Cervical Spine Practical Flashcards
how is muscle length of the levator scapula assessed
Stabilised: Scapula depression
Applied: Contralateral cervical sideflexion, rotation and flexion
how is muscle length of the upper trapezius assessed
Stabilised: Scapula depression
Applied: Contralateral cervical sideflexion, ipsilateral rotation and flexion
how is muscle length of the pectoralis minor assessed
Observe space between shoulder (acromion) and plinth in supine. Can assess
unilaterally by passively retracting at coracoid process and assess end feel
how is muscle length of the latissimus dorsi assessed
Stabilised: Thoracic spine on plinth in crook lying – may need to ask patient to
activate Transversus to prevent spinal extension.
Applied: Shoulder elevation in full lateral rotation
how is muscle length of the anterior scalene assessed
Stabilised: 1st rib
Applied:
Anterior scalene: cervical extension, contralateral sideflexion AND ipsilateral
rotation
how is muscle length of the middle scalene assessed
stabilised - 1st rib
Middle scalene: cervical extension, contralateral sideflexion.
how is muscle length of the posterior scalene assessed
stabilised - 1st rib
Posterior scalene: contralateral sideflexion AND contralateral rotation.
how is muscle length of the sub occipital extensors assessed
Fix C2 with lumbrical grip (caudal direction) and perform occipital roll with other
hand.
what is required to conduct cranio-cervical flexion test
Criterion – unrestricted craniovertebral flexion is required for an accurate test, so
test this first
what movement is wanted for cranio-cervical flexion test
The motion you are looking for is an upper cervical nod, not retraction, to activate longus colli & capitus.
what is the patient to do in the craniocervical flexion test
place towel on occiput
place pressure biofeedback in 3rds
aim patient to nod target - 22, 24, 26, 28, 30 mmHg
observe any compensatory behaviours - retraction, SCM, scalene activity
determine the pressure the patient can hold steady with no palpable superficial muscle activity
measure enurace - 10secs hold, 10 reps
normal pressure patients can maintain in cranio cervical flexion test
26-30 mmHg 10 secs x 10reps
describe patient position, therapist position and movement of side flexion PPIVM
patient - supine, head of table,
physio - supporting weight of patients with abdomen, palpate articular pillar between C2/C3, other hand support head, compare findings
movement - lateral flexion, feel for the opening and closing of the joint
positive findings of cervical spine side flexion PPIVM
increased resistance through motion,
muscle spasm,
decreased opening or closing of the joint,
pain provocation.
describe patient, therapist positioning and movement of rotation PPIVM
Physio - Palpate contralateral articular pillar, reinforced index finger, as joint opens during rotation, other hand support weight of occiput,
patient - supine, head lying off edge of bed
movement - on same hand while index finger on lamina produce produce cervical rotation away from palpating hand