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Cervical Spine Components
- Occiput
- Atlas
- Axis
- C3-T1 Segments
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Type of movement at atlanto-occipital
Slight flexion and extension
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C2 and C1
- Atlantoaxial
- Pivot Joint
- Rotation with a lil bit of flexion
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What usually occurs with side bend at cervical
Rotation in the opposite direction
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Function of transverse and alar ligaments
Wrap C2 and C1's articulating surface
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Anterior Longitudinal Ligament prevents
Extension
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Posterior longitudinal ligament prevents
Flexion
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Intertransverse Ligament prevents
Lateral bend
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Supraspinous Ligament
Flexion
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Interspinous Ligament
Prevent flexion and rotation
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Ligamentum Flavum
- Holds left and right lamina together
- Runs on the inside of the vertebral canal
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Ligamentum Nuchae
The stronger cervical version of the supraspinous
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Reasons for having vertebral artery compromise
- DDD (degenerative disk disease)
- OA
- Trauma
- Hypermob of AA and/or OA
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SnS of Vert Artery Compromise
- Diaphoresis
- Vertigo
- Nystagmus
- Unilateral Dialation
- Diplopia
- Unconsicousness
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Which muscle reversal actions cause cervical compression
- SCM
- Scalenes
- Traps (up?)
- Levator Scap
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2 Most commonly shortened muscles with forward head
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3 secondary affected muscles with forward head
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What seperates C7 from rest of cervical
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What determines full ROM of a neuro stretch
All motions prior to lateral bend
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Hypermobility results from
- Something not doing its job
- RA
- Muscle imbalance
- Trauma
- Ligamentous
- Neurological
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What myo and dermatomes do we need to know for cerv/thoracic
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(Nerve root vs Peripheral Nerve)
Peri Nerve compression results in effecting
Which location it innervates, not a dermatome
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(Nerve root vs Peripheral Nerve)
Dermatome
Pain, numbness, tingling is diff location than peri nerve
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Another way to say nerural menigeal ROM
Neural Extensibility
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Hypermobility is a precaution for
Stretching and ROM
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What exercises to accommodate cervical hypermob
- Postural correction
- Scapulo-thoracic and cervical stabilization
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To decrease forward head posture impairment..
- Axial extension and stabilization exercises
- Stretching strengthening
- Neural Stretching
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Disk Dysfunction definition and causes
- Changes in disk that alter its biomechanics preventing normal function
- DDD
- Herniated Disk
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SnS disk dysfunction
- Painful limit of AROM in all planes
- Especially flexion (interdiscal pressure)
- Pain on cough/sneeze
- Neurological signs
- -referred pain
- -decreased DTR
- -sensory changes
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Positional Dysfunction has pain occur with
- Loading due to upright posture
- Muscle contracts
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Cervical sprain/strain example
Trauma like MVA
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Soft tissue involved with cervical sprain/strain
- Muscle
- Ligament
- Capsule
- Disk
- Articular Cartilage
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Cervical Sprain/Strain SnS
- Severity varies greatly
- Pain with ROM
- Pain with upright postures or muscle contractions
- Usually no neurological signs
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Neural Entrapment Description
- Root impingement. Can be from foramen stenosis or narrowing
- Can happen at plexus, root, or perinerve
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Causes of neural entrapment
- Injury
- Arthritis
- Inflammation
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Sns of neural entrapment
- Referred pain usually in dermatome distribution
- Exacerbated by forward head, cerv extension, or quadrant position (cerebral artery test)
- Neuro changes of dermatome, myotome, and DTRs
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Cervicogenic HA
- Neural entrapment of
- -occipital nerve
- -trigeminal nerve
- -c2-c3 nerve roots
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Accommodations fo Cervicogenic HAs
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Torticollis
Fixed or dynamic tilt, rotation, or flexion of head and/or neck
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Acute phase for disk dysfunction and sprain/strain
- Breathing exercises
- Traction
- Postural EX
- Rest and unloading
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Subacute/Chronic disk dysfunction and sprain/strain
Treat noted impairments
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Deep cervical extensors are lower or higher than suboccipitals?
Lower
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