Headache/Cervical Lab Flashcards
you should stay off patients’
jaw and eye
OA Convex Occiput on Concave Atlas
15 degrees flex/ext
AA: Convex atlas on convex axis
45 degree rotation to each side
C2-C7
- Bifid SP’s
- Transverse foramen
- Uncovertebral Joints
- Facets lie b/t horizontal and frontal planes
Composite cervical motion: Flex/Ext
126
Total rotation of cervical spine
144
total lateral flexion
87 degrees
if you side bend to R, what should dens do?
rotation to L
vertebral artery test
ext, SB, rot
hold > 10 sec
Cognitive task
VBI incidence
- blunt trauma with associated cervical fracture
- or can be spontaneous
Craniovertebral locking
Side bend ipsi
Rotate contra
flexion/upslide assessment
gently glide TP in sup/ant/lat (SAL)
Extension/downslide assessment
glide inf/med/post
How much can the tunica intima of the vertebral artery stretch?
17%
what does 40 degrees of rotation cause?
kinking of bilateral vertebral arteries
where is the most common place for vertebral artery damage
C1-C2
should we manip with rotation?
NOOOOOOOO
pre-manip hold at end range
7 sec
contraindications for cerivical manip
- Recent infection
- Connective tissue disease
- Congenital Collagenous Compromise
- Down’s Syndrome, Ehlers-Danlos, etc.
- Empty end-feel/Instability
- Unwilling Patient
- History of smoking*****
- Atherosclerosis*****
- Hypertension*****
- Long-term steroid usage
- Bleeding disorders
- Recent relevant trauma
- UMN lesion signs/symptoms
- Recent manip by another professional
How to do R O-A Distraction
- L arm cradles the head right against the body, with left CMC thumb joint under patients left zygomatic arch.
- PT’s R hand index finger MCP joint is under the right mastoid process.
- PT’s right elbow/arm should be above the patient’s right shoulder and right
against the right side of their chest. - Use legs to create axial traction (cranial force)
How to do R A-A Distraction in sidelying
- Left arm cradles the patient’s head with the hand around the jaw for support. PT’s right hand uses a lumbrical grip over C1. If this is uncomfortable, the therapist can turn their hand around to thumb is pointing up.
- Slight ext, R rotation of head, then traction (use legs)
- Pre-manip hold [CONSENT]
Cranial force
SNAG
Sustained Natural Apophyseal Glides
* Sustained repositioning of one articular surface on its neighbor while a movement of function is undertaken
* Combination of sustained facet glides with movement
* Always involved with end-range joint movement
what must SNAGS always be
PAINFREE
what happens after you do a thrust
- stretch
-resisted motion
central SNAG
- Use ulnar border of (R) thumb as “dummy thumb” on the SP of the superior segment
- Place (L) thumb on post/inf aspect of (R) thumb
- Force comes from legs through (L)(R) thumb SP
- Pt moves through ROM (painfree) to end range – hold
3 sec. - Maintain SNAG until pt returns to neutral
unilateral SNAG
- Use ulnar border of (L) thumb as “dummy thumb” opn the articular pillar/TP
- Place (R) thumb on post/inf aspect of (L) thumb
- Force comes from legs through (R)(L) thumbTP
- Pt moves through ROM (pain-free) to end range – hold 3 sec.
- Maintain SNAG until pt returns to neutral
