Cerv/ Thoracic

Question 1

Radiculopathy

Answer 1

SSX
Unilateral pn neck, shoulder, arm
Weakness in arm

OX
Pos shoulder abduction test to relieve symptoms
Pos spurlings distraction and compression
Reduced deep tendon reflex
Lhermitte for deep tendon reflex
Ankle clonus rule out UMN
AROM neck Aggs, RROM arms asymmetric

TX
Relative rest and desensitise
AROM
Heat cold
Isometric s
General UL strength
Neural flossing

Question 2

sprain/ strain - whiplash

Answer 2

SSX
Pn increases after days/ hours
Weak stiff neck

OX
Tender neck palp
RROM pain

TX
Avoid loading in end range
Iso/isot
Graded progression once pain free
Ex example: 4 point kneel neck retraction, cushion chin tuck

Question 3

Brachial plexus

Answer 3

SSX
stringer burner UNILATERAL
Head sideways and shoulder down
(If bilat or radiating 🚩)

OX
brachial plexus traction test
Weak RROM in delt,bicep, rotator cuff
Pos tinel sign at supraclabicular fossa

TX
*
Avoid scap depression
Increase strength and rom as indicated by deficits
Isometric - concentric partial range - full range as indicated by pain
Reduce controlled environments final step

Question 4

WRY NECK

Answer 4

SSX
Idiopathic
Pn increases with faster movement
Pn palp SCM
pn lateral flexion

TX
Self resolving
Slow AROM
Trick nervous system

Question 5

kyphosis

Answer 5

SSX
Insidious onset // youth , pn increases with activity and receded with rest, severe do spirometry

OX
Posture , Ct cannot reduce curve, Reduced hip flexion

TX
NSAID, strengthen thoracic paraspinal (erectors) such as: Superman on ball, YTW
Stretch lumbar Paraspinal muscles: knee to chest stretch, child pose
Stretch hamstrings and glutes to support pelvic posture

Question 6

Thoracic outlet

Answer 6

SSX
Physical trauma, repetitive injury, job or sport or posture
Numbness, Tingling, edema, coldness

OX
Roos test
Adsons
Dead arm
ALL ROM UNAFFECTED

Tx
Non steroid anti inflammatory
Modification of sleep and posture
Anterior shoulder stretch
Postural retraining