TEST 3: Cervical Spine Dx OSCE

Question 1

biceps DTR tests which nerve root

Answer 1

C5 with some C6

Question 2

brachioradialis DTR tests which nerve root

Answer 2

C6 with some C5

Question 3

triceps DTR tests which nerve root

Answer 3

C7 with some C8

Question 4

how to document DTRs

Answer 4

0-4/4
0–no response, abnormal
1–slight response, may or may not be normal
2–brisk response, normal
3–very brisk response, may or may not be normal
4–repeating reflex, always abnormal

Question 5

Spurling’s Maneuver

Answer 5

• doc stands behind seated pt
• done in 3 stages each of which is more provocative (if get symptoms, can stop)
  
  1. compression of the head in neutral
  2. compression of head with head in extension
  3. sideband away from affected side then toward affected side and add compression
• positive test is indicated by pain down the arm in the distribution of the nerve root indicating nerve root compression

Question 6

mechanics of OA

Answer 6

modified type I

Question 7

mechanics of AA

Answer 7

rotation only

Question 8

mechanics of C2-7

Answer 8

modified type II

Question 9

OA joint lateral translation

Answer 9

• modified type I
• primary motions are F and E
• sit at head of supine pt
  
  • translate OA joint to R and L with head in neutral (restriction of translation to the R means SB R and rotated L)
  • repeat in F and note if more symmetric
  • repeat in E and note if more symmetric

Question 10

OA joint rotational test

Answer 10

• modified type I
• grasp head with both hands
• with R hand, lift anterior and rotate L (if restricted, then rotated R)
• repeat with L hand
• repeat in F and E

Question 11

AA joint test

Answer 11

• primary motion is rotation
• fully flex C spine to lock these to isolate rotation
• rotate head bilaterally
• greater rotation to the R implies restriction of L rotation (rotated R)
• F, E, and SB not tested

Question 12

C2-7 lateral translation test

Answer 12

• modified type II
• support head and test lateral translation to R and L
  
  • note end feel
  • ex: C3 translates more freely to L vs. R, then segment is SB R, thus rotated R
• repeat in F and E

Question 13

C2-7 rotation test

Answer 13

• modified type II
• rotate R and L in neutral
  
  • if press up on R side, to rotate L, but restricted, then rotated R and SB R
• repeat in F and E