Cervical HVLA

Question 1

Wallenberg Test?

Answer 1

pt’s head is off the table, you extend, side bend and rotate the head in the same direction and ask if they have any dizziness or visual changes, watch for nystagmus

repeat for The other side

Question 2

AA HVLA

example: AA rotated left

Answer 2

localize your fingers on the lateral masses of the AA, cradle hand into palms

so if it’s rotated left, it doesn’t like to rotate to the right

flex the C spine through the AA. (you want to straighten the C spine so you’re not having any extension) **STRAIGHTEN THE CURVE PRETTY MUCH)

rotate into the barrier, and HVLA rotational thrust through a combined motion of BOTH hand contacts.

recheck

Question 3

OA diagnosis?

AA?

C2-C7

Answer 3

always modified type 1

rotation only

Type 2 like

Question 4

OA HVLA

example: OA F SL, RR

Answer 4

modified type 2

we need to extend (a little bit), rotate left first, then side bend up a bit towards the ceiling!

contact the right posterior occiput posterior to, but not on the mastoid process

cradle head with left hand, sidebend OA joint right, rotate left, and extend to ENGAGE barrier and add localizing cephalad directed traction.

thrust medially, anteriorly, and superiorly

Question 5

C2-7 Side Bending emphasis?

Ex: C3 ERRSR

Answer 5

Place index fingers on the articular pillars of the affected vertebrae

flex the head until movement is felt (restrictive, so flexing)

move hand on the rotation side TO THE EASE (so rotate right)

SIDEBEND to the restrictive barrier –> push your thumb towards the notch to induce side bending on the affected side! (so sidebend left)

Question 6

C2-C7 Rotational Emphasis

Example C4 E RRSR

what if it were at C7? C3? middle?

Answer 6

if rotation is more restricted, use this.

left hand cradles around the chin, right hand contacts the PTP with your 2nd MCP

Flex TO the barrier, not below

Sidebend TOWARDS the freedom the segment, not through it.. so sidebend RIGHT

Rotate TOWARDS the RB to the restrictive barrier

apply a thrust in the rotational plane of C4 with the contact on the PTP.

since we are at C4, it’s towards the nose.. thrust straight across the neck

if we were at C7, it points towards the opposite axilla

higher cervical it’s towards the eye

Question 7

Diagnosing the cervical spine?

Answer 7

do rotational testing and side bending rotation

then do the sagittal plane!

note which was more restricted, rotation or side bending.. this will help with your diagnosis