Headache/Cervical Lab

Question 1

you should stay off patients’

Answer 1

jaw and eye

Question 2

OA Convex Occiput on Concave Atlas

Answer 2

15 degrees flex/ext

Question 3

AA: Convex atlas on convex axis

Answer 3

45 degree rotation to each side

Question 4

C2-C7

Answer 4

• Bifid SP’s
• Transverse foramen
• Uncovertebral Joints
• Facets lie b/t horizontal and frontal planes

Question 5

Composite cervical motion: Flex/Ext

Answer 5

126

Question 6

Total rotation of cervical spine

Answer 6

144

Question 7

total lateral flexion

Answer 7

87 degrees

Question 8

if you side bend to R, what should dens do?

Answer 8

rotation to L

Question 9

vertebral artery test

Answer 9

ext, SB, rot
hold > 10 sec
Cognitive task

Question 10

VBI incidence

Answer 10

• blunt trauma with associated cervical fracture
• or can be spontaneous

Question 11

Craniovertebral locking

Answer 11

Side bend ipsi
Rotate contra

Question 12

flexion/upslide assessment

Answer 12

gently glide TP in sup/ant/lat (SAL)

Question 13

Extension/downslide assessment

Answer 13

glide inf/med/post

Question 14

How much can the tunica intima of the vertebral artery stretch?

Answer 14

17%

Question 15

what does 40 degrees of rotation cause?

Answer 15

kinking of bilateral vertebral arteries

Question 16

where is the most common place for vertebral artery damage

Answer 16

C1-C2

Question 17

should we manip with rotation?

Answer 17

NOOOOOOOO

Question 18

pre-manip hold at end range

Answer 18

7 sec

Question 19

contraindications for cerivical manip

Answer 19

• 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

Question 20

How to do R O-A Distraction

Answer 20

• 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)

Question 21

How to do R A-A Distraction in sidelying

Answer 21

• 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

Question 22

SNAG

Answer 22

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

Question 23

what must SNAGS always be

Answer 23

PAINFREE

Question 24

what happens after you do a thrust

Answer 24

• stretch
  -resisted motion

Question 25

central SNAG

Answer 25

• 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

Question 26

unilateral SNAG

Answer 26

• 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) thumbTP
• Pt moves through ROM (pain-free) to end range – hold 3 sec.
• Maintain SNAG until pt returns to neutral