulity of motion at the condyles , should feel symmetry and smooth
+ tmj dysfunction clicking , crepitus asymetry motion and pain

Further assesment
1. Sit at head of table
2. Observe client upside- down face
3. Instruct client to to open and close mandible
4. The mandible should depress and elevate in straight line
+ s shape wobble - muscular source of dysfunction
C - shape capsulare source,,mandible move to that side- capsularly restricted

Question 11

Swallowing test

Answer 11

P: pain from trps in scm? 
Clt: 
1.Seated 
2.pinch and grasp scm 
3 firm pressure on muscle belly and client to swallow 
\+ if pain diminish = trps in Scm

Question 12

Scalene Cramp test

Answer 12

P: to reproduce active scalenes trigger points
Clt
1 : seated
2 : fully rotate head to affected side by contracting affected scalenes the neck is flexed to the same side , pull the chin inferiory into hallow just posterior to clavicle
+= pain in referal pattern for scalenes muscles

Question 13

Scalene relief test

Answer 13

P: presence of active anterior scalene
Clt
1: client seated
2: place forarm on the affected side across he forehead , as close to elbow as possible
3 . Instruct client to elvate and protract the shoulder , which lift the clavicle , releiving compression of scalene and brachial plexus
+ = reduction of pain within a few minutes

Question 14

Atlanto- occipital articulation ., PR ROM

Answer 14

P: asses movement ( flexion and extension , coupled with side bending )
Clt
1supine
2 off the table , grasp clt head with both hands on occipitals region
3: flex client cervical to end range
4: small movement lateral movement left to right
5: clt eyes open
+ restriction subtle letheary end feel
Same as Extension and side bending

Question 15

Atlanto-axial Articulation , PR ROM

Answer 15

P: evaluate movement( mostly rotation) 
Clt 
1: supine 
2: hand on client  temporal both side 
3: rotate head fully to both side 
\+ = restriction, leathery end feel

Question 16

Spurling’s test

Answer 16

P: asses compression of cervical nerve root or facet joint irritation lower cervical spine
Clt
1: seated
2: stand behind clt
3: instruct, Slowly Extend, sidebend, rotate to the affected side
4: apply downward pressure

+ = radiating pain or otehr neurogical sign in the arm on affected side
Distribution of pain indicates where nerve root is involved
+ facet irritation = pain is local

Question 17

Cervical compression test

Answer 17

P: used when client cant rotate or extend head

Same os spurling

Question 18

Cervical distraction test

Answer 18

P: releive pressure on nerve root( particularly
Following spurling’s or cervical compresion test)
Slow traction maintain for at least 30 secs
Allow muscle to relax
+= reduction of pain

Question 19

First rib mobility

Answer 19

P: to asses mobility of first rib
Clt
1: seated
2: rotate head fully away from affected side
Then flex the head forward to the chest as far as possible
+ = first rib hypomobility = limited flexion
Scalene hypertonicity or fascial restrictions may cause the hypomobility

Question 20

Anterior neck flexor stength test AR

Answer 20

P: asses strength scm , ant scalenes
Suprahyoids, infrahyoids , longus cap, colli and rectus capitus anterior muscles
Clt
1: supine arm 90 , elbow hands resting on table
2: instruct ot tuck chin and lift head off against gravity ( grade 3)
3 therapist apply pressure on forehead
+= mm weakenss if unable to hold the position

Question 21

Anterolateral neck flexor strength test Ar

Answer 21

P: to asses Scm and scalens on thr one side
Clt
1: supine
2: arms rest on table at 90degrrss
3: staybilize side being test , instruct rotate face away from side being test
4: instruct clt to lift head off table into slight flexion against gravity
5 : therapist apply oblique pressure
+= anterolateral mm weakenss if client unable to hold

Question 22

Posterolateral neck flexors strngth test AR

Answer 22

P: to asses strength of splenius capitis, cervicis , semispinalis capitus , cervicis ,
Clt:
1: prone , arm abduct at 90, palm on side of table reducing recruting shoulder muscles
2:,instruct extend neck , rotate head TOWARD side being test hold against gravity
3: staybilize side being test , apply pressure against clt
+= unable to hold

Question 23

Upper traps strength test

Answer 23

Same as posterolateral test but turn head AWAY from side being test

Question 24

Orbicularis oris strength test AR

Answer 24

To confirm Bell’s Palsy
try to open clients eyes
+= unable to resist this action