Lower C/S
Upper C/S
Clinical Tests/Scenarios
Random Facts
PT-621 Skills
100
Coupling pattern of the lower C/S
Ipsilateral
100
Coupling pattern of the upper C/S
Contralateral coupling
100
If I imparted an extension, L sidebend, L rotation and the patient reports the 5D's and 3N's, what test am I using and what am I testing
VBI test - L vertebral artery
100
What orientation are the facet joints of the cervical spine
45 degrees
100
If you wanted to use segmental mobilization for upglides/downglides, which direction do you initially place the patient in for each?
Upglides - rotation
Downglides - sidebend
200
Functional spinal unit(s) with the most combined flexion/extension?
C4-C5
C5-C6
200
Degrees of axial rotation between C1-C2
~40 degrees
200
My patient reports nausea/vomiting with neck flexion. What ligament may be involved?
Transverse ligament
200
Unique structures in the lower cervical spine?
Uncinate processes/Uncovertebral joints
Bifid spinous processes
200
What does SNAG actually stand for? What are the parameters for the SNAG HEP?
Sustained natural apophyseal glide
2-3 sets/10 reps
300
Functional spinal unit with the least amount of rotation?
C7-T1
300
Degrees of combined flexion/extension between C0-C1 and C1-C2
~45 degrees
300
You noticed the patient has hypomobility of the lower C/S when turning their head to the right. What other motion would occur?
- Right lateral flexion of the head
- Left lateral flexion of the head
- No effect
Left lateral flexion of the head
300
What is unique about atlas?
It has a biconvex inferior articular surface
It has no vertebral body
300
Why do you take the patient into full flexion when trying to improve AA rotation?
Locks up the lower cervical spine by taking up all the motion of the lower C/S - therefore the only motion available is rotation of the AA
400
Clinical test I can perform if a patient complains of radiating pain down the arm with neck movements
Spurling's test
400
You realized with alar ligament integrity test that spinous process of C2 was not felt on the R side. Which side of the alar ligament are you testing
R alar ligament
400
Patient is driving and you notice that when they turn their head to the left, they're only able to achieve ~30 degrees of rotation. What would you assess?
What would change if the patient had ~70 degrees of rotation?
Assess upper cervical spine because the first ~40 degrees comes from AA joint
Assess lower C/S or CTJ as this is where the last degrees of rotation come from
400
What is unique about the atlanto-axial joint?
It has 3 joints
No intervertebral disc between them
Biconvex joint
400
What is the average neck flexor muscle endurance hold times for healthy patients vs chronic neck patients
Average healthy = 38 sec
Chronic neck pain = 24 sec
500
Patient has hypomobility of C4-C5 FSU on the right side when turning to the L. What motion(s) can I use to localize my upglide to only mobilize C4-C5
Uncoupled motion
Rotation to the left till C4-C5 FSU
Sidebend to R till C3-C4 FSU
500
I want to move/stretch the AA joint into right rotation using coupled motion. How can I do this?
Maximal Left sidebend
R rotation
500
This right handed golfer complains of lack of motion during his backswing. What could potentially be the cause of his neck position?
Trunk is rotated to the right, therefore his cervical spine is relatively left rotated. His final position is in left sidebend which would induce left rotation of the lower cervical spine. Therefore, his upper cervical spine may be hypomobile and unable to return his head to neutral
500
Which ligament is stronger when tested in vitro - Alar ligament or Transverse ligament?
Transverse ligament (350N)
Alar ligament (200N)
500
When using the laser to train C/S proprioception, there are 3 ways you can utilize this exercise.
Ability to reproduce the starting position of the C/S
Ability to move head in the correct direction of movement
Ability to dissociate head/neck control from body
Joint position sense
Head movement control
Head and neck dissociation