Midterm Flashcards
Be able to state the Four Cardinal Signs and Symptoms of Upper Cervical Instability:
All with relation to head movements:
Loss of balance,
Lip paresthesia,
Limb paresthesia,
Nystagmus
Be able to state the Signs and symptoms of vertebrobasilar ischemia (“5 D’s And 3 N’s”):
5D’s
Diplopia (or other visual problems)
Dizziness (vertigo, light-headedness, giddiness)
Drop attacks (sudden weakness in face/arm/leg)
Dysarthria (speech disorder)
Dysphagia (difficulty swallowing)
And
Ataxia of gait (unsteady, hemiparesis)
3 N’s
Nausea (possibly with vomiting)
Numbness (hemianesthesia)
Nystagmus
Be able to state the Signs and symptoms of vertebrobasilar ischemia - “5 D’s”
5D’s
Diplopia (or other visual problems)
Dizziness (vertigo, light-headedness, giddiness)
Drop attacks (sudden weakness in face/arm/leg)
Dysarthria (speech disorder)
Dysphagia (difficulty swallowing)
Be able to state the Signs and symptoms of vertebrobasilar ischemia.- “And 3 N’s”
And
Ataxia of gait (unsteady, hemiparesis)
3 N’s
Nausea (possibly with vomiting)
Numbness (hemianesthesia)
Nystagmus
Be able to state the Canadian C-spine rules for X-rays:
Any positive requires X-rays:
High risk trauma
Cognitive awareness or neuro symptoms (Tingling, numbness, shooting pain)
Age >65 or older (Not on
Be able to state the Cluster Diagnosis for Cervical Radiculopathy (Wainner et.al,)
+ ULTT of median nerve (upper limb tension test)
Cervical rotation
perform the following Upper Cervical Instability tests:
Transverse Atlantal Ligament Stress Test
(C2) … pinch grip-
Pt’s upper C-spine is flexed & held for 5 sec. or until onset of symptoms.
Dr. then performs direct post. translation of the pt’s head
Test is positive if:
- Dec. of s/sx’s w/ post. translation of Occi. & atlas (Head)
- Palpable hypermobility
Lateral Flexion Stress Test of the Alar Ligament
(C2) … pinch grip-
Laterally flex the head to the left and then to the right.
Test is positive if:
Onset of S/sx’s
Excessive lateral flexion in all positions (flexion, neutral, extension)
Positive test results:
Suggests alar ligament tear or instability at the CO-C1 Jt.
Rotational Stress Test of the Alar Ligament
(C2) … pinch grip-
Rotate the occiput and atlas to the right
Test is positive if:
Onset of S/sx’s
Rotation greater than 30° at the upper cervical segments on the same side as the lateral flexion instability.
Be able to perform Cervical Spine Assessment
C1-C7 motion palpation (segmental assessment)
Do what you are assessing last;
Ex:
Rotation= Flexion, Lat. Flexion then Rotation.
Lat. Flex.=Flexion, Rotation, Lat. Flexion
Soft Tissue Techniques;
Post-Isometric Relaxation (PIR)
Summary of PIR procedure
Full stretch for 10 seconds
Isometric contraction of the muscle being stretched for 10 seconds, at 20% of full effort.
Relax the contraction, increase the stretch and hold for 10 seconds.
Repeat steps 2 and 3 twice more.
Release the stretch slowly.
