Cervical

Question 1

Anterior scalene attachments and action

Answer 1

Attachment: TP C3-6, 1st rib.

Action: elevate rib or laterally flex/contra rotate neck

Question 2

Middle scalene attachments and action

Answer 2

Attachment: TP C2-7, 1st rib.

Action: elevate rib or laterally flex/contra rotate neck

Question 3

Posterior scalene attachments and action

Answer 3

Attachment: TP C4-6, 2nd rib

Action: elevate rib, laterally flex neck

Question 4

Splenius muscle actions

Answer 4

bilaterally: extend cervical spine

Unilaterally: laterally flex and rotate ipsilaterally

Question 5

Greater occipital neuralgia: nerve root and muscle involved?

Answer 5

C2 nerve root entrapment in semispinalis

Question 6

Canadian C-spine rule

Answer 6

Any high risk factors

• -age greater than 65
• -dangerous mechanism (fall from 1 meter, MVA over 100km/hr(62mph), rollover, bike accident)
• -parestheias in extremities

If no high risk factors, then AROM checklist:

• -simple rear-end MVA
• -no mid line tenderness
• -ambulatory
• -non-immediate pain

If yes to above, then assess ROM, if less than 45*, radiographs indicated

Question 7

MDC, MDIC for NPRS

Answer 7

MDC:2.1
MCID: 1.3

Question 8

MDC for NDI

Answer 8

20% change

Question 9

FABQ

Answer 9

2 subscales, work and physical activity, each scored separately, no combined score

scored 0-6 for each question

Question 10

FABQ work subscale range

Answer 10

0-42

Question 11

FABQ physical activity subscale range

Answer 11

0-24

Question 12

Neck pain with mobility deficits classification

Answer 12

Age less than 50
duration less than 12 weeks
symptoms isolated to neck
decreased cervical ROM

Question 13

What does Sharp-Purser assess?

Answer 13

integrity of transverse or cruciform ligament of C1/2

Assessing for reduction of C1 subluxation with posteriorly driven force

Reduction of myelopathic symptoms with posterior force may indicate positive test

Question 14

Alar ligament test

Answer 14

tests alar ligaments which support the atlanto-occipital junction

Delayed motion of C2 spinous process would be a positive test

Question 15

Symptoms of VBI

Answer 15

Dizziness, vertigo, giddiness, lightheadedness
Nausea
Numbness (usually facial)
Ataxia
Diploplia

Question 16

6 predictors of positive response to c/s manipulation

Answer 16

NDI less than  11.5
Bilateral symptoms
Non-sedentary work
Neck feels better with movement
Extension doesn't aggravate symptoms
Diagnosis was spondylolysis 

4 of 6= 89% positive outcome

Question 17

T/s manipuation for cervical pain (6 items)

Answer 17

Symptom duration less than 30 days
No symptoms distal to shoulder
Looking up doesn't aggravate symptoms
FABQ-PA less than 12
Decreased upper thoracic kyphosis
Cervical extension less than 30

3 items present, 86% chance of success

Question 18

Neck flexor endurance results

Answer 18

with neck pain: 24s average

without neck pain 39s average

Question 19

CPR for cervical traction usage

Answer 19

Peripheralization with lower cervical mobiliy testing
Positive shoulder abduction sign
Older than 55
ULTTa
Relief with manual traction

4 or more present, increase from 44-94% success rate. +LR of 23.1

3 present +LR of 1.4