Cervical Spine

Question 1

Cervical Spine Bony Palpation

Answer 1

hyoid bone
thyroid cartilage
first cricoid ring
mandible
mastoid processes
inion (EOP)
occiput
superior nuchal line
spinous processes of cervical vertebrae
facet joints

Question 2

Cervical Spine Soft Tissue Palpation

Answer 2

sternocleidomastoid
anterior cervical chain
posterior cervical chain
carotid pulse
thyroid gland
supraclavicular fossa
trapezius
superior nuchal line
greater occipital nerves

Question 3

Foraminal Compression

Answer 3

a. ( + ) Exacerbation of localized cervical pain
a. ( i ) Foraminal encroachment or facet pathology without nerve root compression
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b. ( + ) Exacerbation of cervical pain with a radicular element
b. ( i ) Foraminal encroachment or facet pathology with nerve root compression

Question 4

Cervical Distraction Test

Answer 4

a. ( + ) Diminished or absence of local pain
a. ( i ) Foraminal encroachment
- - - - - - - - - - - - - -
b. ( + ) Diminished or absence of radicular pain
b. ( i ) Nerve root compression
- - - - - - - - - - - - - -
c. ( + ) Increase in cervical pain
c. ( i ) Muscular strain, ligamentous sprain, myospasm, facet capsulitis

Question 5

Spinal Percussion

Answer 5

a. ( + ) Local pain
a. ( i ) Possible fractured vertebrae, ligamentous involvement if there is spinous pain, and or muscular involvement if there is muscular pain.
- - - - - - - - - - - - - -
b. ( + ) Radiating pain
b. ( i ) Possible disc pathology

Question 6

Shoulder Depression Test

Answer 6

a. ( + ) Localized pain on the side being tested
a. ( i ) Dural sleeve adhesion, and muscular adhesion or contracture, or spasm, or ligamentous injury
- - - - - - - - - - - - - -
b. ( + ) Radicular pain on side being tested
b. ( i ) Neurovascular bundle compression, dural sleeve adhesions or Thoracic Outlet Syndrome
- - - - - - - - - - - - - -
c. ( + ) Radicular pain on opposite side being tested
c. ( i ) Foraminal encroachment with nerve root compression

Question 7

Valsava Maneuver

Answer 7

( + ) Radiating pain from site of lesion (usually recreating the complaint in cervical or lumbar area of the spine)

( i ) Space-occupying lesion such as disc pathology

Question 8

Swallowing Test

Answer 8

( + ) Difficulty in swallowing

( i ) Space-occupying lesion at anterior portion of cervical spine. Possibly esophageal or pharyngeal injury, anterior disc defect, muscle spasm or osteophytes, etc.

Question 9

Soto-Hall Sign

Answer 9

( + ) Generalized pain in the cervical region, which may extend down to the level of T2

( i ) Non-specific test for structural integrity of cervical region

Question 10

Kernig Sign

Answer 10

( + ) Inability to fully extend the leg and/or pain (usually in the neck region)

( i ) Meningeal irritation, or meningitis

Question 11

O’Donogue Maneuver

Answer 11

( + ) Pain during passive range of motion
( i )  Ligamentous sprain
- - - - - - - - - - - - - - 
( + ) Pain during active range of motion
( i ) Muscle or tendon strain