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MS II > Cervical Exam > Flashcards

Cervical Exam Flashcards

1
Q

When does age becomes a risk factor for poor outcomes in cervical pathology?

A

> 40

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2
Q

What activity is related to a poor outcome of cervical treatment?

A
  • Bicycling
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3
Q

What co-existing problem is related to poor outcomes of cervical treatment?

A

Low back pain

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4
Q

What 3 psychosocial factors are related to poor outcomes in cervical treatment?

A
  • “worrisome” attitude
  • Poor QoL
  • “Less vitality”
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5
Q

What cervical PMH is related to poor outcomes of cervical treatment?

A
  • Long history of neck pain
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6
Q

Does a “wait and see” approach work with mechanical neck pain?

A

No. The earlier a patient sees a PT. the better the outcome

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7
Q

What is the 1st question of the canadian cervical spine rules?

A
  • Older than 65?

Dangerous mechanism of injury?:

  • Fall from >1m or 5 stairs
  • Axial load to head
  • High speed MVA (100km/h)
  • Motorized recreational vehicle
  • Bicycle collision
  • Parathesias in extremities?
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8
Q

If a patient answers yes to any of the first c-spine rules, what is the course of action? What if the patient answers no?

A

Yes: Get x-rays
No: Move on to #2…

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9
Q

What is the 2nd cervical spine rule question?

A

Are there low-risk factors that allow safe assessment of ROM?

  • Simple rear-end motor vehicle accident?
  • Normal sitting posture in exam?
  • Ambulatory at any time since injury?
  • Delayed onset neck pain and absence of midline tenderness?
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10
Q

If a patient answers yes to all of the #2 questions, what is the course of action? What if a patient answers no to any of the questions?

A

Yes to all: Ask #3

No to any: Get an x-ray

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11
Q

What is the 3rd cervical spine rule?

A
  • Can the patient rotate the neck 45 degrees each direction?
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12
Q

If the patient answers no to the 3rd question, what is the course of action? If the patient answers yes, what is the course of action?

A

Yes: Proceed with exam
No: X-rays

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13
Q

What is VAS?

A

Visual analogue scale (pain)

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14
Q

What is NPRS?

A

Numerical pain rating scale

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15
Q

What is the MCID of VAS and NPRS?

A

2 points

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16
Q

What is the MCID for the Neck Disability Index?

A

5 points

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17
Q

What is GROC?

A

Global Rating of Change

15 statements from - 7 to + 7 (getting worse to getting better)

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18
Q

How is posture assessed during the examination?

A
  • Note deviations, correct, note change in symptoms
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19
Q

What should be assessed in a postural exam of the cervical spine in the frontal plane?

A
  • Lateral flexion

- Scapular position (elevated/ rotated/ winging

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20
Q

What should be assessed in a postural exam of the cervical spine on the transverse plane?

A
  • Rotation
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21
Q

What should be assessed in a postural exam of the cervical spine in the sagittal plane?

A
  • Eyes and mandibles horizontal
  • Forward head posture
  • Protracted and retracted shoulder
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22
Q

Which type of postural deviation is very common in the c-spine?

A
  • Forward head posture
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23
Q

What muscles should be assessed for symmetry in an exam of the c-spine?

A
  • Traps
  • Deltoids (all 3)
  • Pec major
  • SCM
  • Infraspinatus
  • Latissimus dorsi
  • Erector spinae
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24
Q

What term refers to the willingness to move?

A

Kinesiophobia

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25
Q

What 7 things should be assessed during palpation of the c-spine?

A
  • Temperature
  • Skin mobility
  • Fascial tightness
  • Muscle spasm
  • TrP
  • Tender Points
  • Bony prominences
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26
Q

What 4 bony prominences should be palpated?

A
  • Mastoid
  • Nuchal line
  • Spinous processes
  • Articular pillar/ facets
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27
Q

How is cervical axial rotation measured in supine?

A
  • Head is lifted off the surface so that it does not translate during rotation
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28
Q

** Review Cervical ROM **

A

** Review Cervical ROM **

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29
Q

What is the quadrant position of the cervical spine?

A

Combined movements of:

  • Extension
  • Rotation towards the tested side
  • Side bending towards the tested side
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30
Q

What type of pain will be felt in the quadrant position is there is mechanical or joint related neck pain?

A
  • Localized pain
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31
Q

What type of pain will be felt if a nerve root is impinged in the quadrant position?

A
  • Radicular pain

- Change in sensation

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32
Q

How can the upper or lower C-spine be targeted in measurement of flexion?

A
  • Retraction stresses the lower C-spine

- Protraction stresses the upper C-spine

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33
Q

What is a good test item cluster for the radiculopathy?

A
  • Distaction
  • Compression
  • Spurlings
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34
Q

List the least to most aggressive tests for radiculopathy for the following:

  • Spurlings
  • Quadrant
  • Compression
A
  • Compression
  • Spurlings
  • Quadrant
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35
Q

Describe the cervical distraction test.

A
  • Pt supine
  • Top hand on forehead to prevent flexion
  • Bottom hand cups occiput
  • Lift head
  • Distact
  • Hold for about 10 seconds
  • Assess for reduction in symptoms
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36
Q

Describe the cervical compression test.

A
  • Pt sitting
  • Standing behind Pt
  • Place elbows anterior to shoulder and correct posture
  • Lock hands over head
  • Compress downwards
  • Hold for 10 seconds (30 seconds?)
  • Assess for reproduction of symptoms
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37
Q

Describe Spurling’s cervical test.

A
  • Pt sitting
  • Standing behind Pt
  • Hold contralateral shoulder
  • Laterally flex to the same side
  • Provide axial load through C-spine
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38
Q

What is the O/C1 specific segmental motion test?

A
  • Pt supine
  • Full rotation to non- symptomatic side
  • Passively nod head in both directions using the mastoid processes for the axis of motion
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39
Q

What is the sidebend challenge?

A
  • Pt supine
  • Protract the patients head
  • Move the head side to side, and stress at the end of motion
  • Retract
  • Move head side to side, and stress at the end of motion
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40
Q

What is the flexion extension challenge?

A
  • Pt supine
  • Rotate the patient’s head 45 degrees to one side
  • Protract or retract the head (Retract tests posterior, protract tests anterior)
  • Stress in a diagonal plane to assess the passive and active stabilitations of the O/C1 joint
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41
Q

How is segmental motion of the AA joint assessed?

A
  • Pt supine
  • Neck placed into end-range flexion
  • Rotate neck axially, and compare sides
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42
Q

Describe a lateral glide of C2 - C7.

A
  • Pt supine
  • Lift head off pillow
  • Palpate articular pillar
  • Laterally glide vertebra combined with lateral translation of head
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43
Q

What facets are opened, and which are closed in a lateral glide of C2 - C7?

A 
Upper C-spine:
- Side towards motion opens
- Side away from motion closes
Lower C-spine
- Side towards motion closes
- Side away from motion opens
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44
Q

Describe an upslope of C2 - C7.

A
  • Pt supine
  • Palpate articular pillar
  • Lift head and pull across the neck at a 45 degree angle (fingers aligned in this position)
  • Rotate the head away from the palpated side during the motion (combine some sidebend as well)
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45
Q

Describe a downslope of C2 - C7.

A
  • Pt supine
  • Palpate articular pillar, place MCP on anterolateral aspect
  • Provide an axial load through the c-spine
  • Push pillar posteriorly and inferiorly combined with a side bend motion of the neck
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46
Q

Describe a CPA of the C-spine.

A
  • Pt prone
  • Locate the targeted spinous process and place the tips of the thumbs on it
  • Keep thumbs straight, wrist and elbows locked, and shoulders over arms
  • Gather the lateral neck tissue
  • Mobilize in anterior direction
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47
Q

What facets open and close in a CPA of the c-spine?

A
  • The joints above the CPA close

- The joints below the CPA open

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48
Q

Describe a UPA of the C-spine.

A
  • Pt prone
  • Palpate spinous process of targeted vertebra
  • Slip laterally off to the articular pillar
  • Mobilize anteriorly keeping proper form
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49
Q

What facets open and close during a UPA of the C-spine?

A
  • Ipsilateral joints close above the targeted vertebra, and close below
  • Contralateral joints open above the targeted vertebra, and close below
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50
Q

If a patient is hypomobile in one direction, but a mobilization cannot be performed because pain onsets before the movement barrier, what can be done?

A

Mobilize in the opposite direction until symptoms subside, and then reattempt the mobilization

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51
Q

Describe the flexibility test of the levator scapula, splenius cervicus, and posterior scalene.

A
  • Pt side lying with head laterally flexed towards table, and neck flexed forward slightly
  • Head stabilized
  • ## Press shoulder into retraction, depression, and upward rotation
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52
Q

Describe the flexibility test of the upper trapezius and SCM.

A
  • Pt supine with head at the edge of the table
  • Depress shoulder
  • Laterally bend away and rotate towards the targeted side
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53
Q

Describe the flexibility test of the middle and anterior scalene.

A
  • Pt supine with head over the edge of the table
  • Retract the head
  • Depress shoulder
  • Rotate towards the targeted side
  • Side bend away from the targeted side
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54
Q

How is strength grossly tested in the c-spine?

A
  • Isometric break tests of FLX/EXT, lateral FLX/EXT, and rotation
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55
Q

How is deep neck flexor endurance tested?

A
  • Pt supine
  • Chin tucked
  • Head is lifted slightly off the table
  • Place hand under head
  • Hold for about 30 seconds
  • If patient makes contact with hand for more than 1 second, it is a positive test
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56
Q

How long are non-symptomatic patients able to hold their head with their DNF as compared to symptomatic patients?

A

Non-symptomatic: 38.95

Symptomatic: 24.1

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57
Q

What spinal segments are being tested by DTRs of the biceps, brachioradialis, and triceps?

A

C6: Biceps/ brachioradialis
C7: Triceps

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58
Q

What are 5 positive tests of upper neuron dysfunction?

A
  • Hyperreflexive DTRs
  • (+) Hoffmann’s
  • (+) Babinski
  • (+) Clonus
  • Glove like paresthesias
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59
Q

What is indicative of myelopathy?

A

Bilateral paresthesias

60
Q

Describe Hoffmann’s reflex.

A
  • Flicking of DIP of middle finger leads to twitch of other digits
61
Q

Describe the Babinski reflex.

A
  • Light touch along the plantar surface of the foot leads to dorsiflexion of the big toe, and flaring of the other toes
62
Q

Describe Clonus of the wrist and hand.

A
  • Assure relaxation of the tested tissues
  • Apply quick motion into wrist extension or ankle dorsiflexion
  • Assess rhythmic beating
63
Q

How is Clonus graded?

A

Number of beats (1,2… continuous)

64
Q

** Study peripheral nerve distribution **

A

** Study peripheral nerve distribution **

65
Q

Describe Dermatome screening locations for C5 - T1.

A 
C5: Deltoid insertion
C6: Webspace of thumb
C7: Dorsal surface of 3rd digit
C8: Hypothenar eminence
T1: Long flexor muscle belly
66
Q

What is indicated by glove like paresthesias?

A
  • Peripheral artery disease

- Upper nervous system lesion

67
Q

Describe the myotome tests for C1 - T1.

A 
C1-2 = Cervical Flexion
C3 = Cervical Lateral Flexion
C4 = Shoulder Shrug
C5 = Shoulder Abduction
C6 = Elbow Flexion (wrist extension)
C7 = Elbow Extension (wrist flexion)
C8 = Thumb Extension (ulnar deviation)
T1 = Finger Abduction/Adduction
68
Q

What is the valsalva maneuver useful in assessing?

A
  • Disk pain
69
Q

How can the valsalva maneuver be assessed clinically?

A 
During history:
- Does it hurt when you cough or sneeze?
During exam:
- Perform "bathroom procedure" while holding breath
- Cough
- Sneeze
70
Q

What is the brachial plexus compression test?

A
  • Pt sitting
  • Apply pressure above clavicle on symptomatic side targeting lateral scalenes
  • Assess radicular symptoms
71
Q

What is the cervical hyperflexion test?

A
  • Pt sitting
  • Flex head to pain or end-range
  • Assess for reproduction of symptoms
  • Can be referred to same level on T-spine
72
Q

What is the shoulder abduction test?

A
  • Pt sitting
  • Assess resting symptoms
  • Place hand on head
  • Assess symptoms
  • if pain reduced, it is a positive test
73
Q

What is the cranial cervical flexion test?

A
  • Pt hooklying
  • Head and neck positioned and propped into midrange neutral
  • Place blood pressure cuff into cervical lordosis/ hollow at 20 mmHg
  • Patient flattens C-spine in 2 mmHg intervals, holding for 10 seconds each time
  • Check with the head in different positions/ with a chin tuck
    The test is positive if:
  • Patient can’t increase pressure at least 6 mmHg
  • Can’t hold for 10 seconds
  • Uses SCM to produce the motion
  • Cervical extension or chin movement occurs
74
Q

If a patient has a positive cranial cervical flexion test, what are the implications?

A
  • DNFs deconditioned

- Patient categorized into neck pain with movement coordination impairment

75
Q

What are 3 pathological responses to Upper Limb Tension Tests?

A
  • Reproduction of symptoms
  • Sensitizing test alters the symptoms
  • Side to side asymmetry of symptoms
76
Q

What are 6 normal responses to upper limb tension tests?

A
  • Deep ache in cubital fossa
  • Deep ache/ stretch in radial forearm/ hand
  • Tingling in fingers supplied by appropriate nerve
  • Stretch in anterior shoulder
  • Increase in symptoms with contralateral c-spine lateral flexion
  • Decrease in symptoms with ipsilateral c-spine lateral flexion
77
Q

How is the median nerve ULTT performed?

A
  • Shoulder depressed
  • Shoulder abducted 110 degrees with slight extension
  • Forearm supinated
  • Wrist and fingers extended
  • Ulnar deviation
  • Elbow moved from flexion to extension
  • Lateral flexion may be performed to sensitize the procedure
  • May stop the test at any point if symptoms are reproduced
78
Q

How is the radial nerve ULTT performed?

A
  • Shoulder depressed with hip
  • Start in 10 degrees shoulder abduction
  • Internally rotate shoulder
  • Extend the elbow
  • Pronate the forearm
  • Flex and ulnar deviate the wrist
  • Tuck thumb into fist (?)
  • Move into abduction
  • Sensitive into or out of lateral flexion
79
Q

How the ulnar nerve ULTT performed?

A
  • Shoulder depressed with hip
  • Shoulder abducted into 90 degrees
  • Elbow flexed
  • Forearm pronated
  • Wrist extended and radial deviated
  • Fingers extended
  • ER shoulder
  • Move shoulder into abduction
  • Sensitive with lateral flexion
80
Q

What are the special tests for upper C-spine instability in order?

A
  • Sharp-purser test
  • Alar ligament stability
  • Upper cervical flexion test
  • VBI test

Stop at any point if the test is positive; this is a red flag

81
Q

What is the modified Sharp-Purser test?

A
  • Pt sitting
  • Tuck chin/head to turn on symptoms
  • Stabilizes C2 on spinous process
  • Use forearm to stabilize C-spine
  • Drive C1 and head back onto C2 to turn off symptoms
82
Q

Describe the Alar Ligament Stability Test/

A
  • Pt sitting
  • Head slightly flexed
  • Palpate SP of C2
  • Passively side flex or rotate while assessing movement of SP of C2
  • C2 should rotate to the opposite side
83
Q

Describe the upper cervical flexion test.

A
  • Pt supine with no pillow
  • Hold head with fingers on C1 and thumbs cupping head
  • Hold C1 on posterior arch (directly beneath occiput through muscle)
  • Lift the head using fingers (lumbricales)
  • Assess excessive movement or reproduction of symptoms
84
Q

What are the 4 diagnostic categories of patients with neck pain?

A
  • Neck Pain with Mobility Impairments
  • Neck Pain with Headache
  • Neck Pain with Movement Coordination Impairments
  • Neck Pain with Radiating Pain
85
Q

To which category are patients with sprains and strains of the C Spine and whiplash assigned?

A
  • Neck Pain with Movement Coordination Impairments
86
Q

To which category are patients with headache associated with neck movement and position, or cervicocranial syndrome assigned?

A
  • Neck Pain with Headache
87
Q

To which category are patients with: spondylosis with radiculopathy, cervical DDD with radiculopathy, or cervical myelopathy assigned?

A
  • Neck pain with Radiating Pain
88
Q

To which category are patients with: cervicalgia, or pain in thoracic spine assigned?

A
  • Neck pain with mobility impairments
89
Q

What 2 main factors affect the assignment of a patient into a diagnostic category?

A
  • Patient’s main complaints

- Relevant impairments

90
Q

What treatments should be used at a minimum? How can they change?

A
  • Treat at least according to Clinical Practice Guidelines

- May modify or add treatments

91
Q

What treatment category can be referred to as Mechanical Neck Pain?

A
  • Neck Pain with Mobility Deficit
92
Q

Is mechanical neck pain typically unilateral or bilateral?

A

Unilateral.

93
Q

Is mechanical neck pain typically general or localized?

A

Localized

94
Q

To where can mechanical neck pain be referred?

A
  • T-spine
  • Scapula
  • Upper brachium
95
Q

Past what landmark does referred mechanical neck pain typically not travel past?

A

The elbow

96
Q

How can the local and referred pain of Neck Pain with Mobility Deficit typically be reproduced?

A
  • On specific motions
97
Q

What clues should be assessed in Neck Pain with Mobility Deficits?

A
  • Irritability
98
Q

How is motion altered in patients categorized to the Neck Pain with Mobility Deficit category?

A
  • Restriction in AROM, PROM with an altered endfeel
  • Joint play, and accessory motions
  • Flexbility
99
Q

Why may flexibility be difficult to assess in patients with Mechanical neck pain?

A
  • Lack of vertebral motion at vertebral segment
100
Q

What are the 5 relevant special tests for patients categorized into the Mechanical Neck Pain category?

A
  • Distraction
  • Compression
  • Spurlings
  • Quadrant
  • Cranial Cervical Flexion
101
Q

Which muscle group tends to be weak in patients with mechanical neck pain?

A
  • Deep Neck Flexors
102
Q

What are the 6 indicators for cervical manipulation interventions for patients with Neck Pain with Mobility Deficit?

A
  • NDI < 11.5 (Pain not too severe)
  • Bilateral pattern of involvement
  • Do not perform sedentary work (No desk job)
  • Cervical extension does not aggravate symptoms
  • Spondylosis without radiculopathy
  • Neck movement relieves symptoms
103
Q

What is the suggested dosage for cervical manipulation of a patient with Neck Pain with Mobility Deficit?

A
  • Up-slope glide once per hypomobile segment
104
Q

What are 6 indications for manipulation of the T-spine in patients with Neck Pain with Mobility Deficit?

A
  • Symptoms < 30 days
  • No symptoms distal to the shoulder
  • Looking up doesn’t aggravate symptoms
  • FABQPA score of < 12 (Fear avoidance belief questionnaire
  • Decreased upper T-spine kyphosis
  • C-spine extension < 30 degrees
105
Q

What percentage of patients with mechanical neck pain benefit from t-spine manips?

A
  • 54 %
106
Q

What percentage of patients with mechanical neck pain benefit from t-spine manips when following CPR rules?

A
  • 86 %
107
Q

What are the 4 t-spine manips indicated by the CPR rules?

A
  • Seated distraction manipulation twice
  • Supine upper thoracic manipulation (trigger) twice
  • Supine middle thoracic manipulation (trigger) twice
  • Upright AROM rotation in cervical flexion
108
Q

What type of headaches respond well to physical therapy?

A
  • Tension

- Cervicogenic

109
Q

What types of headaches do not respond especially well to physical therapy?

A
  • Migraine
  • Sinus
  • Cluster
110
Q

Is tension headache unilateral or bilateral?

A

Bilateral

111
Q

How often do tension headaches occur?

A
  • 15 days/ month for the last 3 months
112
Q

What type of pain is felt in a tension headache?

A
  • Pressing or tightening headache
113
Q

Does pain increase or decrease with activity in a tension headache?

A

Neither. It is unaffected

114
Q

What types of sensory input are patients with tension headaches sensitive to?

A
  • None
115
Q

How often to patients with tension headaches experience vomiting or nausea?

A

Never

116
Q

What must not be involved for a headache to be termed a tension headache? (5 bullets)

A
  • Secondary headache
  • Whiplash
  • Surgery
  • CNS involvement
  • Red flags
117
Q

What are 4 indications for TrP therapy in tension headaches?

A
  • Headache duration 8.5 hours per day
  • Headache frequency < 5.5 days per week
  • SF-36 Body pain < 47
  • SF-36 Vitality < 47.5
118
Q

What muscles are typically treated for trigger points when indicated in tension headaches?

A
  • Temporalis
  • Suboccipital
  • Upper trapezius
  • Sternocleidomastoid
  • Splenius cervicus
  • Semispinalis capitis
119
Q

What are the 3 interventions indicated by tension headaches?

A
  • Pressure release
  • Muscle Energy Techniques
  • Soft Tissue work
120
Q

Is neck pain associated with cervicogenic headaches?

A

May or may not be present

121
Q

What type of pain is felt in a cervicogenic headache?

A
  • Persistent. sharp to dull pain
122
Q

How can the dizziness from cervicogenic headaches be differentiated from that of the vestibular system?

A
  • Move the head on the body

- Move the body on the head (will provoke dizziness in patients with cervicogenic dizziness, but not vestibular)

123
Q

What are 5 prescriptions for cervicogenic headaches?

A
  • Cervical mobilizations/ manipulations
  • Stretching
  • Coordination
  • Strengthening
  • Endurance training
124
Q

What is the typical mechanism of injury for Neck Pain with Coordination Impairments?

A
  • Traumatic injury to neck (hyperextension/ hyperflexion)

- Commonly motor vehicle accidents

125
Q

What is the major symptom of Neck Pain with Coordination Impairments?

A
  • Mid-range neck pain, with an increase at end-range
126
Q

What type of injury is commonly categorized as Neck Pain with Movement Coordination Impairments?

A

Whiplash

127
Q

What type of pain is associated with Neck Pain with Movement Coordination Impairments?

A
  • Referral into shoulder girdle and/or upper arm
128
Q

What muscles are typically affected in patients with Neck Pain with Movement Coordination Impairments?

A
  • Deep neck flexors
129
Q

What is extremely important in the treatment of acute Whiplash injuries?

A
  • Prevent progression to the chronic stage
130
Q

How can the psychosocial aspects of a patient with whiplash injury be managed by the PT?

A
  • Be gentle with their interventions
  • Pay attention to the patient’s psyche
  • Encourage, and ensure that they will get better
  • Pay attention to the language used to describe their condition and future function
131
Q

What muscles groups are strengthened in patients with Neck Pain with Movement Coordination Impairments?

A
  • DNF

- Posterior neck muscles

132
Q

Besides strengthening, coordination, and endurance, what other therex is appropriate to patient’s with whiplash?

A
  • Stretching (after the symptoms are less acute)
133
Q

What are 4 indications that a patient with whiplash is at high risk for persistent disability?

A
  • Collision occurring at a location other than a city intersection
  • Upper back pain since the collision
  • Neck pain persists for 2 weeks post accident
  • Shoulder pain persists for 2 weeks post accident
134
Q

How many of the 4 indications need to be answered affirmatively to place the patient into the high risk for persistent disability category?

A

Either both: city inter section + upper back pain

OR

Yes to:

Neck pain 2 weeks after accident

OR

Shoulder pain with either city intersection or upper back

135
Q

What are the 4 indications for placement of the patient into the category of cervical radiculopathy?

A
  • Cervical rotation toward involved side < 60 degrees
  • (+) ULTT for the Median Nerve
  • (+) Cervical distraction test
  • (+) Spurling’s A test
136
Q

What is the MCID of the NDI scale?

A

7 points

137
Q

What is MCID of the PSFS scale?

A

2 points

138
Q

What is the MCID of the NPRS?

A

2 points

139
Q

What is the MCID of the GROC?

A

5 points

140
Q

What are the CPR for the use of traction with patients categorized into Cervical Radiculopathy?

A
  • Age > 54
    • Shoulder Abduction Test
    • ULLT Median Nerve
  • Symptoms peripheralize with CPA at C4 - C7
    • Distraction test
141
Q

What are the parameters for distraction when the patient meets the CPR for traction for Cervical Radiculopathy? (Duration? Position? Time on: Time off? Load?)

A
  • 15 minutes
  • Supine with 24 degrees of cervical flexion
  • 60 seconds on: 20 seconds off (50 % of load in off time)
  • Begin at 10 - 12 lbs, then increase if neccessary
142
Q

What 2 exercises were combined with traction in treatment of Cervical Radiculopathy?

A
  • Scap retraction to correct Forward Head Posture

- DNF Training

143
Q

Describe side bend assessment.

A
  • Lateral bend to same side with a localized medial pressure on the lateral articular pillars
144
Q

What are 3 interventions for Neck Pain with Radiating Pain from the Clinical Practice Guidelines?

A
  • Upper quarter and nerve mobilization procedures
  • Traction
  • Thoracic mobilization/ manipulation
145
Q

Describe the upper quarter nerve mobilization procedure (not sure on this one).

A
  • Cervical lateral glide in a neuromobilization position (ULTT)

MS II (20 decks)

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