Examination - Cervicothoracic Spine Flashcards
What are some examples of easing factors?
Positions/motions of comfort, ice/heat, self-manipulation, medications
What should you observe in the waiting room?
General posture, any visible discomfort, gait
What are the Canadian C-Spine Rules used for?
Screening for cervical spine fractures in traumatic situations
What are the key signs of cervical artery dysfunction?
- unilateral head and neck pain
- dizziness
- diplopia - double vision
- dysarthria - difficulty speaking
- dysphagia - swallowing difficulties
- drop attacks
What is the difference between non-ischemic and ischemic signs of cervical artery dysfunction?
- Non-ischemic signs include unfamiliar unilateral head/neck pain.
- Ischemic signs include dizziness, diplopia, dysarthria, etc.
How is the vertebrobasilar insufficiency test performed?
Prolonged rotation of the neck for a minimum of 10 seconds
What are the movements tested in lower cervical range of motion?
Flexion, extension, side-bend, rotation, chin-tuck
How is upper cervical range of motion tested?
Perform standing or sitting, look for quantity, quality, willingness, and provocation
What should you look for in thoracic range of motion?
Flexion, extension, side-bend, rotation
Which nerve root is tested with biceps reflex?
C5
Which nerve root is tested with brachioradialis reflex?
C6
Which nerve root is tested with triceps reflex?
C7
What is the purpose of sensory testing?
To assess the sensory function of different nerve roots
What is passive physiologic segmental mobility?
Assessing the movement between individual spinal segments
What is passive accessory segmental mobility?
Assessing the accessory movements (e.g., glide) of spinal segments
How is passive physiologic segmental mobility tested in the thoracic spine?
Palpate the tips of each spinous process from T1-T4 for general motion, assist with maximum cervical rotation
What are the key characteristics of local cervical syndrome?
Facet joint issues, uncovertebral joint issues, internal disc disruption, C4 nerve root involvement, vertebral or carotid artery involvement
What are the indicators of spondylosis?
Facet arthritis, end-range ROM limits, pain worse with 3D motions, pain with PA segmental mobility
What is Wainner’s Clinical Prediction Rule for cervical radiculopathy?
- Rotation less than 60 degrees, 2+ positive tests has a specificity of 56%, 3+ positive tests has a specificity of 94%, 4+ positive tests has a specificity of 99%
What is the radial neural tension test used for?
Assessing the radial nerve’s mobility and provocation
What is the ulnar neural tension test used for?
Assessing the ulnar nerve’s mobility and provocation
What is a cervicogenic headache?
Headache caused by issues in the cervical spine, often requires thorough examination of upper cervical mobility
What is the cervical flexor endurance test?
A test to bias the deep neck flexors by having the eyes look down and mouth slightly open
How is rib mobility tested?
Spring testing of ribs 2-10, patient prone with head neutral, pressure applied towards the anterior aspect of the armpit
What is the purpose of thoracic disc testing?
To assess the mobility and provocation of thoracic discs, performed with seated progressive thoracic rotation
How is 1st rib testing performed?
Assessment of the mobility of the 1st rib
What are the key signs of thoracic outlet syndrome?
Pain, numbness, tingling in the arm and hand, often worsened by certain positions
What is the closed-fist percussion sign?
A test for thoracic compression fractures, involves tapping the spine with a closed fist
What is Lhermitte’s sign?
A sudden sensation resembling an electric shock that passes down the back of your neck and into your spine when you bend your neck forward
What is the TMJ range of motion with auscultation?
Assessing the range of motion of the temporomandibular joint while listening for any sounds
What is TMJ joint play testing?
Assessing the movement and function of the temporomandibular joint in various directions
What is the Krogh-Poulsen dental stick bite test?
A test to differentiate between joint compression and myalgia in the TMJ by biting and holding on different sides
