Cervical ROM and MMT Flashcards
What are the 3 levels of observation?
Skin, subcutaneous, bony structure
What to observe/inspect for with the cervical spine?
-Head alignment (center/right/left rotation or side bending)
-Neck alignment on trunk
-C-curve
-Soft tissue contours of ant & post structures (atrophy/hypertrophy)
-Observation if individual is a mouth breather (mouth breathers encourage forward head)
What do you palpate for the cervical spine?
Anterior muscles, posterior muscles, bony landmarks (spinous & transverse processes)
What are 3 tools that are used to measure cervical ROM?
Tape measure, goniometer, inclinometer
What ranges of motion do you assess for the cervical spine?
Flexion, extension, side bending right & left, and cervical rotation right & left
Where is cervical flexion and ext initiated at?
C4-C7
Cervical flexion and extension with tape measure (landmarks and cue)
- Tip of mandible to sternal notch
- Flexion: “Nod your head downward without rounding your shoulders”
- Extension: “Nod your head up and try to look at the ceiling”
Cervical SB/lateral flexion with tape measure (landmarks and cue)
- Tip of mastoid process to acromion process
- Watch for lateral shifts
- “Keep nose straight and bring ear to shoulder”
Cervical rotation with measuring tape (landmarks and cue)
- Tip of mandible to acromion process (?)
- “Turn your head and bring your nose over shoulder”
Cervical flexion w/ goni (landmarks and norm values)
SA: perpendicular to floor
F: Ear hole
MA: nares (nostrils)
45-50 degrees
Cervical extension w/ goni (landmarks and norm value)
SA: perpendicular to floor
F: ear hole
MA: nares (nostrils)
85 degrees
Cervical rotation w/ goni (landmarks and norm value)
SA: Acromion to acromion
F: top of head
MA: tip of nose
70-90 degrees
Cervical side bending w/ goni (landmarks and norm values)
SA: perpendicular to floor
Fulcrum: C7
MA: midline of skull
40 degrees
Cervical flexion and extension w/ inclinometer
Back of head and C7 in sagittal plane
Cervical side bending w/ inclinometer
Back of head and C7 in frontal plane
Cervical rotation w/ inclinometer
Pt supine and rest on forehead
Capital extension MMT against gravity
Prone- head toward one end and off table, arms at side palms up, hold pt’s forehead
3- through full available range
4- moderate resistance at slight angle
5- max resistance
What muscles do capital extension?
-Rectus capitis posterior minor and major
-Obliques capitis superior and inferior
-Splenius capitis
-Semispinalis capitis
-Spinalis capitis
Capital extension MMT gravity eliminated
Supine- head supported w/ hands under occiput
2- completes limited range
1- palpate suboccipital
0- no contraction
Cervical extension MMT against gravity
Prone- head off edge of table and arms at side
3- pt holds test position
4- moderate resistance in available
5- max resistance in available
Cervical extension MMT gravity eliminated
Supine
2- pt moves through small range by pushing into PT’s hands
1- palpate
0- no contraction
Muscles for cervical extension
Longissimus cervicis, semispinalis cervicis, iliocostalis cervicis, splenius cervicis, UT, spinalis cervicis
Capital flexion MMT against gravity
Supine- head on tables and arms at side
3- available range w/o lifting head off table
4- moderate resistance applied at mandible
5- max resistance applied at mandible
Capital flexion MMT gravity eliminated
Supine
2- pt completes partial range
1- palpate
0- no contraction
Cervical flexion MMT against gravity
Supine- hook lying and arms at side
3- pt able to do motion w/o
4- moderate resistance
5- max resistance (able to hold against moderate to mild 2 finger resistance)
Cervical flexion MMT gravity eliminated
Supine- head supported
2- partial range
1- palpate
0- no contraction
What do you have to ask pt before applying resistance for cervical flex?
Any jaw pain, TMJ, upper cervical pain?
SCM MMT against gravity
Supine- head supported on table and turned to side
3- completes available range
4- moderate resistance on temporal area above ear
5- max resistance
SCM MMT gravity eliminated
Supine- head supported on table
2- partial range
1- palpate
0- no contraction
Cervical rotation MMT against gravity
Supine- head supported on table w/ face turned to one side as far as possible
3- pt rotates head through full available range on B sides
4- moderate resistance applied on head above ear (c/s in neutral)
5- max resistance
Cervical rotation MMT gravity eliminated
Sitting- trunk and head can be supported against high back chair. Head neutral
2- partial range
1- palpate SCM
0- no contraction
Muscles for cervical flexion
SCM, longus colli, anterior scalenes
Muscles for capital flexion
Rectus capitis anterior and lateralis, longus capitis
