[MDDR] Cervical Spine

Question 1

What are the 5 D’s 3 N’s 1 A that we ask they have in association with their neck pain?

Answer 1

Diplopia (double vision)
Dysarthria (difficulty speaking)
Dysphagia (difficulty swallowing)
Dizziness
Drop Attacks (turn head and fall to ground)
Nausea
Nystagmus (look @ eyes during VBI test)
Numbness of the face, lips, and/or tongue
Ataxia

Question 2

What is a positive test for the Sharp Purser Test (transverse ligament)?

Answer 2

A positive test is a production of a ‘clunk’ that is felt or heard (suggesting relocation of a sublimed dens) and a reduction in symptoms associated with instability

Question 3

Signs of craniocervical damage and ‘instability’ include

Answer 3

• Paraesthesia of lips, tongue
• Signs of vertebral artery compromise (i.e. 5Ds)
• Increase in motion or empty end feel on test movements

Question 4

Typically, how much range of motion is expected during lateral flexion during the alar ligament test?

Answer 4

10 degrees

Question 5

What are the 3 key features of headaches?

Answer 5

Cervicogenic (CGH), Tension Type Headache (TTH), and Vascular (i.e. migraine)

Question 6

What are the proposed symptoms of minor cervical spine instability?

Answer 6

Neck pain
Catching locking
Weakness poor muscle control
Altered ROM
Trauma (macro or micro)

Question 7

Spondylosis in terms of the cervical spine is a

Answer 7

multi level degenerative disease of the cervical spine. OA of the neck.

note: no known cause and can follow significant trauma i.e. whiplash)

Question 8

What are the associated features of a cervicogenic headache?

Answer 8

Neck pain, trauma, posture, reduced ROM

Question 9

What are the associated features of a tension-type headache (TTH)?

Answer 9

Life stresses, work/family related

Question 10

What is thoracic outlet syndrome?

Answer 10

Pain, paresthesia, weakness and discomfort in the upper limb which is aggravated by elevation of the arms or by exaggerated moves of the head & neck

Pain is attributed to compression of nerves and vessels as they pass through the thoracic outlet

Question 11

A feeling of band-like tightness around the head sounds like what kind of headache?

Answer 11

Tension-type headache

Question 12

Why do we stay within 45 degrees when working with the neck?

Answer 12

Beyond 45 degrees increases risk

Question 13

The Spurlings Test is a

Answer 13

Test to assess nerve root pain (aka radicular pain). Nerve root compression test.

(low sensitivity, high specificity)