Cervical Spine

Question 1

first and second goal of PT/differential

Answer 1

diagnose

address dysfunctions

Question 2

passive restraints

Answer 2

disc, ligaments

Question 3

active restraints

Answer 3

muscle , tendons

Question 4

if the structure has a contractile component it will be provoked most with

Answer 4

resisted motions

Question 5

selective tissue tension testing for the joint

Answer 5

distend or load the joint (coupled/combined)

capsular pattern of limitation

Question 6

selective tissue tension testing for the disc

Answer 6

motions that the disc restricts (saggital)

Question 7

selective tissue tension testing for the nerve

Answer 7

neural tension test

local peripheral compression/tinnels

Question 8

selective tissue tension testing for the nerve root

Answer 8

extremity provoked with spinal motions

foraminal compression tests/spurlings

Question 9

pain with resisted motions
acute injuries
trauma
common secondary pain

Answer 9

muscles

Question 10

primary pain for muscles

Answer 10

resisted motions most painful test

Question 11

cervical spine

Answer 11

C1-C7

Question 12

cervical spine disc segments

Answer 12

C2C3 to C6C7

Question 13

cervical spine non disc segments

Answer 13

C0C1 and C1C2

Question 14

coupling in C0 to C2

Answer 14

contra coupling

Question 15

Coupling in C2 to T4

Answer 15

ipsi coupling

Question 16

ZAJ orientation in the cervical spine

Answer 16

inclined 45 degrees

Question 17

age 15-25

Answer 17

acute torticollis 2 degrees to internal dist disorder

Question 18

Age 25-45

Answer 18

internal disc

facet synovitis

Question 19

age 30-45

Answer 19

protrusion/prolapse/extrusion

Question 20

age 45-55+

Answer 20

recurrent chronic IDD
facet arthrosis
NCRS/stenosis

Question 21

irritation to the nerve causing tingling, radiculitis

Answer 21

parasthesia

Question 22

lack of sensation, damage to the nerve and radiculopathy

Answer 22

numbness

Question 23

Parasagittal structures do not cause

Answer 23

midline pain

Question 24

midline structures can cause

Answer 24

parasagittal pain

Question 25

``` parasagittal neck pain no arm pain most pain with rotation no large limits of motion no pain with extension with chin tuck most pain with coupled 3D patterns ```

Answer 25

Cervical facet synovitis

Question 26

cervical facet synovitis most pain with

Answer 26

rotation coupled 3D patterns pain increases with each added motion

Question 27

extension pattern

Answer 27

rotation toward the painful side worse with added SB toward the painful side even worse with added extension

Question 28

flexion pattern

Answer 28

rotation away from pain worse with added SB away from pain even worse with added flexion

Question 29

diffuse occipital pain and headache begins in the back and progresses to front no change with 'true migraine' medication history of trauma to the head worse with protraction or retraction (even worse with added sidebend)

Answer 29

occipital-atlanto (C0-1) joint pain

Question 30

local sub occipital pain can contribute to cervicogenic headaches that begin in the back and progresses to front no change with 'true migrane' medication history of trauma to the head or manipulation worse with protraction or retraction (even worse with added rotation)

Answer 30

Atlanto-axial (C1-2) joint pain

Question 31

active flexion most painful think

Answer 31

disc

Question 32

active extension most painful think

Answer 32

loads the ZAJ: but rotation should be more painful for ZAJ | also loads the discs

Question 33

active rotation most painful

Answer 33

think ZAJ then confirm with 3D testing | ZAJ does not cause large limitation of motion

Question 34

active sidebend most painful think

Answer 34

uncovertebral joint | acute disc pain can cause large limits of sidebend

Question 35

large limits think

Answer 35

disc

Question 36

smaller limits then

Answer 36

look for the most painful motion

Question 37

pain with sagittal motion think

Answer 37

disc

Question 38

pain with increased 3D motion think

Answer 38

ZAJ vs UVJ

Question 39

rotation pain think

Answer 39

ZAJ

Question 40

SB pain think

Answer 40

UVJ

Question 41

most motion is controlled by the influence of the

Answer 41

disc

Question 42

large limits in cervical motions think

Answer 42

disc

Question 43

flexion greatly increases

Answer 43

ID pressure

Question 44

Extension slightly increases

Answer 44

ID pressure

Question 45

extension with chin tuck greatly increases

Answer 45

ID pressure

Question 46

Age 20-40 midline, parasagittal or band-form neck pain can radiate diffusely to the upper extremity but cannot be provoded but no radicular pain sagittal motions worst, especially extension with a chin-tuck 3D motions not most painful can cause large limits of motion

Answer 46

Cerbical internal disc disruption

Question 47

age 25-55 midline, parasagittal or band-form neck pain can radiate in complete or partial dermatomal pattern to the upper extremity but is mild or intermittent sagittal motions most painful for cervical cervicothoracic pain may have neurological changes may have positive foraminal compression test positive axial separation test

Answer 47

cervical protrusion

Question 48

``` age 25-45 arm pain often worse than neck pain radiate pain in complete or partial dermatomal pattern sagittal motions worst will likely have neurological changes may have positive foraminal compression positive axial separation test ```

Answer 48

cervical prolapse

Question 49

age 25-45 arm pain much worse than neck pain severe broad ratiating pain pattern to the upper extremity all motions often limited and painful will have neurological changes negative axial separation test (cannot completely alleviate with axial separation)

Answer 49

cervical extrusion

Question 50

Age 50+ arm pain > neck pain pain/paresthesia radiate in complete or partial dermatomal pattern to the upper extremity but is mild or intermittent provoked with extension, sidebend and/or rotation May have neurological changes (numbness most common) likely have positive foraminal compression test positive axial separation test

Answer 50

cervical stenosis

Question 51

clinically, toation of the cervical spine with coupled ipsilateral sidebend is painful on the

Answer 51

convergent side with added extension (C2 to C4) | or when painful on the divergent side with added flexion (segments C3 to C7)

Question 52

combined loading test

Answer 52

rotate away and sidebend toward the side you are testing

Question 53

first thing you always do for treatment

Answer 53

patient education

Question 54

techniques for muscle direct indirect

Answer 54

soft tissue mobilization, modalities | soft tissue mobilization

Question 55

Direct techniques for Disc/NRCS

Answer 55

manual axial separation | Jenker mobilization

Question 56

Direct techniques for facet

Answer 56

joint-specific traction | joint specific glide

Question 57

indirect technique for Disc/facet

Answer 57

mobilize hypomobile segments | Disc hydration program

Question 58

techniques for costotransverse joint direct indirect

Answer 58

joint mobilization | joint mobilization, soft tissue mobilization (transverse friction over costotransverse joint)

Question 59

PT for discogenic pain

Answer 59

manual axial separation

Question 60

ZAJ coupling for ZAJ synovitis

Answer 60

Rotation (toward painful side) + ipsilateral SB + extension | Rotation (away from painful side) + ipsilateral SB + flexion

Question 61

coupling for ZAJ arthrosis

Answer 61

Rotation away from painful side + SB toward