Cervical ROM and MMT

Question 1

What are the 3 levels of observation?

Answer 1

Skin, subcutaneous, bony structure

Question 2

What to observe/inspect for with the cervical spine?

Answer 2

-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)

Question 3

What do you palpate for the cervical spine?

Answer 3

Anterior muscles, posterior muscles, bony landmarks (spinous & transverse processes)

Question 4

What are 3 tools that are used to measure cervical ROM?

Answer 4

Tape measure, goniometer, inclinometer

Question 5

What ranges of motion do you assess for the cervical spine?

Answer 5

Flexion, extension, side bending right & left, and cervical rotation right & left

Question 6

Where is cervical flexion and ext initiated at?

Answer 6

C4-C7

Question 7

Cervical flexion and extension with tape measure (landmarks and cue)

Answer 7

• 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”

Question 8

Cervical SB/lateral flexion with tape measure (landmarks and cue)

Answer 8

• Tip of mastoid process to acromion process
• Watch for lateral shifts
• “Keep nose straight and bring ear to shoulder”

Question 9

Cervical rotation with measuring tape (landmarks and cue)

Answer 9

• Tip of mandible to acromion process (?)
• “Turn your head and bring your nose over shoulder”

Question 10

Cervical flexion w/ goni (landmarks and norm values)

Answer 10

SA: perpendicular to floor
F: Ear hole
MA: nares (nostrils)
45-50 degrees

Question 11

Cervical extension w/ goni (landmarks and norm value)

Answer 11

SA: perpendicular to floor
F: ear hole
MA: nares (nostrils)
85 degrees

Question 12

Cervical rotation w/ goni (landmarks and norm value)

Answer 12

SA: Acromion to acromion
F: top of head
MA: tip of nose
70-90 degrees

Question 13

Cervical side bending w/ goni (landmarks and norm values)

Answer 13

SA: perpendicular to floor
Fulcrum: C7
MA: midline of skull
40 degrees

Question 14

Cervical flexion and extension w/ inclinometer

Answer 14

Back of head and C7 in sagittal plane

Question 15

Cervical side bending w/ inclinometer

Answer 15

Back of head and C7 in frontal plane

Question 16

Cervical rotation w/ inclinometer

Answer 16

Pt supine and rest on forehead

Question 17

Capital extension MMT against gravity

Answer 17

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

Question 18

What muscles do capital extension?

Answer 18

-Rectus capitis posterior minor and major
-Obliques capitis superior and inferior
-Splenius capitis
-Semispinalis capitis
-Spinalis capitis

Question 19

Capital extension MMT gravity eliminated

Answer 19

Supine- head supported w/ hands under occiput
2- completes limited range
1- palpate suboccipital
0- no contraction

Question 20

Cervical extension MMT against gravity

Answer 20

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

Question 21

Cervical extension MMT gravity eliminated

Answer 21

Supine
2- pt moves through small range by pushing into PT’s hands
1- palpate
0- no contraction

Question 22

Muscles for cervical extension

Answer 22

Longissimus cervicis, semispinalis cervicis, iliocostalis cervicis, splenius cervicis, UT, spinalis cervicis

Question 23

Capital flexion MMT against gravity

Answer 23

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

Question 24

Capital flexion MMT gravity eliminated

Answer 24

Supine
2- pt completes partial range
1- palpate
0- no contraction

Question 25

Cervical flexion MMT against gravity

Answer 25

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)

Question 26

Cervical flexion MMT gravity eliminated

Answer 26

Supine- head supported
2- partial range
1- palpate
0- no contraction

Question 27

What do you have to ask pt before applying resistance for cervical flex?

Answer 27

Any jaw pain, TMJ, upper cervical pain?

Question 28

SCM MMT against gravity

Answer 28

Supine- head supported on table and turned to side
3- completes available range
4- moderate resistance on temporal area above ear
5- max resistance

Question 29

SCM MMT gravity eliminated

Answer 29

Supine- head supported on table
2- partial range
1- palpate
0- no contraction

Question 30

Cervical rotation MMT against gravity

Answer 30

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

Question 31

Cervical rotation MMT gravity eliminated

Answer 31

Sitting- trunk and head can be supported against high back chair. Head neutral
2- partial range
1- palpate SCM
0- no contraction

Question 32

Muscles for cervical flexion

Answer 32

SCM, longus colli, anterior scalenes

Question 33

Muscles for capital flexion

Answer 33

Rectus capitis anterior and lateralis, longus capitis