Head And Neck Flashcards
Flexion
60
Extention
60
Lateral flexion
45
Rotation
80
Flexion mm
Scm ( Bilaterally)
Longus Cervicis , Capitus (Bilaterally)
Anterior Scalene ( bilaterally)
Extention mm
Upper Traps ( bi) splenius Cervicis&Capitus (bi) Levator scapulae ( bi) Suboccipitals Longissimus cap, cervicis ( assisits) Illiocostalis cervicis ( assist) Multifidi( bi)
Lateral Flexion
(Unilaterally to same side ) Upper traps Levator scap Scm All threee scalenes ( ribs fixed) Splenius cervicis, capitus (Assist ) Longussimus cervicis, capitus Illiocostalis cervicis Oblique cap superior
Rotation mm
(On the right/ same side ) Levator scap Splenius cap/ Cervicis Rectus cap post mj Oblique cap inferior Longus colli/cap (Assist on the right/ same side) Longisimus cervicis , Capitus Illiocostalis cervicis ( on the left/ opposite side) Scm All3 scalenes Multifidi rotatores
Vertebral artery test
P: circulation deficiency of vertebral artery at tranverse foramen
Clt:
1 . seat or supine
2 .Fully Rotate head to 1 side & Extend
3.hold 30 secs
4. Repeat the other side
+ clt complain feeling of dizyness or nytagmus
Tmj joint AF ROM
P: asses motion of mandible at tmj
Clt:
1 . Clt seat. Stand behind clt
2. Index finger pads both hands , posterior portion of mandible condyles
3 instruct clt to open and close jaw slowly and fully
4. Asses qaulity of motion at the condyles , should feel symmetry and smooth
+ tmj dysfunction clicking , crepitus asymetry motion and pain
Further assesment
1. Sit at head of table
2. Observe client upside- down face
3. Instruct client to to open and close mandible
4. The mandible should depress and elevate in straight line
+ s shape wobble - muscular source of dysfunction
C - shape capsulare source,,mandible move to that side- capsularly restricted
Swallowing test
P: pain from trps in scm? Clt: 1.Seated 2.pinch and grasp scm 3 firm pressure on muscle belly and client to swallow \+ if pain diminish = trps in Scm
Scalene Cramp test
P: to reproduce active scalenes trigger points
Clt
1 : seated
2 : fully rotate head to affected side by contracting affected scalenes the neck is flexed to the same side , pull the chin inferiory into hallow just posterior to clavicle
+= pain in referal pattern for scalenes muscles
Scalene relief test
P: presence of active anterior scalene
Clt
1: client seated
2: place forarm on the affected side across he forehead , as close to elbow as possible
3 . Instruct client to elvate and protract the shoulder , which lift the clavicle , releiving compression of scalene and brachial plexus
+ = reduction of pain within a few minutes
Atlanto- occipital articulation ., PR ROM
P: asses movement ( flexion and extension , coupled with side bending )
Clt
1supine
2 off the table , grasp clt head with both hands on occipitals region
3: flex client cervical to end range
4: small movement lateral movement left to right
5: clt eyes open
+ restriction subtle letheary end feel
Same as Extension and side bending
Atlanto-axial Articulation , PR ROM
P: evaluate movement( mostly rotation) Clt 1: supine 2: hand on client temporal both side 3: rotate head fully to both side \+ = restriction, leathery end feel
Spurling’s test
P: asses compression of cervical nerve root or facet joint irritation lower cervical spine
Clt
1: seated
2: stand behind clt
3: instruct, Slowly Extend, sidebend, rotate to the affected side
4: apply downward pressure
+ = radiating pain or otehr neurogical sign in the arm on affected side
Distribution of pain indicates where nerve root is involved
+ facet irritation = pain is local
Cervical compression test
P: used when client cant rotate or extend head
Same os spurling
Cervical distraction test
P: releive pressure on nerve root( particularly
Following spurling’s or cervical compresion test)
Slow traction maintain for at least 30 secs
Allow muscle to relax
+= reduction of pain
First rib mobility
P: to asses mobility of first rib
Clt
1: seated
2: rotate head fully away from affected side
Then flex the head forward to the chest as far as possible
+ = first rib hypomobility = limited flexion
Scalene hypertonicity or fascial restrictions may cause the hypomobility
Anterior neck flexor stength test AR
P: asses strength scm , ant scalenes
Suprahyoids, infrahyoids , longus cap, colli and rectus capitus anterior muscles
Clt
1: supine arm 90 , elbow hands resting on table
2: instruct ot tuck chin and lift head off against gravity ( grade 3)
3 therapist apply pressure on forehead
+= mm weakenss if unable to hold the position
Anterolateral neck flexor strength test Ar
P: to asses Scm and scalens on thr one side
Clt
1: supine
2: arms rest on table at 90degrrss
3: staybilize side being test , instruct rotate face away from side being test
4: instruct clt to lift head off table into slight flexion against gravity
5 : therapist apply oblique pressure
+= anterolateral mm weakenss if client unable to hold
Posterolateral neck flexors strngth test AR
P: to asses strength of splenius capitis, cervicis , semispinalis capitus , cervicis ,
Clt:
1: prone , arm abduct at 90, palm on side of table reducing recruting shoulder muscles
2:,instruct extend neck , rotate head TOWARD side being test hold against gravity
3: staybilize side being test , apply pressure against clt
+= unable to hold
Upper traps strength test
Same as posterolateral test but turn head AWAY from side being test
Orbicularis oris strength test AR
To confirm Bell’s Palsy
try to open clients eyes
+= unable to resist this action
