c spine and cranial nerves

CN I

olfactory

s: smell, bypass thalamus

CN II

optic

s: vision(visual field picked up on contralateral retina and cortex)

CN III

oculomotor

m: accomodation, eye movement, pupil size

CN IV

trochlear

m: move eye in and down

CN V

trigeminal

s: ophthalmic, maxillary, mandibular divisions

m: mastication - temporalis, masseter, pterygoids

CN VI

abducens

m: abduct eye

CN VII

facial

s: taste anterior 2/3

m: face muscles, submandibular, sublingual, and lacrimal glands

CN VIII

vestibulocochlear

s: balance and hearing

CN IX

glossopharyngeal

parotid gland

s: taste posterior 1/3, carotid sinus (baroreceptor), gag

m: pharynx, swallowing

CN X

vagus

s: parasympathetic system

m: speech, gag

CN XI

spinal accessory

m: traps and sternocleidomastoid

CN XII

hypoglossal

m: stick tongue out

how to test CN I

smell something 1 nostril at a time

what CN does the light reflex test

2, 3

what CN does the H test

3, 4, 6

how to test CN V

palpate chewing muscles, light tough 3 regions

how to test CN VII

smile, frown, clench eyes, air in cheeks

how to test CN VIII

balance testing, finger rubs towards ear

how to test CN IX

watch pharynx when swallowing

what CN does sticking tongue out and saying AH test

10 and 12 (deviates toward affected side)

what cranial nerves are involved in the gag reflex

s: 9

m: 10

how to test CN XI

resisted shrugging shoulders or head rotation

when does cervical lordosis develop?

lumbar?

C: 2-4 months

L: 9-19 months

what is the closed packed position of the c spine

full extension

AOII sternocleidomastoid

A: flex (bi), rotate and siedbend (uni)

O: medial clavicle and sternum

I: mastoid process

I: CN XI

AOII trapezius

A: raise or lower shoulders

O: EOP, sup nuchal line, nuchal ligament, T spinous processes

I: clavicle, acromion, scapular spine

I: CN XI

AOII semispinalis capitis

A: extend neck (bi), sidebend (uni)

O: T1-T6 transverse, C3-C7 articular process

I: between nuchal lines

I: C1-5

AOII splenius capitis

A: extend (bi), ipsi rotation (uni)

O: C7-T3 spinous processes

I: S nuchal line, mastoid process

I: C2-C3

rectus capitis posterior major attachments

C2 spinous to occiput

rectus capitis posterior minor attachments

C1 posterior tubercle to occiput

obliquus capitis superior attachments

C1 transverse to occiput

obliquus capitis inferior attachments

C2 spinous to C1 transverse

what is found inside the suboccipital triangle?

suboccipital nerve → cervicogenic headaches

how to palpate SCM and scalenes

supine

SCM: resist flexion while rotated

scalenes: posterior to SCM, anterior to traps

how to palpate splenius capitis and semispinalis capitis

prone

splenius: resist extension while rotated - between mastoid process and nuchal line

semispinalis: resist extension - along spinous processes

goni placement for flexion and extension

fulcrum: EAM

stationary: perp to floor/up

moving: nostrils

goni placement for sidebend

fulcrum: C7 spinous

stationary: T spinous, perp to floor/down

moving: EOP

goni placement for rotation

fulcrum: center of cranium

stationary: ipsi acromion

moving: tip of nose

angle norms for flexion, extension, sidebend, rotation

f: 45-60

e: 70-90

s: 45, 60 supine

r: 70-90, 80 inclinometer

tape measure placement and norm for flexion and extension

chin to sternal notch

1-4cm(F)

18.5-22.4(E)

tape measure placement and norm for sidebend

mastoid to acromion

11-13cm

tape measure placement and norm for rotation

chin to acromion

11-13.2cm

what does occiput to wall test?

diagnostic cut off?

T hyperkyphosis, often from compression fracture

≥6.5 cm

grade 2 vs 3 vs 5 MMT

2: full movement gravity eliminated

3: full movement against gravity

5: full movement against max resistance

stabilizing and testing hand positioning for flexion?

nerves tested?

s: T spine

t: forehead

CN XI, C1, C2

stabilizing and testing hand positioning for extension?

nerves tested?

s: sternum

t: occiput

C1, C2

stabilizing and testing hand positioning for sidebend

nerves tested?

s: contra shoulder

t: ipsi temporal bone

CN XI, C3

stabilizing and testing hand positioning for rotation

nerves tested?

s: contra posterior temporal

t: ipsi anterior temporal

CN XI

how to conduct supine lying, prone lying, side lying, and supine lying endurance tests

supine: lift head with chin tuck

prone: lift head into extension

sidelying: lift and hold neutral

supine: lift head off bed and rotate

functional ranges for supine lying endurance test

6-8 reps: functional

3-5: functionally fair

1-2: functionally poor

0: nonfunctional

functional ranges for prone lying, side lying, and supine lying endurance tests

20-25 secs: functional

10-19: functionally fair

1-9: functionally poor

0: nonfunctional

set up and instruction for c spine endurance (deep neck flexors) testing?

norms?

supine hooklying, chin tuck, lift head 1 inch and keep chin tuck

39sec(M), 29sec(W)

describe upper crossed syndrome

forward head

lower C flexion, upper C extension

what can an extra rib coming off C7 cause

compress brachial plexus → thoracic outlet synfrome