Cervical Spine Review (PPIVM and PPAVM Flashcards
What is the basic physiological motion unit of the spine?
A Functional Spinal Unit
- Consists of 2 adjacent vertebrae, their intervertebral disc and the ligaments between them.
What bony characteristic is unique to the cervical spine vertebrae and what makes them significant?
The transverse foramina, they are holes on the transverse processes that allow the vertebral artery, vein, and sympathetic nerves to travel.
What does the vertebral artery and vein supply?
Blood to and from the superior spinal cord and the posterior brain.
Signs and Symptoms of VA insufficiency?
Ipsilateral Facial Dysesthesia (Pain and numbness) - Most Common
Contralateral loss of pain and temperature sensation in the trunk and limbs
Dysarthria or hoarseness.
VA insufficiency is a RF for manual therapy and should avoid cervical manipulation.
The most unique characteristic about the atlas (C1) is?
The lack of a vertebral body
Neck flexion and extension are performed predominantly by which joint? (About 50%)
Atlanto-Occipital Joint
Subcranial rotation predominantly takes place at which joint? (About 60%)
Atlanto-axial Joint
What is the ROM for cervical flexion and extension?
Total ROM = 30
(10 degrees for flexion and 20 degrees for extension)
What is the ROM for Cervical sidebending?
Total TOM = 18
(8-10 degrees in each direction)
Cervical flexion is what type of roll and glide?
Anterior Roll, Posterior Glide
Cervical Extension is which roll and glide?
Posterior Roll, Anterior Glide
What does the transverse ligament prevent?
What does the front arch prevent?
The first vertebra from sliding forward onto the second vertebra when flexing neck.
The front arch prevents the opposite motion when you extend your neck.
What is the significance of the alar ligament?
Tension provided by the alar ligament allows the second vertebra to rotate in the opposite direction as the movement.
What is the uncinate process?
A bony hook-like structure on cervical vertebrae that create joints called uncovertebral joints, which prevents posterior linear translation of the vertebral bodies and limits lateral flexion.
What is the orientation of the cervical spine facet joints?
They face 45 degrees to the transverse plane and lie parallel to the frontal plane.
Go through the Arthrokinematics of all cervical motions
Flexion = Bilateral upglide
Extension = Bilateral Downglide
Lateral Flexion and Sidebending = Up glide on contralateral side and down glide on the ipsilateral side
What are we assessing when we perform cervical PPIVM?
Hypomobility, hypermobility, or aberrant motion of the cervical spine.
When performing PPIVM where should the therapist be positioned?
Anterolateral and close to the patient to cradle their head.
When do we perform PPAIVM of the cervical spine?
After PPIVM when the clinician identifies a dysfunction within a particular vertebra(e)
What direction should the palpation be when performing PPAIVM?
45 degrees in a superior-anterior direction as the patient is in Supine.
When you are performing central PAIVM on C5, what movement(s) are you assessing?
Flexion of C5 on C6
and
Extension of C4 on C5
What direction and where do you apply unilateral pressure for cervical PAIVM?
Just lateral to the spinous process and you apply it to the contralateral side of the movement you wish to work on.
What is Joint traction and what is it used for?
- Joint traction is the action of gapping one cervical vertebra to the others, almost like splaying. The traction force is applied to the caudal hand.
-Used to reduce pain and nerve compression, also for assessment of the cervical spine.
What is side glide testing and mobilization?
The action of cradling the head and neck then using your 2nd MCPJs on the posterolateral side of the vertebra you wish to assess. Then perform the lateral glide.
