Cervical Exam interpretation

Question 1

which age group of people mostly has overhydrated discs

Answer 1

young people

Question 2

key to rehydrating discs

Answer 2

eliminate gravity

Question 3

key to dehydrating discs

Answer 3

utilize gravity and controlled stress

Question 4

most common age for stenosis?

Answer 4

30-60

Question 5

secondary headache

Answer 5

trauma to the head and neck and/or something outside the head

Question 6

primary headache

Answer 6

something inside the head

Question 7

upper motor neuron signs

Answer 7

o hyperreflexia
o more diffuse sensory changes
o clonus
o positive hoffman/babinksi
o clumsiness of gait
o generalized weakness below the level of the compression

Question 8

lower motor neuron signs

Answer 8

o hyporeflexia
o decreased sensation to light touch
o muscle weakness

Question 9

diminished biceps reflex is an indication of…

Answer 9

cervical radiculopathy

Question 10

capsular pattern of the neck

Answer 10

SB/ROT>EXT>flex

Question 11

neck pain with mobility clinical findings

Answer 11

 Age <50 years old
 Acute neck pain, <12 weeks
 Symptoms isolated to the neck
 Restricted cervical ROM

Question 12

neck pain with headache clinical findings

Answer 12

 Unilateral headache associated with neck/suboccipital area
 Symptoms aggravated by neck movements or positions
 Headache produced or aggravated with provocation of ipsilateral posterior cervical myofascial and joints
 Restricted ROM
 Restricted cervical segmental mobility C1-2
 Abnormal/substandard performance on the CCFT

Question 13

WAD clinical findings

Answer 13

 Long standing neck pain >12 weeks
 Abnormal/substandard performance of the CCFT and/or deep flexor endurance test
 Coordination, strength, and endurance deficits of neck and upper quarter muscles
 Flexibility deficits of upper quarter muscles
 Ergonomic inefficiencies with performing repetitive activities

Question 14

Neck pain with radiating pain clinical findings

Answer 14

 UE symptoms, radicular or referred, produced or aggravated with spurling and ULTT
 Reduced pain with neck distraction test
 Signs of nerve root compression
 Success with reducing UE symptoms with initial exam and intervention procedures

Question 15

torticollis age

Answer 15

<12

Question 16

IDD leading to acute torticollis age

Answer 16

15-25

Question 17

local cervical syndrome age

Answer 17

20-45 (disc, ZAJ, UVJ)

Question 18

cervicobrachial due to disc protrusion age

Answer 18

<40-45

Question 19

recurrent cervicobrachial due to degeneration age

Answer 19

> 40-45

Question 20

levator scap action

Answer 20

SB/rot same

Question 21

upper traps and scalenes action

Answer 21

SB/rot opposite

Question 22

increased lordosis is associated with

Answer 22

advanced DD and cervicomedullary syndrome

Question 23

decreased lordosis associated with…

Answer 23

DDD and kyphotic kink

Question 24

DRG pain

Answer 24

sharp/shooting

Question 25

root pain

Answer 25

dull/aching

Question 26

Key BCE findings for the disc

Answer 26

-Painful sagittal motion -Non-capsular ROM loss, altered resting cervical posture -Possible pain with + resisted testing due to compression -May follow hydrostatic pattern of pain based on age and time of day -Reproducible pain with PAIVMs -Relief with traction/distraction -ULTT may be positive

Question 27

best candidate for mechanical traction

Answer 27

- peripheralization with C4-7 mobility testing - positive shoulder ABD test - age > 55 + ULTT + axial separation test

Question 28

capsulitis

Answer 28

irritation of the capsule

Question 29

chondropathy

Answer 29

softening of the cartilage

Question 30

arthrosis

Answer 30

subchondral bone pain

Question 31

migraine without aura

Answer 31

A. at least five attacks fulfilling criteria B-D B. headache attacks lasting 4-72 hours C. headache has at least two of the following four characteristics: 1. Unilateral location 2. Pulsating 3. Mod or severe pain intensity 4. Aggravation by or causing avoidance of routine PA D. during headache at least one of the following 1. Nausea 2. Photophobia or phonophobia

Question 32

Migraine with aura

Answer 32

A. at least two attacks fulfilling criteria B and C B. one or more of the following fully reversible aura symptoms 1. Visual 2. Sensory 3. Speech and/or language 4. Motor 5. Brainstem 6. Retinal C. at least 3 of the following 1. At least one aura symptom spreads gradually over 5 minutes 2. 2+ aura symptoms occur in succession 3. Each individual aura symptom lasts 5-60 minutes 4. At least one aura symptom is unilateral 5. At least one aura symptom is positive 6. Aura is accompanied or followed within 60 minutes by headache

Question 33

phases of a migraine

Answer 33

pre HA/aura>aura>HA>post HA- fatigue, hungover

Question 34

cluster HA

Answer 34

A. at least five attacks fulfilling criteria B-D B. severe or very severe unilateral orbital, supraorbital and/or temporal pain lasting 15-180 minutes C. either or both of the following 1. At least one of the following symptoms or signs, ipsilateral to the headache -Conjunctival injection and/or lacrimation -Nasal congestion and/or rhinorrhea - Eyelid edema - Forehead and facial sweating - Miosis and/or ptosis 2. A sense of restlessness or agitation D. occurring with a frequency between one every other day and eight per day

Question 35

tension type headache

Answer 35

A. at least 10 episodes of headache occurring <1 day/month on average and fulfilling B-D B. lasting from 30 minutes to seven days C. at least 2 of the following:  1. Bilateral location  2. Pressing or tightening  3. Mild or moderate intensity  4. Not aggravated by routine physical activity such as walking or climbing stairs D. both of the following  1. No nausea  2. No more than one of the photophobia or phonophobia

Question 36

Primary exercise HA

Answer 36

A. at least two headaches fulfilling criteria B and C B. brought on by and occurring only during or after exercise C. lasting <48 hours

Question 37

cervicogenic headache

Answer 37

A. any headache fulfilling criteria C B. clinical and/or imaging evidence of a disorder or lesion within the cervical spine or soft tissues of the neck, known to be able to cause headache C. evidence of causation demonstrated by at least 2 of the following  1. Headache has developed in temporal relation to the onset of the cervical disorder in appearance of the lesion  2. Headache has significantly improved/resolved in parallel with improvement in or resolution of the disorder or lesin  3. Cervical ROM reduced and headache is made slightly worse by provocation  4. Headache is abolished following diagnostic blockage of a cervical structure or its nerve supply

Question 38

CPR T-spine manip for the neck

Answer 38

- symptoms less than 30 days - no symptoms distal to the shoulders -looking up does not aggravate symptoms -diminished upper thoracic kyphosis -cervical ext ROM < 30 degs

Question 39

CPR who will respond best to cervical manips

Answer 39

-symptom duration of <38 days + expectation that manip will help - side to side difference in cervical rotation of 10 or greater -pain with posteroanterior spring testing of the middle cervical spine

Question 40

CPR for cervical radiculopathy

Answer 40

+ ULTT + spurling's + axial separation test cervical rotation <60 degrees

Question 41

CPR identifying pts who will respond to intermittent mechanical cervical traction

Answer 41

- pt reported peripheralization with lower C-spine mobility testing -positive shoulder abduction sign -age > 55 -positive ULTT median n -positive neck distraction test

Question 42

cervical myelopathy CPR

Answer 42

-gait deviation + hoffman sign inverted supinator sign + babinski age >45 y/o

Question 43

shoulder abduction sign

Answer 43

SB away from painful arm ABD shoulder of painful arm + if arm/neck symptoms are reduced