what a pt rotates their head they may experience numbness along half of
their tongue
(+) Sharp Purser= transverse ligament compromise in pt's with RA, Downs or
post trauma
Horners Syndrome = common after internal carotid artery dissection
Cervical Flexion Rotation Test = used for CGH identification
VBI = 5D's 3 N's hindbrain TIA, Wallenberg
When preparing to perform a cervical manip, what's the purpose of the pre-
manip hold? - ✔✔assess pt's comfort and response to position
Pt after MVA with neck pain, she flexes her neck and has increased paresthesia
into her hands and feet, what's the next step? - ✔✔appropriate answers:
,cervical collar
refer to ER
refer for imaging
Sharp Purser is not appropriate
What spinal segments do NOT have an intervertebral disc? - ✔✔between
occiput and first cervical vertebrae
between the 1st and 2nd cervical vertebrae
What ligament prevents the dens of the axis from pressing on the during active
cervical flexion and is commonly compromised during trauma? - ✔✔Transverse
- prevents anterior movement of C1 on C2
Where are the joints of Luschka located? - ✔✔c-spine C3-7 and these jts are
commonly assoc with degenerative spine conditions and cervical radiculopathy
,What part of the cervical intervertebral discs is the weakest? - ✔✔posterior;
the annulus fibrosis is thick anteriorly but thin and weak posteriorly
During passive cervical rotation to the right, where does the vertebral artery get
compressed? - ✔✔between the first and second cervical vertebra on the left
What are absolute contraindications for manual therapy? - ✔✔Osteomyelitis
Nerve Root Compression with increasing neuro deficits
Influenze with Fever
Pregnancy is a relative one!
Pt's who are not good for cervical manipulation include? - ✔✔radicular sx to
mid-forearm
, these people would do better with centralization techniques
severe spondylosis without radic are ok
During Cervical Artery Dissection, which arteries would you suspect to be
involved? - ✔✔Vertebrobasilar, which is the posterior arterial system perfusing
the hindbrain and the internal carotid artery which is the anterior arterial
system perfusing the cerebral hemispheres and eyes
Trying to differentiate if a pt's dizziness is 2/2 to a cervical artery dissection or
non-vascular vestibular dizziness. What would you expect if te pt had dizziness
2/2 cervical artery dissection, rather that non-vascular vestibular dizziness - ✔✔-
dizziness is reproduced with active cervical rotation and active trunk rotation
with head stable
-if pt's dizziness is 2/2 vestibular disorder you'd expect dizziness to be
reproducible with active cervical rotation but not trunk rotation since the
vestibular canals remain unchanged in this position
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