200+ EXPERT CERTIFIED QUESTIONS AND
ANSWERS I ALREADY GRADED A+
American College of Radiology would recommend what imaging modality for
migraines - ANSWERS-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? -
ANSWERS-multiple audible pops bilaterally at C1-2
If the Sharp Purser is (+) - why are you still skeptical about instability? - ANSWERS-
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? -
ANSWERS-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 - ANSWERS-TRUE
,What is characteristic of a migraine HA? - ANSWERS-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
What are 3 types of people who have an increased risk for upper cervical
instability? - ANSWERS-RA
Down's
hx of Cervical Spine Trauma
Is the VBI test validated? - ANSWERS-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? - ANSWERS-Hypoglossal!
CN 12
,What is associated with Alar Ligament Instability? - ANSWERS-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? - ANSWERS-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? - ANSWERS-appropriate answers:
cervical collar
refer to ER
refer for imaging
Sharp Purser is not appropriate
What spinal segments do NOT have an intervertebral disc? - ANSWERS-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? - ANSWERS-
Transverse - prevents anterior movement of C1 on C2
Where are the joints of Luschka located? - ANSWERS-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? - ANSWERS-
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? - ANSWERS-between the first and second cervical vertebra on the
left
What are absolute contraindications for manual therapy? - ANSWERS-
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? - ANSWERS-radicular sx
to mid-forearm
these people would do better with centralization techniques