Upper Quarter Screen

Question 1

Which feature is characteristic of typical cervical vertebrae C3–C7?
A. No vertebral body
B. Transverse foramina
C. Dens
D. No facet joints

Answer 1

B. Transverse foramina

Question 2

Which cervical vertebra has no vertebral body and no intervertebral disc?
A. C2
B. C3
C. C1
D. C7

Answer 2

C. C1

Question 3

Which structure is present on C2 and allows axial rotation?
A. Uncovertebral joint
B. Dens
C. Transverse foramen
D. Lamina

Answer 3

B. Dens

Question 4

Which ligament primarily restricts cervical extension?
A. PLL
B. ALL
C. Ligamentum flavum
D. Interspinous

Answer 4

B. ALL

Question 5

Which ligament primarily restricts cervical flexion?
A. ALL
B. PLL
C. Ligamentum flavum
D. Facet capsule

Answer 5

B. PLL

Question 6

Cervical intervertebral discs are described as:
A. Mostly cartilaginous
B. Mostly fibrous
C. Mostly elastic
D. Mostly fatty

Answer 6

B. Mostly fibrous

Question 7

Myelopathy is best described as a:
A. PNS disorder
B. CNS disorder
C. Muscle disorder
D. Tendon disorder

Answer 7

B. CNS disorder

Question 8

Radiculopathy is best described as a:
A. CNS disorder
B. Spinal cord lesion
C. PNS disorder
D. Brain lesion

Answer 8

C. PNS disorder

Question 9

Which motion typically narrows the intervertebral foramen?
A. Flexion
B. Extension
C. Traction
D. Neutral

Answer 9

B. Extension

Question 10

Which cervical motion couples with axial rotation?
A. Flexion
B. Extension
C. Lateral bending
D. Translation

Answer 10

C. Lateral bending

Question 11

What is the PRIMARY purpose of the upper quarter screen?
A. Establish prognosis
B. Rule out serious neurologic deficit
C. Measure strength
D. Determine endurance

Answer 11

B. Rule out serious neurologic deficit

Question 12

Which dermatome corresponds to the middle finger?
A. C5
B. C6
C. C7
D. C8

Answer 12

C. C7

Question 13

Which myotome is tested with finger abduction/adduction?
A. C7
B. C8
C. T1
D. C6

Answer 13

C. T1

Question 14

Referred pain is defined as:
A. Pain along nerve distribution
B. Pain perceived at its source
C. Pain perceived away from source
D. Sharp localized pain

Answer 14

C. Pain perceived away from source

Question 15

Which theory explains referred pain in the upper quarter?
A. Gate control
B. Specificity theory
C. Convergence-projection
D. Motor control

Answer 15

C. Convergence-projection

Question 16

A patient presents with bilateral UE weakness, gait disturbance, and hyperreflexia. What is MOST likely?
A. Radiculopathy
B. Myelopathy
C. Peripheral neuropathy
D. Tendinitis

Answer 16

B. Myelopathy

Question 17

A patient has unilateral arm pain and depressed reflexes. Which condition is MOST consistent?
A. Myelopathy
B. Stroke
C. Radiculopathy
D. Myopathy

Answer 17

C. Radiculopathy

Question 18

During cervical flexion, what happens to the intervertebral foramen?
A. Narrows
B. Widens
C. Closes completely
D. No change

Answer 18

B. Widens

Question 19

Which cervical motion will MOST likely reproduce radicular symptoms?
A. Flexion
B. Extension
C. Traction
D. Neutral

Answer 19

B. Extension

Question 20

A positive Spurling test suggests involvement of:
A. Shoulder joint
B. Nerve root
C. Spinal cord
D. Muscle belly

Answer 20

B. Nerve root

Question 21

Which test uses extension and rotation to assess vertebral artery compromise?
A. Distraction
B. Compression
C. Vertebral artery test
D. ULTT

Answer 21

C. Vertebral artery test

Question 22

Five D’s (dizziness, diplopia, dysarthria, dysphagia, drop attacks) suggest possible compromise of the:
A. Carotid artery
B. Vertebral artery
C. Subclavian artery
D. Axillary artery

Answer 22

B. Vertebral artery

Question 23

Which finding would require immediate referral?
A. Local neck pain
B. Progressive neurologic decline
C. Muscle tightness
D. Mild headache

Answer 23

B. Progressive neurologic decline

Question 24

A patient demonstrates limited cervical rotation and side bending equally, with less limitation in extension. This suggests:
A. Capsular pattern
B. Contractile pattern
C. Disc herniation
D. Vascular compromise

Answer 24

A. Capsular pattern

Question 25

Which myotome would be MOST affected in a C6 radiculopathy? A. Shoulder abduction B. Elbow flexion C. Elbow extension D. Finger abduction

Answer 25

B. Elbow flexion

Question 26

Which sensory area corresponds to C6? A. Lateral arm B. Middle finger C. Dorsal lateral thumb D. Medial forearm

Answer 26

C. Dorsal lateral thumb

Question 27

If axial rotation is performed to the right, what happens to the right IV foramen? A. Widens B. Narrows C. No change D. Opens completely

Answer 27

B. Narrows

Question 28

Which structure is pain sensitive in the posterior one-third? A. Vertebral body B. IV disc C. Transverse process D. Lamina

Answer 28

B. IV disc

Question 29

A patient has neck pain with dull aching shoulder pain not following dermatomes. What mechanism is MOST likely? A. Radiculopathy B. Myelopathy C. Referred pain D. Peripheral nerve entrapment

Answer 29

C. Referred pain

Question 30

Which tissue source has been shown to refer pain to the upper quarter? A. Facet joints B. Kidney C. Lung D. Heart only

Answer 30

A. Facet joints

Question 31

Which joint scan movement is used to help clear the shoulder as a symptom source? A. Wrist flexion B. GH elevation C. Cervical extension D. Finger opposition

Answer 31

B. GH elevation

Question 32

Which reflex corresponds to C7? A. Biceps B. Brachioradialis C. Triceps D. Patellar

Answer 32

C. Triceps

Question 33

If ULTT is positive, what should be done next? A. Stop exam B. Perform passively C. Do vertebral artery test D. Perform traction

Answer 33

B. Perform passively

Question 34

Which motion causes posterior elements to experience compression stress? A. Flexion B. Extension C. Traction D. Neutral

Answer 34

B. Extension

Question 35

A patient reports arm pain but imaging shows no nerve root compression. This BEST fits: A. Radiating pain B. Referred pain C. Central pain D. Peripheral neuropathy

Answer 35

B. Referred pain

Question 36

Which finding is more consistent with radiculopathy than myelopathy? A. Bilateral symptoms B. LE involvement C. Depressed reflexes D. Spasticity

Answer 36

C. Depressed reflexes

Question 37

Which cervical level contributes approximately 50% of axial rotation? A. C3–C4 B. C4–C5 C. C1–C2 D. C6–C7

Answer 37

C. C1–C2

Question 38

Which component of the upper quarter screen evaluates nerve root motor function? A. Dermatome scan B. Myotome scan C. Reflexes D. Joint play

Answer 38

B. Myotome scan

Question 39

Neural palpation reproducing chief complaint suggests involvement of: A. Muscle only B. Peripheral nerve structures C. Bone D. Skin

Answer 39

B. Peripheral nerve structures

Question 40

Which structure provides key stability and spacer function between vertebrae? A. Facet joint B. IV disc C. Spinous process D. Lamina

Answer 40

B. IV disc

Question 41

Which motion combination is used in quadrant testing? A. Flexion, SB, rotation B. Extension, SB, rotation C. Flexion, extension, rotation D. SB only

Answer 41

B. Extension, SB, rotation

Question 42

Which sign suggests spinal cord involvement rather than nerve root? A. Unilateral arm pain B. Dermatomal numbness C. Gait/balance changes D. Local neck pain

Answer 42

C. Gait/balance changes

Question 43

Which tissue type is MOST associated with deeper, poorly localized referred pain? A. Skin B. Superficial fascia C. Deep tissues D. Nails

Answer 43

C. Deep tissues

Question 44

A patient has C8 involvement. Which motion is MOST affected? A. Thumb extension B. Shoulder abduction C. Elbow flexion D. Finger abduction

Answer 44

A. Thumb extension

Question 45

Which upper quarter screen finding best localizes level of neurologic involvement? A. Posture B. Edema C. Combined dermatomes, myotomes, reflexes D. ROM only

Answer 45

C. Combined dermatomes, myotomes, reflexes