OCS Exam Questions With Complete Solutions
What is characteristic of a migraine HA? - (ANSWER)PRIMARY HA
-pulsating/pounding
-unilateral in nature
-4-72 hrs
-nausea is associated
-light/noise sensitivity
also activity increases HA
4/5 present + LR 24 which significant shifts post-test probability of the dx being present
American College of Radiology would recommend what imaging modality for migraines - (ANSWER)CT
without IV contrast
- for sudden onset, severe HA
If you perform a manip to C1-2, where do you expect the cavitation to occur? - (ANSWER)multiple
audible pops bilaterally at C1-2
If the Sharp Purser is (+) - why are you still skeptical about instability? - (ANSWER)test is only diagnostic
for subjects with RA
-specific test for transverse ligament, however it's only been validated in subjects with RA and Down's
Syndrome; also it may be dangerous to perform the test after a traumatic MOI ??
Pt is referred to you with mechanical neck pain and they test (+) for flexion rotation test at C1-2, what
intervention is best for most immediate relief? - (ANSWER)C1-2 manip and upper thoracic manipulation
manip is superior to mobs for short term effects for mechanical neck pain
T/F: there is no increased risk to the VBI for chiro vs PCP - (ANSWER)TRUE
,OCS Exam Questions With Complete Solutions
What are 3 types of people who have an increased risk for upper cervical instability? - (ANSWER)RA
Down's
hx of Cervical Spine Trauma
Is the VBI test validated? - (ANSWER)NO, a neg test doesn't not r/o dissection and can be dangerous
within itself
What is the most commonly affected CN if a pt has an Internal Carotid Artery Dissection? -
(ANSWER)Hypoglossal!
CN 12
What is associated with Alar Ligament Instability? - (ANSWER)Neck Tongue Syndrome
what a pt rotates their head they may experience numbness along half of their tongue
(+) Sharp Purser= transverse ligament compromise in pt's with RA, Downs or post trauma
Horners Syndrome = common after internal carotid artery dissection
Cervical Flexion Rotation Test = used for CGH identification
VBI = 5D's 3 N's hindbrain TIA, Wallenberg
When preparing to perform a cervical manip, what's the purpose of the pre-manip hold? -
(ANSWER)assess pt's comfort and response to position
Pt after MVA with neck pain, she flexes her neck and has increased paresthesia into her hands and feet,
what's the next step? - (ANSWER)appropriate answers:
cervical collar
refer to ER
refer for imaging
,OCS Exam Questions With Complete Solutions
Sharp Purser is not appropriate
What spinal segments do NOT have an intervertebral disc? - (ANSWER)between occiput and first cervical
vertebrae
between the 1st and 2nd cervical vertebrae
What ligament prevents the dens of the axis from pressing on the during active cervical flexion and is
commonly compromised during trauma? - (ANSWER)Transverse - prevents anterior movement of C1 on
C2
Where are the joints of Luschka located? - (ANSWER)c-spine C3-7 and these jts are commonly assoc with
degenerative spine conditions and cervical radiculopathy
What part of the cervical intervertebral discs is the weakest? - (ANSWER)posterior; the annulus fibrosis
is thick anteriorly but thin and weak posteriorly
During passive cervical rotation to the right, where does the vertebral artery get compressed? -
(ANSWER)between the first and second cervical vertebra on the left
What are absolute contraindications for manual therapy? - (ANSWER)Osteomyelitis
Nerve Root Compression with increasing neuro deficits
Influenze with Fever
Pregnancy is a relative one!
Pt's who are not good for cervical manipulation include? - (ANSWER)radicular sx to mid-forearm
these people would do better with centralization techniques
severe spondylosis without radic are ok
, OCS Exam Questions With Complete Solutions
During Cervical Artery Dissection, which arteries would you suspect to be involved? -
(ANSWER)Vertebrobasilar, which is the posterior arterial system perfusing the hindbrain and the
internal carotid artery which is the anterior arterial system perfusing the cerebral hemispheres and eyes
Trying to differentiate if a pt's dizziness is 2/2 to a cervical artery dissection or non-vascular vestibular
dizziness. What would you expect if te pt had dizziness 2/2 cervical artery dissection, rather that non-
vascular vestibular dizziness - (ANSWER)-dizziness is reproduced with active cervical rotation and active
trunk rotation with head stable
-if pt's dizziness is 2/2 vestibular disorder you'd expect dizziness to be reproducible with active cervical
rotation but not trunk rotation since the vestibular canals remain unchanged in this position
If your pt has neck pain starts to develop symptoms related to hindbrain ischemia, all of the following
CN would likely be involved expect - (ANSWER)CN 1, 2
Acute dissection of Internal Carotid, what CN is involved? - (ANSWER)CN 12
What CN's would NOT be effected with Internal Carotid Dissection? - (ANSWER)CN 1 (olfactory)
2-4 can be
Which syndrome is common after Internal Carotid dissection and results is ptosis, miosis, anhidrosis and
enopthalmosis? - (ANSWER)Horner's Syndrome
What kind of malignancy will cause radiculopathy in C8-T1 nerve distribution? What visceral structure? -
(ANSWER)Pancoast Tumor
Heart
What is the best intervention for cervical radic? - (ANSWER)Intermittent mechanical traction
What is characteristic of a migraine HA? - (ANSWER)PRIMARY HA
-pulsating/pounding
-unilateral in nature
-4-72 hrs
-nausea is associated
-light/noise sensitivity
also activity increases HA
4/5 present + LR 24 which significant shifts post-test probability of the dx being present
American College of Radiology would recommend what imaging modality for migraines - (ANSWER)CT
without IV contrast
- for sudden onset, severe HA
If you perform a manip to C1-2, where do you expect the cavitation to occur? - (ANSWER)multiple
audible pops bilaterally at C1-2
If the Sharp Purser is (+) - why are you still skeptical about instability? - (ANSWER)test is only diagnostic
for subjects with RA
-specific test for transverse ligament, however it's only been validated in subjects with RA and Down's
Syndrome; also it may be dangerous to perform the test after a traumatic MOI ??
Pt is referred to you with mechanical neck pain and they test (+) for flexion rotation test at C1-2, what
intervention is best for most immediate relief? - (ANSWER)C1-2 manip and upper thoracic manipulation
manip is superior to mobs for short term effects for mechanical neck pain
T/F: there is no increased risk to the VBI for chiro vs PCP - (ANSWER)TRUE
,OCS Exam Questions With Complete Solutions
What are 3 types of people who have an increased risk for upper cervical instability? - (ANSWER)RA
Down's
hx of Cervical Spine Trauma
Is the VBI test validated? - (ANSWER)NO, a neg test doesn't not r/o dissection and can be dangerous
within itself
What is the most commonly affected CN if a pt has an Internal Carotid Artery Dissection? -
(ANSWER)Hypoglossal!
CN 12
What is associated with Alar Ligament Instability? - (ANSWER)Neck Tongue Syndrome
what a pt rotates their head they may experience numbness along half of their tongue
(+) Sharp Purser= transverse ligament compromise in pt's with RA, Downs or post trauma
Horners Syndrome = common after internal carotid artery dissection
Cervical Flexion Rotation Test = used for CGH identification
VBI = 5D's 3 N's hindbrain TIA, Wallenberg
When preparing to perform a cervical manip, what's the purpose of the pre-manip hold? -
(ANSWER)assess pt's comfort and response to position
Pt after MVA with neck pain, she flexes her neck and has increased paresthesia into her hands and feet,
what's the next step? - (ANSWER)appropriate answers:
cervical collar
refer to ER
refer for imaging
,OCS Exam Questions With Complete Solutions
Sharp Purser is not appropriate
What spinal segments do NOT have an intervertebral disc? - (ANSWER)between occiput and first cervical
vertebrae
between the 1st and 2nd cervical vertebrae
What ligament prevents the dens of the axis from pressing on the during active cervical flexion and is
commonly compromised during trauma? - (ANSWER)Transverse - prevents anterior movement of C1 on
C2
Where are the joints of Luschka located? - (ANSWER)c-spine C3-7 and these jts are commonly assoc with
degenerative spine conditions and cervical radiculopathy
What part of the cervical intervertebral discs is the weakest? - (ANSWER)posterior; the annulus fibrosis
is thick anteriorly but thin and weak posteriorly
During passive cervical rotation to the right, where does the vertebral artery get compressed? -
(ANSWER)between the first and second cervical vertebra on the left
What are absolute contraindications for manual therapy? - (ANSWER)Osteomyelitis
Nerve Root Compression with increasing neuro deficits
Influenze with Fever
Pregnancy is a relative one!
Pt's who are not good for cervical manipulation include? - (ANSWER)radicular sx to mid-forearm
these people would do better with centralization techniques
severe spondylosis without radic are ok
, OCS Exam Questions With Complete Solutions
During Cervical Artery Dissection, which arteries would you suspect to be involved? -
(ANSWER)Vertebrobasilar, which is the posterior arterial system perfusing the hindbrain and the
internal carotid artery which is the anterior arterial system perfusing the cerebral hemispheres and eyes
Trying to differentiate if a pt's dizziness is 2/2 to a cervical artery dissection or non-vascular vestibular
dizziness. What would you expect if te pt had dizziness 2/2 cervical artery dissection, rather that non-
vascular vestibular dizziness - (ANSWER)-dizziness is reproduced with active cervical rotation and active
trunk rotation with head stable
-if pt's dizziness is 2/2 vestibular disorder you'd expect dizziness to be reproducible with active cervical
rotation but not trunk rotation since the vestibular canals remain unchanged in this position
If your pt has neck pain starts to develop symptoms related to hindbrain ischemia, all of the following
CN would likely be involved expect - (ANSWER)CN 1, 2
Acute dissection of Internal Carotid, what CN is involved? - (ANSWER)CN 12
What CN's would NOT be effected with Internal Carotid Dissection? - (ANSWER)CN 1 (olfactory)
2-4 can be
Which syndrome is common after Internal Carotid dissection and results is ptosis, miosis, anhidrosis and
enopthalmosis? - (ANSWER)Horner's Syndrome
What kind of malignancy will cause radiculopathy in C8-T1 nerve distribution? What visceral structure? -
(ANSWER)Pancoast Tumor
Heart
What is the best intervention for cervical radic? - (ANSWER)Intermittent mechanical traction
