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OMM II > Neck > Flashcards

Neck Flashcards

1
Q

What are the steps of the neck PE?

A
  1. Inspect
  2. Movements
  3. Scapular movements
  4. Arm tests
  5. Adjunctive tests
  6. Palpation
  7. SD eval
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2
Q

What are the four things you are assessing for with movements of the neck?

A
  1. RROM
  2. Weakness
  3. Pain
  4. Location of pain
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3
Q

If the neck movements are clearly disturbed, then the problem is most likely what?

A

In the neck itself

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4
Q

If there is neck pain but there is no RROM, then what is the etiology of the pain?

A
  • Referred pain

- Non-mechanical

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5
Q

If there is pain in shoulder girdle, what are the four joints that should be assessed?

A
  • Sterno-clavicular
  • Acromio-clavicular
  • costo-scapular
  • 1st costo-transverse
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6
Q

What are the neck problems that can lead to arm pain?

A

Spinal cord/cervical root lesion

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7
Q

What does rotation of the neck check?

A

Stretches elements on either side of the neck

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8
Q

What does sidebending of the neck test for?

A

facets on either side

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9
Q

Is there limitation to flexion with flexion of the neck with capsular pain?

A

No

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10
Q

Which is worse with capsular neck pain: side bendings or rotation

A

Both equally bad

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11
Q

Is there limitation to flexion with extension of the neck with capsular pain?

A

Can be

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12
Q

Painful capsular pattern of RROM indicates what?

A

Fracture or RA

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13
Q

What are the physiologic types of end feel?

A

Hard
Elastic
Tissue approx

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14
Q

What are the pathologic type of end feel?

A

Guarding

Muscle spasm

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15
Q

What is elastic end feel?

A

At the end of ROM, the examiner feels resistance, but further stretching over a few degrees is possible, typical of a normal joint capsule

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16
Q

What do muscle spasms indicate?

A

restricted ROM–severe disorder

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17
Q

What are the two end-feels that contraindicate OMM?

A

Guarding

Muscle

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18
Q

Pain on active and passive stretching in one direction, but also on isometric testing in the opposite direction indicates what?

A

Musculotendinous lesion,

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19
Q

Pain with elevation of the scapula indicates what?

A

The need for a shoulder girdle exam

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20
Q

Resisted elevation of the shoulder tests which spinal levels? What nerve is this?

A

C3-C5 + CN XI

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21
Q

If there is painful limitation of movement without weakness with elevation of the arm, this indicates what?

A

Local lesion in the arm

22
Q

Hyperreflexia is an UMN or LMN sign?

A

UMN

23
Q

Hyporeflexia is an UMN or LMN sign?

A

LMN

24
Q

Biceps reflex tests which spinal level?

A

C5/6

25
Q

Brachioradialis reflex tests which spinal level?

A

C5/6

26
Q

Triceps reflex tests which spinal level?

A

C7

27
Q

Patellar reflex tests which spinal level?

A

L4

28
Q

Achilles reflex tests which spinal level?

A

S1

29
Q

Shoulder adduction = which spinal level?

A

C5/6

30
Q

Elbow flexion = which spinal level?

A

C5/6

31
Q

Wrist extension = which spinal level?

A

C6

32
Q

Elbow extension = which spinal level?

A

C7

33
Q

Long finger flexion = which spinal level?

A

C8-T1

34
Q

Abduction of the 5th digit = which spinal level?

A

C8-T1

35
Q

What does Spurling’s test look for?

A

Nerve root compression

36
Q

What is the procedure for Spurling’s test?

A

Add rotation, sidebending and axial compression

37
Q

What is the distraction maneuver for spurling’s? What is a positive test? What does this indicate?

A

Dural stretch.
Positive = decrease in radicular pain
Indicates radiculopathy

38
Q

When should you do x-rays before doing ROM of the neck? (3)

A
  • Suspect fracture
  • Severe neurological complaints
  • Intoxication
39
Q

What are the five things that you should decide after a neck PE?

A
  1. Need to examine further
  2. further testing?
  3. Consult?
  4. OMM?
  5. Other treatments?
40
Q

True or false: capsular pattern is an indication for x-ray

A

True

41
Q

True or false: neurological findings are an indication for an x-ray

A

True

42
Q

What should you examine if the patient gets dizzy looking up?

A

Auscultate the carotids

43
Q

How, generally,do you assess joint surfaces? Ligaments? Muscles?

A

joint surfaces = squish
Ligaments = pull apart
Muscles = have them contract

44
Q

True or false: anticoagulation is a relative contraindication to OMM

A

True

45
Q

What are the four neck problems that should be assessed for with inspection of the neck?

A
  • Abnormal head position
  • Abnormal Shape
  • Masses
  • Scoliosis reaching the neck
46
Q

If there is dizziness when looking up, what imaging should you get?

A
  • Flexion/extension cervical spine x-rays

- Carotid and vertebral US

47
Q

What are the characteristics of the capsular pattern of the neck in terms of:

  • Flexion
  • Side bending/rotation
  • Extension
A
  • No limitation of flexion
  • Equal degree of limitation of side bending and rotation
  • Some or great limitation of extension
48
Q

What are the likely etiologies of the capsular pattern of the neck?

A

Fracture or tumor.

49
Q

True or false: Capsular pattern is a contraindication to OMM

A

True

50
Q

What are the three things you are looking for with passive movement of the neck?

A

Restriction
Pain
End feel

51
Q

What are the two things you are looking for with resisted movement of the neck?

A

Pain

Weakness

OMM II (43 decks)

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