Cervical Spine/Neck

Question 1

What are you going to do if you have a neck problem for your patient?

Answer 1

1) sanitize hands
2) inspection of cervical spine and verbalize finding
3) palpation of –> cervical spine on skin, spinous process, TP, cervical muscles… TRACHEA, THYROID
4) range of motion on cervical spine
5) UE strength testing and verbalize finding
6) sensory testing on upper extremity
7) UE DTR (at least one)
8) specialty test

Question 2

Roos Test?

Answer 2

have the pt abduct shoulders to 90 degrees and externally rotate with elbow flexed to 90 degrees (like you’re cheering)

Have the pt open and close fists for up to 3 minutes

positive test –> reproduction of symptoms –> Pain/parasthesia

indication –> thoracic outlet syndrome, compression of subclavian artery

Question 3

Distraction Test?

Answer 3

one hand under the patients chin, one hand under the occiput. slowly distract head

positive test –> alleviate symptoms

indication –> central neuropathy

Question 4

Spurling Maneuver?

Answer 4

IN ORDER

stand behind. 3 stages, if you get positive somewhere, don’t move on.

1) neutral compression
2) extension pain
3) sidebend and rotation in that plane and compression
4) other side same thing

Positive test –> reproduction of symptoms (pain or parasthesia in distribution of nerve root

indication –> radiculopathy

Question 5

ROM for the neck?

Answer 5

F - 45-90
E - 45-90
SB - 20-45
R - 70-90

Question 6

when do you not perform spurlings?

Answer 6

people with RA
spondylosis
cervical malformations
metastatic disease