Cervical Spine- 17, 18, and 19

Question 1

What are the 2 functional units of the cervical spine?

Answer 1

1. Occiput, atlas and axis. 2. cervicals C3-7

Question 2

What direction do the superior facets of the atlas face?

Answer 2

BUM- backward, upward and medially

Question 3

What is occipital condylar compression?

Answer 3

newborn problem, affects CN 9-11. Sx- poor suck, swallowing
difficulties, emesis, hiccups, congenital
torticollis, and perhaps pyloric stenosis.

Question 4

What is the primary motion of the OA joint?

Answer 4

Flexion and extension

Question 5

Rotation and sidebending are what at the OA joint?

Answer 5

opposite

Question 6

What is the movement of the AA joint?

Answer 6

rotation

Question 7

What did Fryette say about the cervical spine?

Answer 7

Nothing. lol

Question 8

When you rotate on the AA, what do the left and right facets of the atlas do?

Answer 8

the left slides uphill, the right slides downhill

Question 9

What is the most common place for chronic somatic disfxn?

Answer 9

between C2 and C3. they sustain a tremendous amt of stress

Question 10

What is the approximate disk height:vertebral body ratio?

Answer 10

2:5

Question 11

As far as C3-7 facets are concerned, roation and sidebending are to what side?

Answer 11

Same side

Question 12

What type of motion is C3-7 most RESTRICTED?

Answer 12

flexion and extension.

Question 13

What is the primary motion of C3-7?

Answer 13

rotation

Question 14

What do the joints of luschka do?

Answer 14

maintain stability while allowing motion, an adaptation for upright posture

Question 15

When do the unciform joints develop?

Answer 15

age 8-10

Question 16

What type of movement do the joints of luschka create?

Answer 16

they are “guide rails” for flexion/extension. they limit side slip.

Question 17

Where does a hangmans fracture occur?

Answer 17

it’s an unstable frature of the C2 pedicles. there is forward displacement of C1 and the body of C2 on C3

Question 18

What are articular pillars/lateral masses?

Answer 18

arrea between the cervical facet joints

Question 19

What is the anterior compartment?

Answer 19

refers to the less prominent transverse process. shows the side of rotation.

Question 20

What is the posterior compartment?

Answer 20

refers to the more prominent transverse process

Question 21

What type of mechanics are C2-7?

Answer 21

Type II

Question 22

What is active motion?

Answer 22

when the pt moves their head

Question 23

What is passive motion?

Answer 23

when the operator moves the pt’s head

Question 24

What does the lateral OA translation test for?

Answer 24

the side of sidebending. typically the OA is opposite. If they have a right posterior occiput and translate easier to the right then it is OA RrSl

Question 25

What Dx would you give to a L anterior occiput with freer rotation to the R?

Answer 25

OA RrSl

Question 26

How do we Dx an AA that rotates easier to the left?

Answer 26

AA left. Always to the direction of ease.

Question 27

What is the Dx of a pt who’s C4 is posterior on the right and has a freer translation to the left?

Answer 27

C4 RrSr

Question 28

How is the cervical and sacrum connected?

Answer 28

Dural connections. you need to treat both areas to prevent reoccurence

Question 29

How does benign cervical vertigo occur?

Answer 29

muscular ties between the cervical region (which has a spasm) and the temporal bone can cause vestibular assymetry –> vertigo.

Question 30

Tight SCM will cause what type of motion in the cervicals?

Answer 30

rotation and sidebending to the opposite side

Question 31

What type of treatments do you do for a whiplash injury?

Answer 31

Counterstrain, indirect, fascial release, and cranial are more appropriate initially

Question 32

What type of treatment do you do for acute muscle spasm?

Answer 32

muscle energy

Question 33

What are pt presentations with a cervical root irritation?

Answer 33

sensory loss and motor weakness along the affected dermo/myotome. also, pt’s will experience “shoulder” pain when supine and neck extension exasterbates symptoms.

Question 34

How can you diagnose cervical root irritation?

Answer 34

Oblique cervical x-ray for osteophytes. EMG will confirm neruological findings. MRI if you wana have the pt spend $$$$.

Question 35

What are some Sx of acute myositis?

Answer 35

inability to move the neck and upper thoracic area freely, pain worst after activity or at night

Question 36

How do you treat acute myositis?

Answer 36

HVLA, mobilization, muscle energy, soft tissue, muscle stretching, deep inhibitory pressure, analgesics, muscle relaxants, tranquilizers

Question 37

What is the “Wright” whiplash?

Answer 37

sudden hyperflexion of the cervical spine, followed by spontaneous extension recoil of the posterior articular ligament and ligamentum flavum.

Question 38

What is the “McHenry” whiplash?

Answer 38

acute hyperextension with a flexion rebound.
a blow from the rear results in sudden forward movement of the victim
momentary posterior lag in the head and neck as the body moves forward

Question 39

What is the “McKeever” whiplash?

Answer 39

normal sitting position - head is a bit forward of its normal position over the shoulders. normal return to physiologic position is through an arc.
with sudden impact from the rear - the body in the area of the cervico-dorsal junction is thrown forward, the head moves relatively backward in a straight line, forcefully shortening the cervical spine by about one inch.

Question 40

How does a muscle tension headache occur?

Answer 40

increased sympathetic tone results in increase muscle tone and vasoconstriction, reducing blood supply to the muscles of the upper back, neck, and head. This produces a relative ischemic muscle tenderness.

Question 41

How do you treat a muscle tension headache?

Answer 41

OMT of the cervicals, sacrum and pelvis. over the counter pain meds. Ice after treatment.