Cervical Spine

Question 1

Bony palpation

Answer 1

Anterior: hyoid, thyroid cartilage, first cricoid ring, mandible. Posterior: occiput, inion(EOP), superior nuchal line, mastoid processes, spinous processes of cervical, and facet joints.

Question 2

Soft Tissue Palpation

Answer 2

SCM, anterior lymph node chain, posterior lymph node chain, thyroid gland, carotid pulse, supraclavicular fossa, trapezius muscle, greater occipital nerves, superior nuchal ligament.

Question 3

Range of motion

Answer 3

flexion: 50 degrees
extension: 60 degrees
lateral bend left and right: 45 degrees
left and right rotation: 80 degrees

Question 4

Foraminal Compression Test

Answer 4

Positive 1: Exacerbation of localized cervical pain.
Indicates: Foraminal encroachment or facet pathology without nerve root compression.
Positive 2: Exacerbation of cervical pain with a radicular component.
Indicates: Foraminal encroachment or facet pathology with nerve root compression.

Question 5

Cervical Distraction Test

Answer 5

Positive 1: Diminished or absence of pain.
Indicates: Foraminal encroachment (local pain diminishes), nerve root compression (radicular pain diminishes).
Positive 2: Increase of cervical pain.
Indicates: Muscular strain, ligamentous sprain, myospasm, facet capsulitis.

Question 6

Spinal Percussion Test

Answer 6

Positive 1: Local pain
Indicates: Possible fractured vertabrae, ligamentous involvement (spinous pain), and muscular involvement (muscular pain).
Positive 2: Radiating Pain
Indicates: Possible disc pathology

Question 7

Shoulder Depression Test

Answer 7

Positive 1: Localized pain on the side being tested.
Indicates: LOCALIZED PAIN: Dural sleeve adhesion, and muscular adhesion/contracture, or spasm, or ligamentous injury.
Positive 2: Radiating pain on the side being tested
Indicates: RADIATING PAIN: On side being tested, neurovascular bundle compression, dural sleeve adhesions, or Thoracic Outlest Syndrome.
Positive 3: Radicular pain on the opposite side being tested.
Indicates: foraminal encroachment with nerve root compression.

Question 8

Valsalva Maneuver:

Answer 8

Positive: radiating pain from site of lesion (usually recreating the complaint in cervical or lumbar area of the spine).
Indicates: Space occupying lesion(e.g. disc pathology)

Question 9

Swallowing Test

Answer 9

Positive: Difficulty swallowing
Indicates: Space-occupying lesion at anterior portion of cervical spine. Possibly esophageal or pharyngeal injury, anterior disc defect, muscle spasm or osteophytes etc.

Question 10

Soto-Hall Sign

Answer 10

Positive: Generalized pain in the cervical region, which may extend down to the level of T2.
Indicates: Non-specific test for structural integrity of cervical region.

Question 11

Kernig Sign

Answer 11

Positive: Inability to fully extend the leg and/or pain (usually in the neck region)
Indicates: Meningeal irritation/meningitis

Question 12

O’Donoghue Maneuever

Answer 12

Positive 1: Pain during passive range of motion.
Indicates: Ligamentous sprain.( Passive ROM stresses ligaments)
Positive 2: Pain during resisted range of motion.
Indicates: Muscle/tendon strain. (Active ROM stresses muscles and tendons)