Cervical Spine Manual

Subjective History/Special Questions
Mandatory questions

Paresthesia, numbness, dizziness, vertigo, drop attacks, hearing, swallowing, dysarthria/phagia, mechanism of injury, pain on cough

Vertebral artery symptoms (5 D’s)

Questions for consideration

Upper resp tract infections, headache, sleep position, dizziness

Observations
·        Movement & posture of Cspine (sitting, standing, resting position)

Active Movements Tests
·        CV movement (E F SF R)

·        Mid-lower C-spine (E F SF R)

·         * Rotation* deviation me give sign of lesion

                                i. Immediate = AA joint lesion 

                              ii. Midway = mid cervical lesion

                            iii. End = upper tspine lesion 

·        Acutely injured patients may have guarding, but can still

                                i. Total SF loss in one direction ~ CV subluxation

                              ii. Flexion giving paresthesia (bilat/quad) ~ spinal cord compression (Csp/Tsp)

                            iii. Most cases might just be just stiffness at CV joint

==Craniovertebral and Vertebrobasilar Stress Tests==

·         From UQ scan

 

Craniovertebral joints
·        Passive Physiological Movements (PPIVMs)

i. OA Flexion

ii. OA Extension

iii. OA Sideflexion/Rotation

iv. AA Flexion

v. AA Extension

vi. AA Rotation

·        Passive Accessory Movements (PPAIVMs)

i. OA Unilateral Posterior Glide

ii. OA Unilateral Anterior Glide

iii. AA Posterior Glide

Mid and Lower Cervical joints
·        Segmental Screening Tests

·        Passive Physiological Movements (PPIVMs)

i. Zygapophyseal Joint Flexion

ii. Zygapophyseal Joint Extension

iii. Zygapophyseal Sideflexion/Rotation

·        Passive Accessory Movements (PPAIVMs)

i. Inferior-Medial-Posterior Glide (IMP) of Zygapophyseal Joint

ii. Superior-Anterior-Lateral (SAL) of Zygapophyseal Joint

iii. Inferior-Posterior Glide of Uncovertebral Joint

iv. Superior-Anterior Glide of Uncovertebral Joint