Cervical Lab

Question 1

O-A, A-A motion

Answer 1

O-A = 15 deg flex/ext

A-A = 45 deg rotation each side

Question 2

Composite cervical motion

Answer 2

Total flexion/extensión = 126 deg
Total rotation = 144 deg
Total lateral flexion = 87 deg

Question 3

What happens because of forward head posture

Answer 3

1. Upper cervical extension
2. Lower cervical flexion
3. Upper thoracic flexion

Question 4

What are safety considerations when evaluating C Spine

Answer 4

1. Alar ligament test — done in seated. Slight lateral flexion — C2 SP contra rotation
2. Vertebral artery test — supine, head of table — gotta keep eyes open and assess cog function during

Question 5

What is craniovertebral locking

Answer 5

Method of protecting VA during cervical assessment and treatment
- Keeps vertebral foramen aligned — no kinking because the more movement we get from C2 the more impinging VA can occur
- You side bend to the side you want to assess and rotate away
- SUPER TINY MOVEMENTS

Question 6

C2 movement during craniovertebral locking

Answer 6

Ex: L CVlocking
Side bend left — C2 moves to the right.
Don’t want that sucker moving and kinking VA
Rotate right — C2 gets back aligned to center = no kinking

Question 7

What is direction of mobilization for a downslide in C spine

Answer 7

Inferior
Posterior
Little medial

Question 8

What is direction of mobilization for upglide

Answer 8

Superior
Anterior
Slightly lateral

Question 9

Contraindications for cervical manip

Answer 9

1. Recent infection
2. Connective tissue disease
3. Congenital collagenous compromise — DS, ED
4. Empty end feel
5. Unwilling patient
6. History of smoking
7. Atherosclerosis
8. HTN
9. Long term steroid use
10. Bleeding disorders
11. Recent relevant trauma
12. UMN lesion s/s
13. Recent manip by another professional

Question 10

O-A distraction manip

Answer 10

Ex: (R) side
1. Left arm cradles head right against the body, with left CMC thumb joint under patients left zygomatic arch
2. PT’s R hand index finger MCP joint is under the R mastoid process
3. PT’s right elbow should be above patient’s right shoulder and right against the right side of their chest
4. Use legs to create axial traction force
5. PRE-MANIP HOLD
6. CONSET
7. MANIIIPPPPPP

Question 11

A-A Distraction manip

Answer 11

Side lying

Question 12

What happens after the thrust?

Answer 12

Re-assess
Exercise!!!!!!!!!!!!
Work in the new motion - stretch, ROM, PPIVMS

Question 13

What is a SNAG

Answer 13

Sustained natural apophyseal glides
— sustained repositioning of one articular surface on its neighbor while a movement of function is undertaken
— combo of sustained facet glides with movement
— always involved with end-range joint movement
HAS TO BE PAIN FREE