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Kinesiology- Spine > Upper Cervical And TMJ > Flashcards

Upper Cervical And TMJ Flashcards

1
Q

Secondary curves

A

Cervical, lumbar lordosis

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2
Q

Early phase of opening

A

Condyle rolls posteriorly

Body of mandible moves posterior and inferior

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3
Q

Later phase of opening

A

It is a gliding jt.
Anterior slide of disc and condyle
Move from rotation to translators motion
Maximal anterior stretch on the disc

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4
Q

Closing phase is _____ of opening phase

A

Opposite

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5
Q

Intermediate part of the disc is located where

A

On top of the mandibular condyle

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6
Q

Vertebral artery goes through

A

The transverse foraminae of the the cervical spine

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7
Q

Atlas (C1) arthrokinematics

A

Superior articulate facet is concave
Superior moving on inferior when we are talking arthrokinematiccs
Convex on concave

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8
Q

AO jt primary movement

A

Flexion and extension (nodding)

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9
Q

T/F atlas always moves with the head

A

T

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10
Q

Total ROM at AO jt

A

15 (Flex 5, ext 15)

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11
Q

AA jt primary motion

A

Rotation

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12
Q

35-40 degrees

A

Axial rotation at AA jt

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13
Q

AO jt arthrokinematics

A

Flex - Ant roll, post slide

Ext - post roll, ant slide

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14
Q

One motion around one plane is associated with another motion around a different plane

A

Spinal coupling

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15
Q

T/F spinal coupling occurs in the upper cervical spine

A

T

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16
Q

AO and AA jt spinal coupling

A

Lateral flex is coupled with contra lateral rotation

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17
Q

Primary curves

A

Thoracic and sacral kyphosis

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18
Q

When palpating the TMJ where is the therapist posisitoned

A

Patient is sitting
Therapists behind patient
Palate lateral poles of the mandible condyle a by placing index fingers in the ears-external auditory meatus
You may also perform this test externally by placing index fingers on lateral poles of the mandible condyle a
Ask patient to open mouth (depression) and assess for symmetry, willingness to move, quality of movement

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19
Q

When in front of patient, measure the distance of __________ from the bottom of the top _________ an the top of the _______ .
Normal active motion in an adult is ______mm

A

Mouth opening
Central incisors
Bottom central incisors
40-50

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20
Q

Mandibular depression is considered WNL if _______

A

The PIP jts of 3 fingers can be inserted between the teeth

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21
Q

Normal active ROM in an adult of lateral deviation of the mandible

A

10-12 mm

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22
Q

Normal active protrusion of the mandible in an adult

A

6-9 mm

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23
Q

When palpating the muscles of mastication, patient is in ______ and therapist is ______
Palpate the extra oral musculature ____ ____ _____
Palpate the Intra oral musculature _____ _____

A

Supine
At the head
Masseter, temporalis, suprahyoids
Lateral and medial pterygoids

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24
Q

Where does most rotation occur in the cervical spine

A

C1C2 AA jt

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25
Q

1st step of sub-occipital active ROM

A

OA nodding

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26
Q

In forward and backward nodding (OA nodding) patient is ____ with therapist ____ and ask patient to ______ and then ______ slightly. This is a small movement with ______ total ROM. No _______ is applied in this area as you have not yet tested ligaments.

A 
Sitting
To the patient's side
Actively tuck his chin down and in
Back bend slightly
15 degrees
Over pressure
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27
Q

In AA rotation, patient is ______ and therapist is standing ______. Ask patient to _______ and then _______ to test _____. If tight muscles are preventing full side bend ROM to the right, _______. Repeat to the other side. There is _____ of AA rotation per side

A 
Sitting
In front
Bring their right ear to their right shoulder
Rotate their head to the left
AA left rotation
Unweight the left arm
35-40 degrees
28
Q

Palpating of the upper cervical region (8)

A 
Sub occipital muscles
Mastoid process
TP of C1
Posterior tubercle of atlas
SP of C2
TP of C2
Hyoid bone
Digastrics, infrahyoids, suprahyoids
29
Q

Perform prior to any other passive testing

A

Ligament testing

30
Q

Test assesses the integrity of the transverse ligament

A

Sharp-purser test (Saginaw plane stability)

31
Q

Therapist stands to the side of the patient places palm of one hand on the patient’s forehead and uses the other hand to stabilize the SP of C2 using a pinch grip of the thumb and fingertip pads

A

Sharp-purser test

32
Q

Therapist slightly flexes the patient’s head and neck about 20-30 degrees, then applies a posterior pressure on the forehead to posteriorly translated the occipital and atlas

A

Sharp-preset test

33
Q

Sharp purser test is considered positive if

A

Symptoms (Cardinal signs/symptoms of spinal cord compression) occur during Flexion and are relieved when posterior pressure is applied to the forehead.
Excessive translation is also considered a positive test

34
Q

Continuation of the posterior longitudinal ligament from the posterior body of the atlas to wrap around the posterior tip of the dens to the gutter in the basic input of the for amen magnum posterior to the atlantal axial ligament

A

Tectorial membrane

35
Q

Restricts OA Flexion and gives longitudinal stability

A

Tectorial membrane

36
Q

When testing tectorial membrane, patient is ____, and therapist is _____. Depress the patient’s ________ with forearms and firmly hold the _____ while performing light _____ to the upper cervical spine and gentle passive ____.

A 
Sitting
Behind
Shoulders
Occiput
Traction
Upper cervical Flexion
37
Q

Tectorial membrane test is positive if

A 
Nystagmus
Facial paraesthesias
Profuse sweating
Nausea, vomiting
Difficulty swallowing
38
Q

Controls axial rotation and side bending

A

Alar ligament

39
Q

Posterior superior aspect of the dens laterally to the no articulate medial aspect of the occipital condyle a on either side with variable position in relation to the dens and occipital. It also runs from the dens to the atlas

A

Alar ligament

40
Q

The alar ligament restricts

A

Side-bending and rotation of the axis to the opposite side

41
Q

To test the alar ligament, patient is _____. Palpate _____ on the left and passively __________._______ should Conde into contact with finger on the _____. This is and indication of an intact _____ alar ligament. How much motion?

A 
Supine
C2 SP
Rotate cervical spine to the right
C2 SP
Left
Left
15-20 degrees
42
Q

Positive alar lig test

A

C2 SP does not move with cervical movement. Look for spasm of sub occipital muscles in presence of alar lig tear.

43
Q

Stability in the sagittal plane

A

Transverse cruciate ligament

44
Q

Posterior to the dens attaching to the posterior aspect of the anterior arch of the atlas bilaterally to hold the dens forward against the anterior arch o the atlas

A

Transverse cruciate ligament

45
Q

The transverse cruciate ligament restricts

A

Anterior glide of the atlas in Flexion of C1 on C2 (it holds the dens in place)

46
Q

If the transverse cruciate ligament is torn

A

The dens will move posteriorly onto the spinal cord

47
Q

When testing the transverse cruciate ligament, patient is _______, Palpate ______. Gently ___ on ______. Hold this position for ______. Note if symptoms present before this timeframe, _____ as this is a positive test.

A 
Supine
C1 TPs
Lift up (glide anteriorly)
C1 TPs
15-20 sec
Release your hold
48
Q

The transverse cruciate ligament test is positive if

A 
Nystagmus
Facial paraesthesias
Profuse sweating
Nausea, vomiting
Difficulty swallowing
*refer back to physician immediately. Transverse lig laxity may be present in individuals with Rheumatoid arthritis and Down syndrome
49
Q

When assessing sub occipital nodding (mostly OA), patient is ____. Hold the head with a hand on each side, with the head in slight _____; gently _____ the head on the neck. Assess both ______ nodding of the head feeling for _____. Once the slack is taken up, move gently to ______. Assess the ______. This is the quality of resistance to the movement at the end range of the movement.

A 
Supine
Flexion
Nod
Left and right nodding
The willingness of the head to move
End ROM
End feel
50
Q

Passive ROM of AA rotation. Patient is ____. Hold the patient’s head with a hand on each side, _____ the patient’s mid cervical spine ______ to the right (purpose is to downslide all ______). In full right side bend, rotate the head to the _____.once the slack is taken up, move gently to the end of the rom. Assess the ____. Repeat of right AA rotation

A 
Supine
Side-bend
As far as possible
Right cervical facets to lock out mid cervical spine
Left
End feel
51
Q

Passive combined motions

A

OA (Flexion with side bending)

OA (extension with side bending)

52
Q

you must be careful doing passive combined motions. OA jt flexes and extends ____ if you see movement into the neck it is ____ movement

A

Around 15 degrees

Too much

53
Q

OA (Flexion with side-bending). Patient is _____. Perform OA ____, adding ______ to right and left.
During OA Flexion, occipital condyle a roll _____ and slide ____ on both sides (convex on concave). When right side bending is added, there will be coupled ____ rotation. The ____ condyle will glide further ______. This tests __________

A 
Supine
Flexion
Side bend
Anteriorly
Posteriorly
Left
Left 
Posteriorly
Left occipital condyle posterior glide AAROM
54
Q

OA (extension with side-bending) patient is ______. Perform OA extension, adding a side bend to right and left. During OA extension, occipital condyle a roll ____ and slide _____ on both sides. When right side bending is added, there will be coupled ____ rotation. The right condyle will glide further ____. This tests _____

A 
Supine
Posteriorly
Anteriorly
Left
Anteriorly
Right occipital condyle anterior glide AAROM
55
Q

Osteokinematics of OA jt in four motions

A

Flex - 5
Ext -10
Lat flex 5
Rotation negligible

56
Q

Arthrokinematics of OA jt in 4 motions

A

Flex - ant roll, post slide
Ext -post roll, ant slide
Lat flex - slide opposite of roll
Rotation - restricted motion

57
Q

Osteokinematics of AA jt four motions

A

Flex - 5
Ext -10
Lat flex - negligible
Rotation - 35-40

58
Q

Arthrokinematics of AA jt four motions

A

Flex - follows OA - ant tilt
Ext - follows OA - post tilt
Lat flex - tilt
Rotation - spin

59
Q

What clinical test would you use with a patient who me you suspect has instability in the upper cervical spine

A

Sharp-purser
Longitudinal ligament stability
Alar ligament
Transverse cruciate ligament

60
Q

List four Simmons suggestive of a CNS compromise

A

Nystagmus
Facial paraesthesias
Profuse sweating
Nausea

61
Q

A of suprahyoids

A

Depress mandible

62
Q

A of lateral pterygoid

A

Protracts mandible

63
Q

A of medial pterygoid

A

Protracted and deviates mandible

64
Q

A of masseter

A

Elevates, abducts, protrudes mandible

65
Q

A of temporalis

A

Elevation, retraction of mandible (chewing)

66
Q

Normal measurements for
Opening
Protrusion
Lateral deviation

A

40-50 mm
6-9 mm
10-12 mm

67
Q

Describe muscle and jt interactions during opening and closing of the mouth

A

Opening of the mouth- posterior rotation, ant. Translation, followed by more posterior rotation. Muscles involved are Lat pterygoid, infra and suprahyoids.
Closing the mouth - ant rotation, posterior translation and then more ant rotation. Musc involved - temporalis, masseter, medial pterygoid.

Kinesiology- Spine (2 decks)

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