Term
| Upper cervical spine screen: start with... (3) |
|
Definition
ligt stability
neuro exam
vertebral a. testing |
|
|
Term
| Observation: look-fors in sitting (3) |
|
Definition
rigid holding pattern
neck rotation - cock robin posture
eye/face symmetry |
|
|
Term
| Observation: look-fors in standing/gait |
|
Definition
unsteadiness
postural sway
ataxia |
|
|
Term
| Components of neuro exam (2) |
|
Definition
CNs
reflexes (including abnormal) |
|
|
Term
|
Definition
Sharp-Purser
alar ligt
transverse ligt of atlas |
|
|
Term
| Sharp-Purser test: tests _____ ligt |
|
Definition
|
|
Term
| Sharp-Purser test: procedure |
|
Definition
AROM neck flex to onset of symptoms
stabilize C2 sp pr
AP pressure through forehead |
|
|
Term
| Sharp-Purser test: positive |
|
Definition
|
|
Term
| Positive ligt test: next step |
|
Definition
place pt in cervical collar,
refer for medical treatment immediately |
|
|
Term
|
Definition
perioral anesthesia/paresthesia,
drop attacks,
LOB,
nystagums,
quad paresthesia,
ataxia |
|
|
Term
| Alar ligt test: procedure |
|
Definition
PROM sidebending
palpate C2 sp pr
lat flex >> ipsilat C2 rot (sp pr moves away from sidebend) |
|
|
Term
| Alar ligt test: positive test |
|
Definition
no mvmt,
symptom reproduction |
|
|
Term
| Transverse ligt of atlas test: procedure |
|
Definition
pt supine
PT fingers on C1
ant force to C1
hold 15-20 sec
use shldr to provide post force if no symptoms |
|
|
Term
| Transverse ligt of atlas test: contraindications |
|
Definition
|
|
Term
|
Definition
sustained cervical rotation
test for vestibular involvement |
|
|
Term
|
Definition
dysarthria
dysphagia
diplopia
drop attacks
dizziness |
|
|
Term
| Maitland: If ANY positive VAI findings on ____, ____, ____, or ____, manips are contraindicated |
|
Definition
exam
while getting into Rx position
during Rx technique
p Rx |
|
|
Term
| Manips in elderly pt c marked degenerative ∆s |
|
Definition
|
|
Term
|
Definition
VAI
inner ear trauma/disturbance
postural hypotension
upper cervical proprioceptive disturbance
meds |
|
|
Term
| Time to hold sustained cervical rotation |
|
Definition
| 10 sec (each side, and neutral; count aloud) |
|
|
Term
| Common (non-pathological) response to VAI testing |
|
Definition
| positional vertigo lasting 30-45 sec (vascular issue lasts longer) |
|
|
Term
| Ideal posture: plumb-bob line + landmarks (8) |
|
Definition
ear lobe
bodies of cervical vertebrae
tip of shoulder
mid-thorax
bodies of lumbar vertebrae
slightly post to hip
slightly ant to knee
slightly ant to lat malleolus |
|
|
Term
| APM eval: motions to test (5) |
|
Definition
flex (upper&lower)
ext (upper&lower)
sidebend
rotation (most commonly limited)
combined mvmt |
|
|
Term
|
Definition
OA flex/ext
AA rot
OA combined sidebend+rot |
|
|
Term
| PPM: OA flex/ext - procedure |
|
Definition
PT index finger btwn C1 tr pr & mastoid
PT other hand on head >> flex/ext
feel for uality of mvmt, mm spasm, pain response; compare each side |
|
|
Term
|
Definition
index finger on C2 sp pr
thumb btwn C1/C2
feel for C2 motion @ ~30-50º rot |
|
|
Term
| PPM: AA rot - normal range to feel mvmt of C2 |
|
Definition
| begin feeling C2 mvmt at 30-50º total rotation |
|
|
Term
| PPM: OA combined sidebend + rotation - purpose |
|
Definition
| reproduction of (less-easily-aggravated) symptoms |
|
|
Term
| 3 types of pain found c PAM |
|
Definition
actual pain (comparable/concordant sign)
localized discomfort (joint/discordant sign)
localized discomfort described as "good hurt" |
|
|
Term
| 3 types of resistance found c PAM |
|
Definition
limitation of motion compared to other levels
no limitation, but effort to produce motion is greater/less than other segments
endfeel differs from other levels |
|
|
Term
| 2 types of spasm found c PAM |
|
Definition
reflex twitching (spinal reflex; indicates instability)
voluntary protective contraction by pt |
|
|
Term
|
Definition
OA flex/ext c traction
CPA
UPA
transverse pressures
atlas side=gliding
lateral glide c caudal fixation |
|
|
Term
| PAM: Side gliding atlas - procedure |
|
Definition
pt prone, c head rot 30-40º
UPA toward ear |
|
|
Term
| PAM: Lateral glide c caudal fixation - procedure |
|
Definition
perform AFTER AA rot testing
pt supine
radial border of index finger on C1
radial border of other index finger on C2
glide laterally, assess for motion/pain |
|
|
Term
|
Definition
Neutral;
sidebend >> opposite rotation |
|
|
Term
|
Definition
Non-neutral;
sidebend >> same side rotation |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| C-Spine Special tests (3) |
|
Definition
Jt differentiation for causes of rotatory restrictions:
- upper v lower
- OA v AA
- AA rot |
|
|
Term
| Upper v lower c-spine test |
|
Definition
e.g. R rot painful:
sidebend L
rot R
R rot painful: upper
R rot non-painful: lower |
|
|
Term
|
Definition
rot to restriction
rotate C1 further
decr symptoms: OA
incr symptoms: AA |
|
|
Term
|
Definition
pt supine
passively fully flex neck
rot each direction
+ for AA rot restriction : <45º rot, 10º difference between sides |
|
|
Term
|
Definition
15º rot
chin tuck
rot limited on side OPPOSITE of chin tuck rot
(example: 15º rot to L tests >> R OA rotation) |
|
|
Term
| Types of pain patterns of mvmt (3) |
|
Definition
regular compressive (closing)
regular stretching (opening)
irregular |
|
|
Term
| Atypical types of pain (3) |
|
Definition
recovery pain
release pain
latent pain |
|
|
Term
|
Definition
pain produced upon returning to neutral;
pain generally through an arc |
|
|
Term
|
Definition
| pain produced upon release of overpressure |
|
|
Term
|
Definition
pain occurring after test mvmts are complete;
condition is more irritable that previously thought (could include inflammatory process) |
|
|
Term
| PPM: eval planar mvmts in ... [pt position] |
|
Definition
|
|
Term
| PPM: intersegmental flexion - position/procedure |
|
Definition
pt supine
PT sitting at head
L hand stabilize c-spine ant, L thumb palpate sp pr
R hand flex neck |
|
|
Term
| PPM: intersegmental extension - position/procedure |
|
Definition
pt supine
PT sitting/standing at head
PT's hands support head
PT fingers palpate sp pr |
|
|
Term
| PPM: intersegmental rotation - position/procedure |
|
Definition
pt supine
PT uses chin cradle grip
PT index finger palpates sp pr while head rotated AWAY |
|
|
Term
| PPM: intersegmental sidebending - position/procedure |
|
Definition
chin cradle grip
palpation through 1st MCP
sidebend TOWARD MCP (feel for gap closing) |
|
|
Term
| PAM: main use of transverse pressures |
|
Definition
|
|
Term
|
Definition
cervical compression
spurlings test
ULTT
cervical distraction
neural tension
shoulder abduction (relief) test |
|
|
Term
| Spurlings test: tests for.. |
|
Definition
| nn root compression/irritation |
|
|
Term
| Spurlings test: procedure |
|
Definition
sidebend toward painful side
add compression
hold for 5 sec |
|
|
Term
| Spurlings test: positive sign |
|
Definition
| reproduction of ARM pain (past AC jt) |
|
|
Term
| Shoulder abduction test: tests for... |
|
Definition
| compression of C6 nn root |
|
|
Term
| Shoulder abduction test: position |
|
Definition
| shoulder abduction c elbow flexion |
|
|
Term
| Look fors in deep cervical flexor test: |
|
Definition
early fatigue,
excessive SCM use,
loss of chin tuck |
|
|
Term
| Palpation: categoried look fors (4) |
|
Definition
temp ∆
ST palpation
bony palpation
TrP palpation |
|
|
Term
| Indications for neurodynamic testing (5) |
|
Definition
R/O cervical radiculopathy
hand/arm/shoulder symptoms not reproduced by other tests
symptoms have not resolved as expected
postural eval shows sh elevation
upper quadrant pain incr by c contralat sidebend + rot |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
reproduction of pt's symptoms,
considerable diff between sides |
|
|
Term
|
Definition
finger /
wrist /
sh ER
elbow / |
|
|
Term
|
Definition
UE IR
wrist √
wrist ulnar dev
thumb √ |
|
|
Term
| ULTT 2: degree of UE placement |
|
Definition
10-30º abd
neutral rot
60-90º elbow √
>>
sh ER
elbow / |
|
|
Term
| ULTT 2: shoulder depression performed using... |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Joint manip: Kaltenborn techniques (2) |
|
Definition
occiput-atlas traction manip
occiput-atlas manip: flex/ext |
|
|
Term
| Joint manip: Maitland techniques |
|
Definition
CPA
UPA
PA unilat vert pressure (C2 in 30º rot)
Transverse pressures |
|
|
Term
| Occiput-atlas traction manip |
|
Definition
pt sitting
PT stabilize head against chest
sup hand support occiput, inf hand over C1 (stabilizes) |
|
|
Term
| Occiput-atlas manip: flex/ext |
|
Definition
occiput-atlas traction manip
PLUS
ant/post gliding of occipital condyles |
|
|
Term
|
Definition
|
|
Term
| PA unilat vertebral pressures (C2 in 30º rot): purpose of technique |
|
Definition
|
|
Term
| PA unilat vertebral pressures (C2 in 30º rot): technique |
|
Definition
pt prone c head rot to painful side
PT unilat PA glides on C2 (toward mouth) |
|
|
Term
|
Definition
subocc
ant/mid scalenes
upp trap
SCM |
|
|
Term
| Subocc stretching: procedure |
|
Definition
radial border of L inex finger >> btwn occiput & C1
R hand under occiput (traction)
shoulder on pt forehwead |
|
|
Term
|
Definition
ipsilat rot
contralat sidebend
slight flex |
|
|
Term
|
Definition
depr shoulder
contralat sidebend c mod flex |
|
|
Term
|
Definition
1. upp cervical flex
2. contralat sidebend c ipsilat rot
3. extension (gentle; lower cervical) |
|
|
Term
MET: AA jxn
(atlas stuck in rot) |
|
Definition
pt supine
neck 45º flex
PROM rot to barrier
isometric rot contraction away from barrier (3-5 sec)
move into new range
repeat (3-5x) |
|
|
Term
MET: OA jxn
(cockrobin posture) |
|
Definition
1. upp cervical flex
2. sidebend toward barrier (>>coupled rot)
3. isometric contraction into upp cervical ext (3-5 sec) |
|
|
Term
| Myofascial/Massage techniques (2) |
|
Definition
subocc release
paravertebral postmed stretch |
|
|
Term
| Neural mobility: indications for Rx (3) |
|
Definition
pain in 'lines', 'clumps'
symptoms that have not responded to other forms of manual rx
testing reproduces symptoms, but other forms of rx unsuccessful |
|
|
Term
| Neural mobility: precautions (2) |
|
Definition
irritability
R/O serious disorders |
|
|
Term
| Neural mobility: applications of technique |
|
Definition
treat cervical jt signs & surrounding tissue first
start conservatively
oscillation >> sustained stretching; re-eval p 20-30 sec |
|
|
Term
| Neural mobility: home exercises (4) |
|
Definition
doorway stretches (pecs)
airplanes
waiters tip (radial neural glide)
elbows together >> elevate (levator scap) |
|
|
Term
| Cervical Stabilization: suggested Rx sequence |
|
Definition
1. restore ROM
2. correct posture
3. retrain deep cervical flexors
4. retrain cervical extensors
5. retrain lower trap & serratus ant
6. other
7. sensorimotor training
8. cardiovascular |
|
|
Term
| Cervical Stabilization - correct posture (3) |
|
Definition
manual correction of sitting
occipital lift
Brügger exercise |
|
|
Term
|
Definition
pt sit edge of chair c ant pelvic tilt
arms slower ER'd, sh depr+retr
slow, diaphragmatic BREATHING
(activates sh ER & mid trap) |
|
|
Term
| Cervical Stabilization - retrain deep cervical flexors (3) |
|
Definition
pressure biofeedback
manual feedback
supine neck curls |
|
|
Term
| pressure biofeedback: uses... |
|
Definition
| biofeedback cuff under cervical lordosis |
|
|
Term
| manual feedback (retrain deep cervical flexors) |
|
Definition
| pt palpates SCM to ensure min contraction |
|
|
Term
| Cervical Stabilization - retrain cervical extensors (2) |
|
Definition
|
|
Term
| Retrain cervical extensors: quadruped |
|
Definition
| PT palpates T1 & C2, encouraging active ext here |
|
|
Term
| Cervical Stabilization - other (2) |
|
Definition
strengthen lower trap
strengthen sh ERs |
|
|
Term
| Cervical Stabilization - HEP (4) |
|
Definition
self-mob to cervical spine
self-mob to thoracic spine
AROM
posture re-ed |
|
|
