Cervical Spine SD Diagnosis and Tx ME and ART

Question 1

What is Spurling’s Maneuver?

Answer 1

done in 3 stages, each of which is more provocative. If symptoms are produced, one does not proceed to the next stage.

1. compression of head in neutral
2. compression of head w/ head in extension
3. sidebend away from the affected side then toward the affected side and add compression

Question 2

C-spine: bilateral forearm fulcrum fwd bending

Answer 2

both arms crossed under pt’s head
repetitively flex pt’s neck
repeat for 2-3 min or until desired effect achieved

Question 3

Cervical MET/ART: Regional Restrictor

Answer 3

Cross both arms under pt’s head
gently flex neck to edge of barrier
pt extends neck against resistance
MET principles

Question 4

What are the major motions of the OA?

Answer 4

flexion and extension

type-1 like sidebending and rotation (TONGO)

Question 5

OA MET
Dx: OA ESlRr
Tx: OA FSrRl

Answer 5

Pt supine and Dr at head of table
one hand on occiupt and two fingers of other hand under pt’s chin
Flex, sidebend, and rotate
instruct pt to lift chin against resistance
3-5 times or until motion is improved

Question 6

OA - MET
Dx: OA FSlRr
Tx: OA ESrRl

Answer 6

Pt supine and dr sits at head of table
one hand under occiput and 2 fingers are under chin
extend, sidbend right, and rotate left
instruct pt to nod head against resistance
MET 3-5 times or until no barriers met

Question 7

What is the primary rotation at the AA joint?

Answer 7

rotation

almost no sidebending or flexion/extension

Question 8

How do you diagnose the AA?

Answer 8

fully flex C spine –> check rotation

Question 9

AA - MET/ART

Dx AA Rl

Answer 9

Pt supine and physician sits at head of table
fully flex pt’s head w/ hands on sides of head by ears
rotate head to right until barrier is reached
do MET/ART

Question 10

How do C2-C7 move?

Answer 10

rotation and sidebending occur in same direction - due to uncinate process
type 2-like sidebending and rotation (flexion/extension component)

Question 11

Typical Cervical MET/ART

Answer 11

Pt supine w/ physician at head of table
dr’s 2nd MP joint on articular pillar to aid in sidebending
Dr cradles occiput and flexes/extends –> rotate and sidebends
do MET/ART
for MET: instruct pt to sidebend or rotate their head away from the RB