LAB: cervical spine

Question 1

Describe how you would perform the Spurling’s maneuver with compression

Answer 1

physician is behind the patient
the neck is extended
side bend to the testing side
rotate to the testing side

add compression if needed

Question 2

What is a positive Spurlings test?

Answer 2

Pain or paresthesia down the arm in a nerve distribution

Question 3

If the patient has symptoms on the contralateral side from the side that is being testing in Spurlings, what does that indicate?

Answer 3

scalene nerve compression

Question 4

______ pain tends to be unilateral and needs further testing and careful manipulation

Answer 4

radicular

Question 5

Describe C-spine bilateral fulcrum testing

Answer 5

Arms are crossed under patient’s head and hands placed palm down on patient’s anterior shoulders.
Gently flex patients neck, giving a longitudinal stretch of the paravertebral muscles.
Repeat for 30-90 sec. or until desired effect is achieved.
Re-evaluate TART for efficacy.

Question 6

The _____ side is the side towards which you’re inducing the side bending

Answer 6

fulcrum

Question 7

Describe the treatment for a C3-7 flexed cervial MET

Answer 7

1. Patient supine with the physician seated at the head of the table
2. The physician cradles the patient’s occiput within their hands
   and slightly extends the neck.
3. Press laterally on left articular pillar with 2nd MTP inducing sidebending towards and up to the regional restriction.
4. Rotate occiput (induces motion from top down) towards and up to the restriction until vertebra moves at the level. (The right barrier is now engaged in all three planes).
5. For 3-5 seconds, patient GENTLY sidebends or rotates their head away from the barrier, while meeting the patient’s force with equal and opposite counterforce (isometric contraction).
6. After tissue relaxation, take up the slack to engage the new barrier in all 3 planes (add slightly more side bending and rotation).
7. If needed, repeat up to 3 cycles until tissue and joint restriction resolves.
8. Reassess for TART findings to confirm therapeutic benefit

Question 8

By having the patient look in the direction of the desired motion, this reflex can be used as a part of the treatment

Answer 8

Oculocephalogyric reflex

Question 9

In the articulatory technique for an _______ ______, the treatment circles go in a posterior circle direction with the downward and lateral portions being emphasized

Answer 9

extension dysfunction

Question 10

In the flexion articulatory technique, the _______ and _____ portions of the figure 8 are emphasized

Answer 10

upward and lateral

Question 11

This joint has the primary movement of rotation and no side bending or flexion and extension

Answer 11

AA joint

Question 12

Describe how you would diagnose an AA dysfunction

Answer 12

Grasp the head and fully flex the C-spine
rotate the head bilaterally, assessing the ROM feeling for any subtle barriers

** greater rotation to the right implies a restriction of left rotation

Question 13

Describe an AA MET/ART

Answer 13

1. pt is supine
2. physician takes the patients neck and fully flexes it
3. rotate head toward the side of restricted motion until the barrier is reached
4. have the patient try to get to neutral for 3-5 seconds against counterforce
5. after tissue relaxation, take up the slack and engage the new barrier
6. if needed, repeat 1-3 times
7. reassess TART

Question 14

Describe how to perform an OA diagnosis side bending

Answer 14

Grasp the head with both hands over the occipital articulation

translate joint to the right and the left noting side bending restriction

repeat in flexion and extension

Question 15

Describe how to perform an OA diagnosis rotation

Answer 15

grasp the head in both hands with the neck in neutral position. With the right hand, left the lift the right ridge to rotate the OA joint to the left and note any restriction

If there is preferred rotation to the left, then it is rotated left

repeat in flexion and extension