3. Cervical Spine Somatic Dysfunction Diagnosis

Question 1

Name the red, brown, green, and blue lines on the picture below.

(C-Spine Lateral View)

Answer 1

Red: anterior vertebral line
Brown: posterior vertebral line
Green: spinal laminar line
Blue: posterior spinous process line

Question 2

If we see a significant misalignment of the spinous processes in an AP radiograph, what diagnosis might we expect?

Answer 2

Unilateral facet joint dislocation

Question 3

If we see a significant widening of the spinous processes on an AP radiograph, what diagnosis might we expect?

Answer 3

Anterior cervical dislocation

Question 4

How could an open mouth radiograph assist us in visualizing the spine?

Answer 4

It gives us a unique view of C1/C2

Question 5

If the lateral masses of C1 overhang the lateral masses of C2, what diagnosis might we expect?

Answer 5

Jefferson burst fracture

Question 6

Which foramina is visible in a right posterior oblique (45°) view?

Answer 6

The left foramina

(posterior oblique views show the other foramina)

Question 7

What are the major motions of the OA joint?

What are the minor motions?

Answer 7

Major motions: flexion and extension

Minor motions: side bending and rotation

Question 8

Which way do side bending and rotation occur for the OA joint?

Which way do side bending and rotation occur for C3/C7?

Answer 8

OA: opposite directions

C3/C7: same directions

Question 9

What two muscles are in charge of rotation of the AA joint?

Answer 9

Obliquus Capitis Inferior

Question 10

Theoretically, why does the rotation of C2-C7 occur in the same direction?

Answer 10

There uncinate processes

Question 11

What are the indications for soft tissue cervical treatment?

Answer 11

Cervical somatic dysfunction with significant soft tissue component

Question 12

What are the contraindications for soft tissue cervical treatment?

Answer 12

Fractures, open wounds, surgical sites, infection (bony or soft tissue), DVT, coagulopathy, neoplasm

Question 13

What are the indications for HVLA, and ART?

Answer 13

Cervical somatic dysfunction with identified range of motion restriction attributable to a somatic dysfunction in the cervical facet joint, a joint

Question 14

What are the contraindications for HVLA and ART?

Answer 14

Advanced RA

Down’s Syndrome

Vertebral / Carotid Artery Disease

Inflammatory arthritis

Malignancy

Acute radiculopathy

Klippel-Feil syndrome

Chiari malformation

Achondroplastic dwarfism

Question 15

What are the indications for Still’s Technique or MET?

Answer 15

Cervical SD

Question 16

What are the contraindications for MET or Still’s?

Answer 16

Undiagnosed joint swelling, severe osteoporosis, neoplasm, infection, hematoma, RA, fracture, dislocation

Question 17

What are the three stages of Spurling’s Maneuver?

Answer 17

1. Compression of the head in neutral
2. Compression of the head in extension
3. Sidebend away from the affected side, then toward the affected side and add compression

Question 18

What does a positive Spurling’s test indicate?

Answer 18

Nerve root compression