TMJ/Upper Cervical Lab

Question 1

characteristics of normal sub-occipital AROM

Answer 1

smooth, regardless of speed
range is full for body type
pain free

Question 2

Sharp-Purser Test

• assesses…
• what joint are you trying to test and what are you trying to do to that joint
• positive test

Answer 2

assesses integrity of transverse ligament
AA joint
trying to posteriorly translate the occiput and atlas if they have moved forward when putting the patient’s head in flexion

Question 3

tectorial membrane

• what is it
• location
• function

Answer 3

continuation of posterior longitudinal ligament
from posterior body of atlas
-wraps around posterior tip of dens to the gutter of the base of the occiput inthe foramen magnus posterior to the atlantal axial ligament
restricts AO flexion
-provides longitudinal stability

Question 4

tectorial membrane test

-procedure

Answer 4

patient sitting
stand behind patient
depress patient’s shoulders with forearms
perform light traction of the upper C-spine and gently move patient into upper cervical flexion

Question 5

cardinal signs or symptoms of spinal cord compression

Answer 5

nystagmus
facial paresthesias
profuse sweating
nausea, vomiting
difficulty swallowing

Question 6

alar ligament

• function
• location

Answer 6

restrict axial rotation (horizontal plane) and side bending (frontal plane) to the opposite side
location
-posterior superior aspect of the dens laterally to nonarticular medial aspect of the occipital condyles
-also runs from dens to atlas (atlanto-axial ligament)

Question 7

alar ligament test

-positive sign

Answer 7

C2 does not move with cervical movement

look for spasm of suboccipital muscles in presence of alar ligament tear

Question 8

transverse cruciate ligament

• stability in what plane
• location

Answer 8

stability in sagittal plane
posterior to dens attaching to the posterior aspect of the anterior arch of the atlas bilaterally to hold the dens forward against the anterior arch of the atlas

Question 9

transverse cruciate ligament

• function
• if torn, what occurs

Answer 9

restricts anterior glide of atlas in flexion of C1 on C2

dens will move posteriorly onto spinal cord