Cervical lab Flashcards
The c-spine functions as type _ mechanics
II
What are the differentiating tests?
sustained movements
combined movements
compression
distraction
This movement may produce referred symptoms
a. combined movements
b. sustained movements
c. distraction
d. compression
sustained movements
What are the combined movements for differentiating tests?
upper quadrant
lower quadrant
Combined movement testing can be done if
all physiological movement testing is clear
This differentiating test is done with the patient seated, pt goes into ext of upper c-spine and maintains then adds rotation toward painful side then SB
upper quadrant
This differentiating test is with the patient seated, have them tilt their head back into full extension, SB to painful side, then rotate
lower quadrant
This test is done by compressing the top of the head down for 30 seconds
compression
This test is done by distracting the head via the mastoid process and holding it for 30 seconds
distraction
What neurological testing needs to be done for clearance?
dermatomes
myotomes
reflexes
CN screen
Dermatome: bilateral on head, next to midline
a. C1
b. C2
c. C3
d. C4
C1
Dermatome: cheek bone
a. C1
b. C2
c. C3
d. C4
C2
Dermatome: anterior aspect of neck
a. C1
b. C2
c. C3
d. C4
C3
Dermatome: on top of shoulder to deltoid insertion
a. C2
b. C3
c. C4
d. C5
C4
Dermatome: lateral aspect of shoulder, following lateral aspect of arm to radial styloid process
a. C2
b. C3
c. C4
d. C5
C5
Dermatome: distal segment I thumb and index finger
a. C5
b. C6
c. C7
d. C8
C6
Dermatome: middle 3 fingers
a. C5
b. C6
c. C7
d. C8
C7
Dermatome: ring finger and pinkie up to wrist
a. C5
b. C6
c. C7
d. C8
C8
Dermatome: medial aspect of arm, beginning of wrist and extending up to shoulder
a. C7
b. C8
c. T1
d. T2
T1
Dermatome: from the elbow, medial aspect through axilla over the chest
a. C7
b. C8
c. T1
d. T2
T2
Myotome: neck flexion
a. C1
b. C2
c. C3
d. C4
C1
Myotome: neck extension
a. C1
b. C2
c. C3
d. C4
C2
myotome: neck SB
a. C1
b. C2
c. C3
d. C4
C3
myotome: elevation of shoulder blades - shrug
a. C1
b. C2
c. C3
d. C4
C4
myotome: shoulder abduction
a. C5
b. C6
c. C7
d. C8
C5
myotome: elbow flexion, supination, wrist extension
a. C5
b. C6
c. C7
d. C8
C6
myotome: elbow extension, pronation, wrist flexion
a. C5
b. C6
c. C7
d. C8
C7
myotome: long finger flexors and thumb extension
a. C5
b. C6
c. C7
d. C8
C8
myotome: lumbricales and interossei
a. C6
b. C8
c. T1
d. T2
T1
Biceps reflex
a. C4, C5
b. C5, C6
c. C7, C8
d. C8, T1
C5,6
triceps reflex
a. C4, C5
b. C5, C6
c. C7, C8
d. C8, T1
C7, 8
Romberg close and open eye eye tracking finger rustle peripheral vision tongue out
CN screen
VA testing
Rotation right then left to end range; count from 15 down to 1
Observe for loss of count, confusion, dizziness, nystagmus, fluttering, voice changes, nausea
How do you take the middle ear out from VA testing?
turn shoulders dont move head
trigger points show what kind of pain
refer pain
ULNT 1 is testing
a. radial nerve
b. ulnar nerve
c. median nerve
median nerve
ULNT 2a is testing
a. radial nerve
b. ulnar nerve
c. median nerve
median nerve
ULNT 2b is testing
a. radial nerve
b. ulnar nerve
c. median nerve
radial neve
ULNT 3 is testing
a. radial nerve
b. ulnar nerve
c. median nerve
ulnar nerve
CCFT is used to test which muscle
longus collis
what is key with CCFT?
head nod
how do you do CCFT
head nod then lift
This test measures errors viewed in return from extension and rotation (can also do flexion and sidebending)
cervical joint position sense
How do you complete the cervical joint position sense?
Mark starting position, close eyes, move into extension or rotation and return to start
then
Measure difference in marks in centimeters and not over/undershoot
What is normal joint position sense
less than or equal to 7cm from starting mark
Slide glides, side bending and PA in prone can be used to test
segmental mobility
What are you looking for with side glide testing
see if its stiff at end range
What happens when you do segmental mobility side bending?
SB closes and slides down
PA in prone assess _
extension
What percentage of rotation occurs at C1/C2?
60-70%
What are you looking for with cervical-flexion rotation test?
how much rotation and flexion they have
Spurling test is used to test for
cervical radiculopathy
This test is compression to close down the facet with the head side bent
a. Brachial plexus compression test
b. distraction test
c. spurling test
d. Sharp pusher test
spurling test
This test is compressing just above the clavicle and putting traction on the nerve root
a. Brachial plexus compression test
b. distraction test
c. spurling test
d. Sharp pusher test
brachial plexus compression test
The brachial plexus test compression test is testing for
cervical radiculopathy
This test is cupping of neck around mastoid process and other hand on top of chin, fulling with cupping hand
a. Brachial plexus compression test
b. distraction test
c. spurling test
d. Sharp pusher test
distraction test
The distraction test is used to test for
cervical radiculopathy
A positive distraction test is indicated by
a. pain provocation
b. nerve pain
c. shooting pain
d. symptoms made better
symptoms made better
Patient brings shoulder up into abduction with elbow flexion to see if there’s pain
a. Brachial plexus compression test
b. distraction test
c. spurling test
d. abduction test
abduction test
A positive shoulder abduction test is indicated by
making symptoms better
Cervical rotation less than 60 degrees to involved side, Positive spurlings, positive distraction and positive ULNT is what prediction rule
Wainer for cervical radiculopathy
What is the Wainners CPR for cervical radiculopathy?
Cervical rotation less than 60 degrees to involved side, Positive spurlings
positive distraction
positive ULNT
ULNT 1 has high (sensitivity/specificity)
sensitivity
The modified sharp pusher test, alar ligament stability, anterior shear/transverse ligament test are used to test for
upper cervical instability
this test is pinching the spinous process of C2 and flex head with applied force to the forehead
modified sharp pusher test
cervical flexion rotation test and joint mobility assessment assess for
cervicogenic headache
cervical flexion rotation test is used to
check mobility of C1 and C2
what CPR is used to see if the c-spine radiographs are needed
Canadian c-spine rules
AA joint does
rotation
AA muscle energy technique
flexion then rotation and hold against resistance
What grades should you do for cervical slide glide mobilization?
grade 3 and 4
cervical side bending mobilization is used to treat
radiculopathy
How do you do splenius capitis soft tissue release
extend neck with contact on occipital then lengthen under fingers and hold, drag superiorly
Prone PA mobs work on
extension
this mobilization is stand on side of pt, cup hand under c2, stack fingers and take up slack with soft tissue then rotate head with hand on top of forehead and feel C2 in your fingers
AA mobilization
How do you do an upslope manipulation?
rotation
side bend
extend
