Cervical spine

Question 1

Flexed dysfunctions of the typical cervical spine behave in what way? Where is the most common location for this to occur?

Answer 1

They behave as though one facet does not close. There is usually deep muscle hypertonicity overlying the dysfunctional facet.

Most common at C5-6

Question 2

When a typical cervical facet is not closing, how do you diagnose this and why?

Answer 2

Always the position of ease which is when the facet is open. If it’s open on the Left of C6 then the diagnosis is Flexed SLRL at C6. The facets are typically closed in extension.

Question 3

Extended dysfunction of the typical cervical spine behave in what way? Where is the most common location?

Answer 3

Behaves as though one facet does not open.

Most common at C2-3

Question 4

An OA dysfunction that is FRRSL tell you what information about the glide of the condyles?

Answer 4

One condyle cannot glide forward, opposite for extension where it cannot glide backward.

Question 5

When multiple spinal segments resist translation (all want to sidebend to the same side) what should you suspect?

Answer 5

Hypertonicity of the scalenes. Treat with stretch prior to HVLA, may help with diagnosis also.

Question 6

What is the HVLA OA hand placement? What direction is the force applied?

Answer 6

Hand on nuchal line of occiput, other cradles the chin with forearm on the side of the head.

ForcLe is toward the physician-pull the head off.
Same for flexion and extension

Question 7

AA joint hand placement for HVLA?

Answer 7

Flex head to AA

R MCP on R posterior arch, if rotating left for thrust

Question 8

With typcial cervicals in HVLA how many treatments are there for flexed vs extended dysfunctions? What are they?

Answer 8

Flexed- force to opposite axilla (side bending)

Extended- rotation or side bending

Question 9

Hand placement for ERSL dysfunction using sidebending thrust

Answer 9

MCP opposite closed facet Right side
Flex
Thrust R to L with R MCP
Open closed facet

Question 10

ERSL rotational thrust hand placement

Answer 10

Index finger blocks facet opposite closed facet on Right side
Flex
MCP on side of closed facet Left
Sidebend over fulcrum created by right fingers
L MCP rotates R by carrying left elbow to the ceiling

Question 11

FRSL HVLA hand placement

Answer 11

AVOID EXTENSION TO PROTECT VERTEBRAL ARTERY

R MCP on R pillar of dysfunctional joint, lift anterior to barrier
Translate left to induce sidebending
Trust left to opposite axilla