Cervical Spine exam

Question 1

CPG Neck pain with mobility deficits common symptoms

Answer 1

central and/or unilateral pain

limitation in neck motion that consistently reproduces symptoms

associated shoulder girdle or UE pain may be present

Question 2

CPG Neck pain with mobility deficits
exam findings

Answer 2

limited cervical ROM

neck pain reproduced at end ranges of active and passive motions

restricted cervical and thoracic mobility

mobility testing reveals restriction

neck and referred pain reproduction with provocation of involved cervical or upper thoracic segments or musculature

deficits in cervicoscapulothoracic strength and motor control may be present in individuals with subacute or chronic neck pain

Question 3

CPG neck pain with Movement coordination impairments (WAD) symptoms

Answer 3

MOI linked to trauma or whiplash

associated shoulder girdle or UE pain

assocaite varied nonspecific concussive signs and symptoms

dizziness/nausea

headache, concentration or memory difficulties; confusion; hypersensitivity to mechanical thermal acoustic odor light stimuli

Question 4

CPG neck pain with Movement coordination impairments (WAD) exam findings

Answer 4

positive cranial cervial flexion test

positive neck flexor endurance test

positive pressure algometry

strength and endurance deficits

neck pain with mid range motion that worsens in end range

point tenderness

sensorimotoe impairment include altered muscle activation patterns, propioceptive deficit, postural balance or control

neck and referred pain reproduced by provocation of cervical segments

Question 5

CPG neck pain with HA (cervicogenic) symptoms

Answer 5

non continous, unilateral neck pain and associated headache

headache is precipitated or aggravated by neck movements/sustatined positions

Question 6

CPG neck pain with HA (cervicogenic) exam findings

Answer 6

positive cervical flexion rotation test

HA reproduced with provocation of segments involved

limited Cervical ROM

restricted upper cervical segmental mobility

strength, endurance, and coordination deficits of the neck muscles

Question 7

CPG neck pain with radiating pain symptoms

Answer 7

neck pain with radiating pain in UE

UE dermatonmal paresthia or numbness and myotomal muscle weakness

Question 8

CPG neck pain with radiating pain exam findings

Answer 8

neck pain and radiating pain reproduced or relieved with radiculopathy testing; positive test cluster includes upper-limb nerve mobility, Spurlings test, cervical distraction, cervical ROM

may have UE sensory, strength, or reflex deficits associated with involved nerve roots

Question 9

CPG neck pain with mobility deficits acute tx

Answer 9

thoracic manip

cervical mob or manip

cervical ROM, stretching, isometric strengthening

stay active, home cervical ROM and isometrics

supervised exercise

Question 10

CPG neck pain with mobility deficits acute tx

Answer 10

cervical mob or manip

thoracic manip

cervicoscapulothoracic endurance exercise

Question 11

CPG neck pain with mobility deficits chronic tx

Answer 11

thoracic manip

cervical mob

cervicoscapulothoracic exercise plus mob or manip

mixed exercise for regions - NM exercise: coordination, propioception and postural training; stretching; strengthening; endurance; aerobic conditioning; cognitive affective elements

supervised individualized exercises

stay active

dry needling, low-level laser, pulsed or high=power ultrasound, mechanical traction, TENS

Question 12

neck pain w movement coordination WAD acute tx

Answer 12

education: advise to remain active, act as usual

home exercise: pain free cervical ROM and postural element

monitor for acceptable progress

minimize collar use

Question 13

neck pain w movement coordination WAD subacute tx

Answer 13

education: activation and counseling
combined exercise: active cervical ROM and isometric low-load strengthening plus manual therapy (cervical mob or manip) plus physical agents: ice, heat, TENS

supervised exercise: active cervical ROM or stretching, strengthening, endurance, neuromuscular exercise, including postural, coordination and stabilization elements

Question 14

neck pain w movment coordination WAD chronic tx

Answer 14

education - prognosis encouragement, reassurance, pain managment

cervical mob plus individualized exercise: low-load cervicoscapulothoracic strengthening, endurace, flexiblity, functional training using CBT principles, vestibular rehab, eye-head-neck coordination, TENS

Question 15

neck pain w HA cervicogenic acute tx

Answer 15

exercise: C1-C2 seld SNAG

Question 16

neck pain w HA cervicogenic subacute tx

Answer 16

cervical manip and mob

C1-C2 self SNAG

Question 17

neck pain w HA cervicogenic chronic tx

Answer 17

cervical manip
cervical and thoracic manip

exercise for cervical and scapulothoracac region, strength endurance w NM training, including motor control and biofeedbacl elements

combined manual therapy plus exercise

Question 18

neck pain with radiating pain acute tx

Answer 18

exercise - mobilizing and stabilizing elements

low-level laser

possible short term collar use

Question 19

neck pain with radiating pain chronic tx

Answer 19

combined exercise: strengthening and stretching plus manual therapy for cervical and thoracic region: mob or manip

education counseling to encourage participation in occupational and exercise activity

intemrittent traction