Chiro Practice 1. Spinal Analysis and Patient Evaluation

Normal cervical flexion is approximately __________.

50°

Normal cervical extension is approximately __________.

60°

Normal cervical rotation is approximately __________.

80°

Normal cervical lateral flexion is approximately __________.

45°

The end-feel of cervical ROM is generally __________.

Firm (except for flexion

Thoracic spine is primarily __________ dominant.

Rotation

Lumbar spine is primarily __________ dominant.

Flexion/extension

Normal thoracolumbar flexion is approximately __________.

60°

Normal thoracolumbar extension is approximately __________.

25°

Normal thoracolumbar rotation is approximately __________.

30°

Normal thoracolumbar lateral flexion is approximately __________.

25°

Pain with flexion more commonly suggests a __________ origin

Disc involvement

Pain with lateral bending commonly suggests a __________ origin.

Facet or disc involvement

Normal shoulder flexion is __________.

180°

Normal shoulder extension is __________.

50-60°

Normal shoulder abduction is __________.

180°

Normal shoulder adduction is __________.

50-75°

Normal shoulder external rotation is __________.

90°

Normal shoulder internal rotation is __________.

90°

Normal elbow flexion is __________.

150°

Normal elbow extension is __________.

0° (up to 10° hyperextension normal)

Normal forearm supination is __________.

80-90°

Normal forearm pronation is __________.

80-90°

Normal wrist flexion is __________.

80-90°

Normal wrist extension is __________.

70-90°

Normal radial deviation is __________.

20-25°

Normal ulnar deviation is __________.

30-40°

Normal MCP flexion (fingers) is __________.

90°

Normal MCP extension (fingers) is __________.

30-45°

Normal MCP abduction/adduction is __________.

20-30°

Normal thumb CMC flexion is __________.

15°

Normal thumb CMC extension is __________.

20°

Normal thumb abduction is __________.

70°

Normal thumb opposition is to the __________.

finger pad of 5th finger

Normal hip flexion is __________.

120-135°

Normal hip extension is __________.

10-30°

Normal hip abduction is __________.

45-50°

Normal hip adduction is __________.

20-30°

Normal hip external rotation is __________.

45°

Normal hip internal rotation is __________.

35-40°

Normal knee flexion is __________.

135-150°

Normal knee extension is __________.

0° (up to 10° hyperextension normal)

Normal ankle dorsiflexion is __________.

20°

Normal ankle plantarflexion is __________.

45-50°

Normal foot inversion is __________.

35°

Normal foot eversion is __________.

15-20°

Normal great toe flexion (1st MTP) is __________.

45°

Normal great toe extension (1st MTP) is __________.

70-90°

Normal ROM values should be the same for __________ testing.

Active and passive

Passive is often going to be slightly more than active due to muscle tightness/limitations

Reduced ROM generally indicates __________.

Presence of dysfunction (non-specific)

The transverse process of T1-T4 is palpated __________ interspinous space(s) above the spinous process.

1

The transverse process of T5-T8 is palpated __________ interspinous space(s) above the spinous process.

2

The transverse process of T9-T12 is palpated __________ interspinous space(s) above the spinous process.

1

Thoracic transverse processes are palpated __________ to the midline.

Lateral

The first palpable spinous process is __________.

C2 (Axis)

C3 aligns with the __________.

Hyoid bone

C3 is also aligned with the __________.

Carotid artery

C4-C5 align with the __________.

Thyroid cartilage

C6 aligns with the __________.

Cricoid cartilage

C6 is also known as the __________.

Carotid tubercle

C7 is the vertebral prominens in approximately __________% of cases.

70

T1 is the vertebral prominens in approximately __________% of cases.

30

T3 aligns with the __________.

Spine of scapula

T4-T5 align with the __________.

Sternal angle (Angle of Louis)

T6 aligns with the inferior angle of the scapula in the __________ position.

Lying down

T7 aligns with the inferior angle of the scapula in the __________ position.

Seated

T10 aligns with the __________.

Xiphoid process

L3 aligns with the __________.

Umbilicus

L4 aligns with the __________.

Iliac crest

S2 aligns with the __________.

PSIS

C5 myotome tests __________.

Shoulder abduction and elbow flexion

The primary muscles tested at C5 are __________ and __________.

Deltoid / biceps

C6 myotome tests __________.

Wrist extension and elbow flexion

The primary muscle tested at C6 is __________.

Brachioradialis

C7 myotome tests __________.

Elbow extension, wrist flexion, finger extension

The primary muscle tested for C7 nerve root is __________.

Triceps

T1 myotome tests __________.

Finger abduction/adduction

The primary muscles tested at T1 are __________.

Interossei

L2 myotome tests __________.

Hip flexion

The primary muscle tested at L2 is __________.

Iliopsoas

L3 myotome tests __________.

Knee extension

The primary muscle tested at L3 is __________.

Quadriceps

L4 myotome tests __________.

Ankle dorsiflexion

The primary muscle tested at L4 is __________.

Tibialis anterior

L5 myotome tests what movement __________.

Great toe extension

The primary muscle tested at L5 is __________.

Extensor hallucis longus

S1 myotome tests what 2 movements? (1 at the ankle, 1 hip)

Ankle plantarflexion and hip extension

The primary muscles tested at nerve root S1 are __________ and __________.

Gastrocnemius/soleus

S2 myotome tests what movement at the knee?

Knee flexion - hamstring activation

The primary muscles tested at S2 are __________.

Hamstrings

The biceps reflex tests nerve root __________.

C5

The brachioradialis reflex tests nerve root __________.

C6

The triceps reflex tests nerve root __________.

C7

The patellar reflex tests nerve root __________.

L4

The medial hamstring reflex tests nerve root __________.

L5

The Achilles reflex tests nerve root __________.

S1

What does a positive Babinski test look like?

Dorsiflexion of big toe and fanning of the other ones

What does a positive Babinski indicate?

UMNL

- Positive Babinski is NORMAL in a newborn

What does a positive Oppenheim test look like?

Dorsiflexion of big toe and fanning of the other ones - SAME AS BABINSKI

What does a positive Chaddock test look like?

Dorsiflexion of big toe and fanning of the other ones - SAME AS BABINSKI