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Brachial Plexus Stretch Test
- P: sitting
- E: behind athlete, one hand on lateral aspect of head on affected side, the other on affected side shoulder
- Pr: passively apply lateral neck flexion away from affected side creating a stretch
- +: radiating pain down arm; bi lat
- I: brachial plexus stretch injury
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Brachial Plexus Compression Test
- P: sitting
- E: behind athlete, one hand on lateral aspect of head on non-affected side, the other on the affected shoulder
- Pr: laterally flex the neck toward the affected side
- +: radiating pain down affected arm; bi lat
- I: brachial plexus compression injury
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Cervical Compression Test
- P: sitting
- E: behind athlete, both hands on top of their head
- Pr: apply an axial load to the cervical spine
- +: associated pain to nerve root
- I: nerve root impingement
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Spuling's test
- P: sitting
- E: behind athlete, both hands on top of head
- Pr: slightly extend and laterally flex the neck and then apply an axial load
- +: radiating pain to the shoulder and arm on the flexed side
- I: nerve root impingement
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Vertebral Artery Test
- P: lying supine with head off the table
- E: at the head of the athlete, both hands supporting their head
- Pr: extend, laterally flex and rotate the neck (in the same direction of the flexion), instructing them to keep their eyes open
- +: dizziness and or nystagmus
- I: vertebral artery is occluded through compression
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Shoulder Abduction Test
- P: sit/stand, shoulder abducted 90 and hand placed on side of head
- E: observing
- Pr: instruct athlete to apply medial pressure while resisting with their head
- +: decrease of symptoms
- I: nerve root compression (herniated disk)
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Deep Tendon Reflexes
- Biceps--C5 and 6
- Brachiradialis C6
- Triceps C7
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Myotomes
- C1- none
- C2- neck flexion
- C3- neck lateral flexion and extension
- C4-shoulder shrug
- C5-shoulder abduction
- C6- elbow flexion/wrist extension
- C7-elbow extension/wrist flexion
- C8-ulnar deviation/thumb extension
- T1- finger abduction and adduction
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Kyphosis
- increased thoracic curve
- scapulae that are protracted which produces rounded shoulder appearance
- usually associated with forward head
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Foreward Head
- if there's a kyphotic curve there will be a compensatory change in position of head and neck
- patient extends cervical spine to keep eyes level
- short and strong neck extensors
- long and weak neck flexors
- the head is in forward position
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Swayback
- anterior shifting of entire pelvis, resulting in hip extension
- thoracic shifts posterior
- decreased lordosis
- increased kyphosis
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Lordosis
- increase curve in lumbar spine
- increase in both anterior tilt of pelvis and hip flexion
- lordosis+kyphosis+forward head=kypholordotic posture
- Can result from obseity, osteoporosis, spondylolisthesis
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Scoliosis
- lateral curvature
- abnormal curve in one direction and compensatory curve in opposite direction
- functional: non-spinal defect (leg length, muscle imbalance or nutrition deficits). May straighten when bending
- structural: defect in bony structure of spine. Remains twisted while bending over
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Flatback
- caused by decrease lumbar curve and increase in posterior pelvic tilt and hip flexion
- patient appears stooped forward, difficulty standing up straight
- can occur as a result of degenerative arthritis or from a spinal fusion
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Sternocleidomastoid-Origin
- Sternal head: top of manubrium
- Clavicular head: medial one third of clavicle
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Sternocleidomastoid-Insertion
Mastoid process of temporal bone and the lateral portion of superior nuchal line of occiput
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Anterior Scalene-Origin
transverse processes of 3-6 cervical vertebrae (anterior tubercles)
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Middle Scalene-Origin
transverse processes of 2-7th cervical vertebrae (posterior tubercles)
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Posterior Scalene-Origin
transverse processes of 6 and 7th cervical vertebrae (posterior tubercles)
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Anterior and Middle Scalene-Insertion
first rib
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Posterior Scalene- Insertion
second rib
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