cervical spine

Question 1

C3 to C7

Answer 1

cervical spine

Question 2

serves as attachment site for neck muscles

MOI: MVA, posture, poor breathing pattern

Answer 2

first rib

Question 3

joints of the CS

Answer 3

IVJ
Z jt
U jt

Question 4

saddle shaped, diarthrodial jts
extend from c3 to t1
formed between uncinate processes
thought to prevent disc herniation

Answer 4

unconvertebral joints/joints of von luschka (u joints)

Question 5

neck pain origins

Answer 5

whiplash/MVA
Collisions
Spondylosis
infection, tumor or disease processes

Question 6

a restriction of cervical extension, side bending and rotation to the same side as the pain is

Answer 6

closing restriction

Question 7

a restriction of cervical flexion, sidebending and rotation to the opposite side of the pain is

Answer 7

opening restriction

Question 8

patients with mechanical neck pain benefit from

Answer 8

thoracic spine manipulation

Question 9

referred pain areas of discs into the scapular region from the CS

Answer 9

Cloward signs

Question 10

deep, dull ache
focal pain areasin the middle of back and scapular boarder from timulation of anterior/anterolat disc
spread out over the scapula and into the upper arm with post/postlat disc
induced by local pressure
associated with muscle spasms

Answer 10

cloward sign

Question 11

CS disc herniation patient presentation

Answer 11

20-30 years of age
less common than lumbar
C6-7 and C5-6 most common
can result in localized pain, referred pain, radiculopathy or myelopaty

Question 12

disc herniation, subjective

Answer 12

ache/stiffness
cloward signs
may or may not have distal symptoms

Question 13

UCS DH pain pattern

Answer 13

base of the neck, head and face

Question 14

C4-5 DH pain pattern

Answer 14

base of the neck and top of the shoulder

Question 15

C5-6, C6-7 DH pain pattern

Answer 15

scapula, across the shoulder jt, and post/lat aspect of upper arm

Question 16

CS DH agg

Answer 16

looking down, turning head
ADLs may be limited
speed of movement may be altered
driving, sitting, work

Question 17

DH history

Answer 17

not associated with incident
may be related to sustained posture
slow onset or wake with pain
may have history of MVA

Question 18

DH objective

Answer 18

ROM: limited flexion/extension
Painful ipsilateral ROM: SB and rot
Painful CPA’s
Positive spurling

Question 19

DH intervention

Answer 19

traction
posture
modalities
ergonomics
body mechanics
mckenzie's repeated motion

Question 20

spondylosis of discs

Answer 20

30-55 y/o

Question 21

spondylosis of facet jts

Answer 21

> 55 yrs of age

Question 22

spondylosis of u jts

Answer 22

> 55 yrs of age

Question 23

common levels of disc degeneration

Answer 23

C4-5
C5-6
C6-7

Question 24

Disappearance of NP by age of

Answer 24

40-45

Question 25

loss of disc height
loss of normal lordosis
results in intersegmental hypermobility and instability/subluxation

Answer 25

Disc degeneration

Question 26

spondylosis subjective

Answer 26

cloward sign
diffuse symptoms, unilat or bilat
presence of radiculopathy
long history of neck pain
may have history or MVA

Question 27

Spondylosis agg

Answer 27

sustained flexion
quick movements
end of range movements

Question 28

Spondylosis objective

Answer 28

Posture
ROM may be limited with pain
Palpation: central and unilat
segmental exam: sensory loss, motor loss, hyporeflexia
upper limb neural tension

Question 29

spondylosis intervention

Answer 29

joint mobs
traction
posture education
ergonomics
exercise: scapular stabiliation, thoracic extension

Question 30

MOI acute cervical facet syndrome

Answer 30

sudden neck movement
result of synovial capsule impingement within a facet
localized pain with or without muscle spasms
acute torticollis

Question 31

MOI chronic cervical facet syndrome

Answer 31

caused by chronic inflammation due to arthritis/injury

Question 32

cervical facet syndrome objective

Answer 32

limited ROM w/wo muscle guarding
side flexion is limited to both sides
PPIVM: segmental motion limited
PAIVM: limited, painful
Lack of neurological signs
palpable point tenderness and muscle spasm

Question 33

cervical facet syndrome intervention

Answer 33

think of specific techniques rather than global approaches
manual therapy: unilat PA, contract-relax, joint specific traction
HEP
posture

Question 34

ANR subjective

Answer 34

pain worse distally in dermatomal pattern
possible cloward sign
can be constant and/or latent

Question 35

ANR objective

Answer 35

posture looks uncomfortable
attempt to correct deformity increases symptoms
ROM: only able to test 1-2 motions
Palpation may not be able to do this
neuro +

Question 36

ANR intervention

Answer 36

education
ice/modalities
manual traction
joint mobilization:only when decreased severity and irritability

Question 37

CNR subjective

Answer 37

patchy distribution
usually intermittent
can be nagging, able to sleep at night

Question 38

CNR agg

Answer 38

sustained flexion

movements that narrow foramen

Question 39

CNR objective

Answer 39

postural changes
\+/- neuro signs
ROM: limited in closing movments
possible GH limitations
Central PA
\+spurling
\+ neurodynamic findings

Question 40

CNR intervention

Answer 40

joint mob
traction
neurodynamic treatment
ergonomic 
modification of activities
joint protection

Question 41

stenosis objective

Answer 41

neck pain my be absent initially
neck and arm pain
painful and restricted ROM
presence of sensory and motor deficits
wasting of intrinsic muscles of hands resulting in loss of hand dexterity
segmental and central neuro exam

Question 42

stenosis intervention

Answer 42

patient education
Ther-ex
manual therapy: specific level traction, unilat pa
cervical collar
surgery