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22 Cards in this Set
- Front
- Back
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C0-C1 FB and BB ROM
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- 13 to 18 degrees total
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OA FB + LSB stresses which side?
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- Right
- Contralateral if FB |
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OA BB + LSB stresses which side?
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- Left
- Ipsilateral if BB |
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C1-C2 ROM
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- Rotation: 45 degrees bilaterally
- FB: Minimal (limited by tectorial membrane) - BB: Minimal (limited by anterior arch of atlas and dens) |
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Atlanto-odontoid interval
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- Excessive: > 3mm adults, > 4.5 mm child
- Caused by trauma, RA, Down's syndrome, aplasia of dens (small dens) |
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What are the clinical implications of an excessive OA interval?
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- Don't mobilize
- Do soft tissue work |
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Where do CV structures refer pain to?
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- Occipital structures: Frontal
- C1 dorsal ramus: Frontal, orbit, vertex - C1-C2: Temporal, suboccipital - C3 dorsal ramus: Frontal, occipital, mastoid |
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What percentage of patients with chronic neck pain have headaches? What are the headache types?
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- 58%
- Vascular HA: Throbbing, pounding - Tension HA |
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What are the four HA sites? What structures refer to each site?
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- Frontal: Sinusitis, occipital
- Occipital: Disc, htn, eye disorder - Parietal: Meningitis, tumor - Facial: Sinusitis, dental disorders, trigeminal neuralgia |
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What are the three types and causes of dizziness (vertigo)?
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- Central: Vestibular origin
- Peripheral: Unsteady or lightheaded - Cervical: CV dysfunction, VBI |
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CV History Demographics (Age, gender, medications)
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- Older: DJD, htn, cardio disease
- Female: Immediate postpartum, oral contraceptives - Medications: Side effects |
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CV PE: Observation
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- Gait: Poor balance
- Nystagmus: Usually a latent period |
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AROM Short FB
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- Lhermitte's sign
- Severe LOM: Fx, transverse ligament |
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AROM Short BB
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- Tingling in feet = spinal cord
- Drop attack: Spinal cord, VBI |
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AROM Rotation
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- Severe LOM: Fx, C1-C2 fx/dislocation
- WNL: Probably not CV in origin |
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Neuro Findings-Reflexes
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- Hyper-reflexia
- Babinski - Hoffman's - Clonus |
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Neuro Findings-Sensation
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- Quadrilateral paresthesia
- Bilateral UE paresthesia |
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Alar ligament test
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- Negative findings: SP moves contralaterally, C2 rotates ipsilaterally
- Interventions: C-collar, return to MD |
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Positive SC or VBI s/sx
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- Nystagmus or visual disturbances
- Dizziness - Unexplained nausea - Paresthesias (lip, face, hemi, quad, bilat) - Repeated swallowing - Dysarthria (abnormal speech) - Drop attacks |
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Modified Sharp-Purser test
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- Positive findings: Myelopathic symptoms with FB, decreased symptoms with force
- High specificity |
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Transverse Ligament Test
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- Positive findings: Myelopathic symptoms under stress
- Opposite of Sharp-Purser test |
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What should you do if a patient has positive ligamentous instability tests?
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- C-collar
- Return to physician |
