Upper C-Spine Flashcards
Job of Transverse Ligament?
Restraint for posterior-anterior translation at the AA joint
Job of Alar Ligament
Primary rotatory stability at AA joint- checks side to side movements of head
Primary motion at OA joint is:
Flexion-Extension
OA joint Flexion Arthrokinematics
Condyles move posteriorly- stresses posterior capsule
OA joint Extension Arthrokinematics
condyles move anteriorly- stresses anterior capsule
Primary motion at AA joint:
Rotation
How much head rotation comes from AA joint?
50%
Normal ROM of C1/C2?
45 degrees
Subjective Red flags tell you not to do what?
Not to perform manual therapy techniques
What are some subjective red flags:
- H/O acute trauma
- C/o Dizziness, drop attacks
- c/o lump in throat, lip paresthesi, nausea or vomitting, severe HA
- facial numbness
change in bowel/bladder continence - Ataxia
- extreme reluctance to move head
- pt c/o difficulty lying down or lifting head from pillow
Cervical exam red flags are?
- BL or QL paresthesias or paresis (medical emergency)
- diplopia
- trapezius or SCM paresis
- Hyperreflexia
- Postitive Babinski, Hoffman’s, Clonus
- Disdiadokokinesia
- Dysphasia, dysarthria
- Change in bowel/bladder continence
Cervical Myelopathy Red Flags
- sensory disturbance in hands
- muscle wasting in intrinsics
- unsteady gait
- hoffman’s reflex
- hyperreflexia
- bowel or bladder dysfunction
- multi-segmental motor weakness, sensory, or both
VBI Red flags (5 D’s)
- dizziness
- drop attacks
- diplopia
- Dysarthria
- Dysphagia
VBI red flags (3N’s)
- nausea
- numbness
- nystagmus
Inflammatory or Systemic Disease red flags
Temp > 100 F BP > 160/95 RR > 25 bpm Pulse > 100 bpm general fatigue
Spinal Fractures Red Flags
major trauma without proper imaging
-severe limitation in AROM
Upper CS ligament Instability Red Flags
Occipital headache and numbness
- severe limitation in all AROM
- signs of myelopathy
Red Flags Neoplastic Conditions
> 50 yrs age
- Hx of CA
- unexplained weight loss
- constant pain and no relief with bed rest
- night pain
Other VBI considerations
- CN testing
- Cardiovascular disease risk factors
- recent trauma
- severe ongoing HA/Migraine
What are the cervical spine clearing test?
- sharp-purser test
- Alar Ligmanet
- Transverse Ligament
- Vertebral Artery Test
What is the purpose of the sharp purser test?
test to determine subluxation of atlas (C1) on axis (C2)
What is the purpose of the alar ligament test?
Test of immediacy, if alar ligament is intact, C2 will roate immediately to the opposite direction
What is th epurpose ot he transverse ligament test?
anterior shear is resisted by the transverse ligament–> checking to make sure dens is in place
What 2 tests can be done to assess AA Joint mobility?
- AA segmental motion central and unilateral PA’s
2. AA cervical Flexion-Rotation test
What 2 tests can be done to assess OA joint mobility?
- OA SG with flexion/extension
2. OA posterior condylar glide technique with Rotation
When testing OA joint in extension, which way do you SB?
Toward the side being tested
When testing OA joint in flexion, which way do you SB?
away from side being tested
