Cervical

Question 1

Canadian C Spine Rules

Answer 1

Yes to any of the following:
65 yrs
Fall from >1 meter or 5 stairs, axial load to the head, MVA >62 mph, bike accident
Parasthesias in extremities

Question 2

Lhermette’s sign

Answer 2

Shock type feeling down spine and into extremities. Can be painful

Question 3

What is cervical radiculopathy?

Answer 3

Affected cervical spine root most often caused by cervical disc herniation or other space occupying lesion that may result in nerve root impingement, inflammation or both.

Question 4

What are possible treatment for cervical radiculopathy?

Answer 4

Position changes, traction, manual therapy and injections/surgical

Question 5

What is cervical myelopathy?

Answer 5

Sensory disturbance in the hands where they will have issues as well with fine motor such as buttoning a shirt.

Question 6

What is a positive for Babinski?

Answer 6

NORMAL: Toes curling (down-going)
ABNORMAL: Toes sprawling (up-going)

Question 7

What is a positive for Hoffman’s?

Answer 7

Noxious stimuli to the nail bed where the thumb goes in and fingers sprawl.

Question 8

What does ROWS stand for?

Answer 8

Rule out the worst case scenario

Question 9

How do we test for Jefferson Fx and What is it?

Answer 9

A Jefferson Fx is a fracture of C-1. Pts who have this type of fx are immediately ruled out for manipulations.

Test: Find the transverse process of C-1 by finding the mastoid process and going slightly inferior and posterior and the palpation should be tender.

Question 10

What is the sharp purser test?

Answer 10

Patient is sitting and the therapist is standing where the therapist will act as the C2 axis. The therapist uses a soft pincer grip while pushing with a posterior force on the force head in the webbing of the therapist’s hand. We are trying to reorient C1 on C2.

Relevance?
Pain
Reduction of pain

Question 11

Transverse Ligament Stress Test

Answer 11

Steps of the test:

Patient in supine

Place index fingers on the posterior aspect of C1

Use the shoulder to stabilize the head, occiput (back of head) and fingers on C1

Use opposite arm, index fingers to locate the spinous process of C2

Apply anterior force to C2, and observe the chin jutting forward

Relevance?
Pain and reproduction of symptoms.

Question 12

What is the Alar Ligament Test?

Answer 12

It is known as the kick test.
We palpate the transverse process of C2 and then we have the pt side bend and we should feel a kickout and a positive test is if the process does not kick out.

Question 13

What are the five D’s AND three N’s

Answer 13

Dizziness
Double Vision
Difficulty Speaking
Difficulty swallowing
Drop Attacks

Ataxia

Nystagmus
Nausea
Numbness of the face and mouth

Question 14

What is the TIC (Test Item Cluster) for cervical radiculopathy?

Answer 14

1. Spurling’s A: Interlock fingers go into ipslateral flexion where the s/s returning is (+)
2. Neck Distraction
3. ULTT+

Question 15

What are ways we can assess segmental mobility?

Answer 15

Central PA’s
Unilateral
Side Glide