Cervical

Question 1

Chronic pain characterized by widespread ache,

stiffness, trigger points, fatigue, and stress.

Answer 1

Fibromyalgia

Question 2

Criteria for fibromyalgia if the following 3 conditions are met:

Answer 2

1a. The WPI score (Part 1) is greater than or equal to 7
AND the SS score (Part 2a & b) is greater than or equal to 5
OR
1b. The WPI score (Part 1) is from 3 to 6 AND the SS score (Part 2a & b) is greater than or equal to 9.
2. Symptoms have been present at a similar level for at least 3 months.
3. You do not have a disorder that would otherwise explain the pain.

Question 3

Patient presents with Clumsy or weak hands, Leg weakness or stiffness, Neck stiffness, Pain in shoulders or arms and Unsteady gait

Answer 3

Cervical Spondylotic Myelopathy

Question 4

Atrophy of the hand musculature, Hyperreflexia, Lhermitte’s sign, and Sensory loss are Common signs of

Answer 4

Cervical Spondylotic Myelopathy

Question 5

pathognomonic of cord compression because of cervical spondylosis at the C5-C6 interspace

Answer 5

Biceps & supinator reflexes (C5 and C6) may be absent and Brisk triceps reflex (C7).

Question 6

• Musculoskeletal findings
• Morning stiffness for more than 1
hour, often more prolonged
• Muscle stiffness after prolonged
inactivity
• Carpal tunnel syndrome (in about 15%
of patients)
• Distal extremity swelling (uncommon)
• Possible development of arthralgia
and myalgia up to 6 months after
onset of systemic symptoms

Answer 6

Polymalgia

Rheumatica

Question 7

Cervical spine extended and head
rotated ipsilateral. Axial load placed
on head

Answer 7

Spurling’s Test

Maximal Cervical Compression test

Question 8

distraction will aggravate

Answer 8

ligamentous pain

Question 9

• Palpate radial pulse
• Move upper extremity in abduction,
  extension, and external rotation.
• Rotate head ipsilateral
• Deep breath and hold it.

Answer 9

Adson’s test

(Scalenes Anticus) for Scalenes or Cervical rib

Question 10

• Locate radial pulse
•Draw patient’s shoulder down and back as they lift their chest in an
exaggerated “at attention” posture.
•Examiners hand depresses shoulder

Answer 10

Costoclavicular Maneuver for TOS

Question 11

Wright’s test
Hyperabduction
• Palpate radial pulse with arm at side.
• Arm fully abducted in external
rotation

Answer 11

Wright’s test

(Hyperabduction) for TOS or Hyperabduction syndrome

Question 12

• Hold both elbows at shoulder height while pushing shoulders
  back.
• Repeatedly open and close fist for up to 3 minutes

Answer 12

Ross stress test

East’s

Question 13

• Elevate hand and makes fist
• Pressure applied over radial and / ulnar arteries
• Hand lowered and hand opened.
• Examiner releases ulnar compression
• Repeat by releasing radial artery

Answer 13

Allen’s Test

Question 14

normal Allen’s test the Hand color flushes within

Answer 14

5 to 7 seconds

Question 15

Maximal neck flexion looking for shooting, electric-like pain in the lower extremities.

Answer 15

Lhermitte’s Sign indicating Cervical Myelopathy

Question 16

• Patient Supine
• Examiner exerts pressure on sternum
• Examiner’s other hand under the patient’s occiput and flexes neck
toward sternum.

Answer 16

Soto-Hall Test

Question 17

Patient abducts arm to put hand on top of head, positive if relieves symptoms

Answer 17

Bakody’s Sign

Arm abduction sign

Question 18

Paresthesias, numbness, / upper extremity pains associated with or without upper back stiffness.

Answer 18

T4 Syndrome