Final

Question 1

C2-C7

Motion Palpation: Lateral Flexion

Answer 1

Example:

Right lateral flexion restriction may cause prominence and tenderness of the articular pillar/lamina on the right side.

Question 2

Motion palpation: CO-C1-C2

“egg on spoon”

Answer 2

Procedure:
Radial and ulnar deviation of both hands creates a nodding motion of the occiput on atlas.

Imagine an axis through the external auditory meatuses—rotate around this axis.

To bias the assessment to the right CO-C1 joint laterally, flex the occiput right and induce nodding.
To bias the assessment to the left CO-C1 joint, laterally flex the occiput to the left and induce nodding.

Question 3

State the elements of “the First Three First” & the interpret each finding. Perform it & what does it mean?

Answer 3

“First three first”:
1. Observe (Rust’s sign or abnormalities)
Rust’s sign: Hands holding Cervicles…

Bakody’s sign (AKA Shoulder Abduction Relief Sign, Shoulder Abduction Test): Nv. root irritation if a patient reports relief from peripheral sxs with the arm overhead.

2. AROM of head & neck
3. Fracture screen (if this was trauma)
   ⬥ AROM
   ⬥ Palpation & visualization … pain, displacement, swelling, discoloration
   ⬥ Percussion & Vibration (tuning fork) … unreliable
   ⬥ Resistance and Torque

Question 4

Canadian C-spine rules for X-rays

Answer 4

• Cognitive awareness (Glasgow Coma Scale > 15)
• Neurological symptoms
• High-Risk trauma (MVC high speed, roll-over, ejection)
• Age 65 or older (does not apply to

Question 5

Middle Deltoid

Answer 5

C5- Auxillary Nv.

Question 6

C6 Motor Fxn

Answer 6

Biceps->Musculocutaneous n.

Wrist extensors->Radial nerve

Question 7

Wrist extensors

Answer 7

Radial nerve-C6

Question 8

Musculocutaneous n.

Answer 8

Biceps-C6

Question 9

C7 Motor Fxn

Answer 9

Triceps->Radial Nv.
Wrist flexors->Median/Ulnar nerve
Finger extensors->Ulnar/Median nerve

Question 10

Wrist flexors

Answer 10

Median/Ulnar nerve-C7

Question 11

Finger extensors

Answer 11

Median/Ulnar nerve-C7

Question 12

Triceps

Answer 12

Radial Nv.-C7

Question 13

C8 Motor Fxn

Answer 13

Finger flexors-Ulnar/Median nerve

Question 14

T1 Motor Fxn

Answer 14

Ulnar Nerve-Finger abductors/adductors

Question 15

DTR-Biceps

Answer 15

C5 & C6

Question 16

DTR-Brachioradialis

Answer 16

C5 & C6

Question 17

DTR-Triceps

Answer 17

C7 & C8

Question 18

Sensation C5-T2

Answer 18

Nerve root	Dermatome location
C5	Over deltoid tuberosity
C6	Lateral distal forearm and radial aspect of the hand
C7	Middle finger
C8	Ulnar aspect of hand and wrist
T1	Medial forearm at level of elbow
T2	Medial upper arm (axilla region)

Question 19

What are the 5D’s

Answer 19

5D’s:
Diplopia (or other visual problems)

Dizziness (vertigo, light-headedness, giddiness)

Drop attacks (sudden weakness in face/arm/leg)

Dysarthria (speech disorder)

Dysphagia (difficulty swallowing)

Question 20

What are the “And the 3N’s?”

Answer 20

And:
Ataxia of gait (unsteady, hemiparesis)

3 N’s:
Nausea (possibly with vomiting)

Numbness (hemianesthesia)

Nystagmus

Question 21

(TOS)

Scalene syndromes

Answer 21

Adson’s & Reverse Adson’s

Question 22

(TOS)

Costoclavicular syndrome

Answer 22

Eden’s test (-Valsalva) & Roos’ test (3 Min.)

Question 23

(TOS)

Hyperabduction syndrome

Answer 23

(d/t ->Pectoralis Minor & Hyperabd. S/d)

Wright’s test
(+) Positive test …..
the radial pulse disappears
if symptoms of pain are reproduced

Question 24

Neurogenic Syndrome

Answer 24

Upper limb tension test
(differentiate nervous tissue from local tissue)

Soto Hall test

Question 25

Rust’s sign

Answer 25

Pt. holds neck with hands

Question 26

Nerve root irritation sign

Answer 26

Bakody’s sign:

Patient reports relief from peripheral sxs with the arm overhead.

Question 27

Brudzinski sign

Answer 27

Reflexive hip and knee flexion

• meningitis, infection, abscess, SOL

Question 28

Soto Hall test is used to confirm what 6 things?

Answer 28

⬥ vertebral fracture (localized pain)
⬥ joint or ligament injury (localized pain)
⬥ Cervicothoracic strain
⬥ facet syndrome
⬥ disc derangement
⬥ (+) Brudzinski sign … reflexive hip and knee flexion
• meningitis, infection, abscess, SOL