Neck

Question 1

What are the steps of the neck PE?

Answer 1

1. Inspect
2. Movements
3. Scapular movements
4. Arm tests
5. Adjunctive tests
6. Palpation
7. SD eval

Question 2

What are the four things you are assessing for with movements of the neck?

Answer 2

1. RROM
2. Weakness
3. Pain
4. Location of pain

Question 3

If the neck movements are clearly disturbed, then the problem is most likely what?

Answer 3

In the neck itself

Question 4

If there is neck pain but there is no RROM, then what is the etiology of the pain?

Answer 4

• Referred pain

- Non-mechanical

Question 5

If there is pain in shoulder girdle, what are the four joints that should be assessed?

Answer 5

• Sterno-clavicular
• Acromio-clavicular
• costo-scapular
• 1st costo-transverse

Question 6

What are the neck problems that can lead to arm pain?

Answer 6

Spinal cord/cervical root lesion

Question 7

What does rotation of the neck check?

Answer 7

Stretches elements on either side of the neck

Question 8

What does sidebending of the neck test for?

Answer 8

facets on either side

Question 9

Is there limitation to flexion with flexion of the neck with capsular pain?

Answer 9

No

Question 10

Which is worse with capsular neck pain: side bendings or rotation

Answer 10

Both equally bad

Question 11

Is there limitation to flexion with extension of the neck with capsular pain?

Answer 11

Can be

Question 12

Painful capsular pattern of RROM indicates what?

Answer 12

Fracture or RA

Question 13

What are the physiologic types of end feel?

Answer 13

Hard
Elastic
Tissue approx

Question 14

What are the pathologic type of end feel?

Answer 14

Guarding

Muscle spasm

Question 15

What is elastic end feel?

Answer 15

At the end of ROM, the examiner feels resistance, but further stretching over a few degrees is possible, typical of a normal joint capsule

Question 16

What do muscle spasms indicate?

Answer 16

restricted ROM–severe disorder

Question 17

What are the two end-feels that contraindicate OMM?

Answer 17

Guarding

Muscle

Question 18

Pain on active and passive stretching in one direction, but also on isometric testing in the opposite direction indicates what?

Answer 18

Musculotendinous lesion,

Question 19

Pain with elevation of the scapula indicates what?

Answer 19

The need for a shoulder girdle exam

Question 20

Resisted elevation of the shoulder tests which spinal levels? What nerve is this?

Answer 20

C3-C5 + CN XI

Question 21

If there is painful limitation of movement without weakness with elevation of the arm, this indicates what?

Answer 21

Local lesion in the arm

Question 22

Hyperreflexia is an UMN or LMN sign?

Answer 22

UMN

Question 23

Hyporeflexia is an UMN or LMN sign?

Answer 23

LMN

Question 24

Biceps reflex tests which spinal level?

Answer 24

C5/6

Question 25

Brachioradialis reflex tests which spinal level?

Answer 25

C5/6

Question 26

Triceps reflex tests which spinal level?

Answer 26

C7

Question 27

Patellar reflex tests which spinal level?

Answer 27

L4

Question 28

Achilles reflex tests which spinal level?

Answer 28

S1

Question 29

Shoulder adduction = which spinal level?

Answer 29

C5/6

Question 30

Elbow flexion = which spinal level?

Answer 30

C5/6

Question 31

Wrist extension = which spinal level?

Answer 31

C6

Question 32

Elbow extension = which spinal level?

Answer 32

C7

Question 33

Long finger flexion = which spinal level?

Answer 33

C8-T1

Question 34

Abduction of the 5th digit = which spinal level?

Answer 34

C8-T1

Question 35

What does Spurling's test look for?

Answer 35

Nerve root compression

Question 36

What is the procedure for Spurling's test?

Answer 36

Add rotation, sidebending and axial compression

Question 37

What is the distraction maneuver for spurling's? What is a positive test? What does this indicate?

Answer 37

Dural stretch. Positive = decrease in radicular pain Indicates radiculopathy

Question 38

When should you do x-rays before doing ROM of the neck? (3)

Answer 38

- Suspect fracture - Severe neurological complaints - Intoxication

Question 39

What are the five things that you should decide after a neck PE?

Answer 39

1. Need to examine further 2. further testing? 3. Consult? 4. OMM? 5. Other treatments?

Question 40

True or false: capsular pattern is an indication for x-ray

Answer 40

True

Question 41

True or false: neurological findings are an indication for an x-ray

Answer 41

True

Question 42

What should you examine if the patient gets dizzy looking up?

Answer 42

Auscultate the carotids

Question 43

How, generally,do you assess joint surfaces? Ligaments? Muscles?

Answer 43

joint surfaces = squish Ligaments = pull apart Muscles = have them contract

Question 44

True or false: anticoagulation is a relative contraindication to OMM

Answer 44

True

Question 45

What are the four neck problems that should be assessed for with inspection of the neck?

Answer 45

- Abnormal head position - Abnormal Shape - Masses - Scoliosis reaching the neck

Question 46

If there is dizziness when looking up, what imaging should you get?

Answer 46

- Flexion/extension cervical spine x-rays | - Carotid and vertebral US

Question 47

What are the characteristics of the capsular pattern of the neck in terms of: - Flexion - Side bending/rotation - Extension

Answer 47

- No limitation of flexion - Equal degree of limitation of side bending and rotation - Some or great limitation of extension

Question 48

What are the likely etiologies of the capsular pattern of the neck?

Answer 48

Fracture or tumor.

Question 49

True or false: Capsular pattern is a contraindication to OMM

Answer 49

True

Question 50

What are the three things you are looking for with passive movement of the neck?

Answer 50

Restriction Pain End feel

Question 51

What are the two things you are looking for with resisted movement of the neck?

Answer 51

Pain | Weakness