Cervical ME

Question 1

What are the angles of cervical

• Flexion
• Extension
• Rotation
• Sidebending

Answer 1

• Flexion
  
  • 45°
• Extension
  
  • 90°
• Rotation
  
  • 80-90°
• Sidebending
  
  • 35-45°

Question 2

OA BIOMECHANICS

• Major Motion

Answer 2

FLEXION and EXTENSION

Question 3

What are coupling effects produced by?

Answer 3

COUPLING EFFECTS PRODUCED BY UNCOVERTEBRAL JOINTS, C2-C7

Question 4

SUPERIOR FACET ORIENTATION IN THE CERVICAL SPINE

Answer 4

BUM: Cervical spine
Backward, upward, medial

Question 5

STANDARD METHOD OF RECORDING MOTOR STRENGTH

• What does each score mean?
  
  • 0
  • 1
  • 2
  • 3
  • 4
  • 5

Answer 5

• 0
  
  • No evidence of contractility
• 1
  
  • Evidence of slight contractility; no joint motion
• 2
  
  • Complete range of motion with gravity eliminated
• 3
  
  • Complete range of motion against gravity
• 4
  
  • Complete range of motion against gravity with some resistance
• 5
  
  • Complete range of motion against gravity with full resistance

Question 6

TESTS TO RULE OUT RADICULOPATHY

• Name the DTR, Motion, and Volar surface for each spinal level
  
  • C5
  • C6
  • C7
  • T1

Answer 6

Question 7

STANDARD METHOD OF RECORDING AMPLITUDE OF A REFLEX

• 0
• 1
• 2
• 3
• 4

Answer 7

• 0
  
  • Absent
• 1
  
  • Decreased but present
• 2
  
  • Normal
• 3
  
  • Brisk with/without unsustained clonus
• 4
  
  • Brisk with sustained clonus

Question 8

SPURLING MANEUVER

• What is it used for?
• What motion is the head placed in?
• Where do sidebending and rotation go?
• When do you compress?
• What is a positive test?
  
  • What is a negative test?
• Sensitivity? Specificity?

Answer 8

• What is it used for?
  
  • The Spurling maneuver attempts to narrow the intervertebral foramina, leading to radicular symptoms.
• What motion is the head placed in?
  
  • Extension
• Where do sidebending and rotation go?
  
  • Toward Shoulder of Interest
• When do you compress?
  
  • Last
• What is a positive test?
  
  • The patient reports pain or other symptoms (numbness) radiating below the shoulder in the arm on that side.
  • What is a negative test?
    
    • No pain
• Sensitivity? Specificity?
  
  • Sen: 30%
  • Spec: 93%

Question 9

POSTERIOR FOSSA

• Signs of vertebrobasilar insufficiency?
• When does OMT require condition?

Answer 9

• Signs of vertebrobasilar insufficiency?
  
  • Nausea
  • Vomiting
  • Visual disturbance
  • Vertigo
• When does OMT require condition?
  
  • ​Caution when using OMT in cases of cervical spondylosis or vertebrobasilar insufficiency

Question 10

Motion for AA Muscle Energy

Answer 10

• ALWAYS FLEXION
  
  • Localize motion to the AA and lockout motion from lower fact joints.
• ROTATION

Question 11

AO Joint Somatic Dysfunctions

Answer 11

• Sidebending and Rotation are always opposite
  
  • Type 1
  • Opposite = O A

Question 12

C2-C7 Joint Somatic Dysfunctions

Answer 12

• Sidebending and Rotation are always opposite
  
  • Type 2
  • C2 and Beyond = Type 2

Question 13

COMMON ERRORS IN MUSCLE ENERGY TECHNIQUES

• Name all 7

Answer 13

1. Wrong diagnosis
2. Initial position for treatment is not localized
3. Not monitoring motion at the involved joint
4. Too forceful a muscle contraction by the patient
5. Too short a duration of muscle contraction by the patient
6. Not allowing patient to totally relax before repositioning to new restrictive barrier (forcing the new motion barrier)
7. Forgetting to retest

Question 14

CONTRAINDICATIONS FOR CERVICAL ME

Answer 14

1. Fracture
2. Dislocation
3. Rheumatologic conditions which cause instability
4. Painful tissue damage including tears, hematoma Infection of ligamentous, tendon, and muscle tissues or joints
5. Centrally mediated muscle spasm
6. Positioning that compromises vasculature
7. Uncooperative patient on one incapable of cooperation
8. An evocation of increased neurologic symptoms

Question 15

MOST COMMON COMPLICATION IN CERVICAL ME

Answer 15

Muscle stiffness or soreness, self-limiting, generally resolved in 24-36 hours