Diagnosing cervical somatic dysfunction
Notes
Cervical spine
Diagnosing cervical somatic dysfunction
DIAGNOSING THE CERVICAL SPINE
Remember that Fryette’s laws do not technically apply to the cervical spine. However, the cervical spine is similar in many ways to the thoracolumbar spine, so it is said to have “type I- / II-like mechanics.”
The atlanto-occipital (OA) joint follows type I-like mechanics:
C2–C7 dysfunction follows type II-like mechanics:
The atlanto-occipital (OA) joint follows type I-like mechanics:
- Side bending and rotation occur in opposite directions
- Dysfunctions may occur in the neutral, flexion, or extension positions
- The somatic dysfunction is determined by examining three components:
- Depth of occipital sulci – the side of the deep sulcus is the side of rotation (as the occiput rotates, your fingers palpate more of the occiput, making that sulcus deep)
- Translation at that vertebral segment – translation induces side bending, so restriction in translating left-to-right implies restriction in side bending to the left
- Symmetry with neutral, flexion, and extension positions – the occipital sulci even out in the patient’s position of ease, and become more asymmetric in the other two positions
C2–C7 dysfunction follows type II-like mechanics:
- Side bending and rotation occur in the same direction
- Dysfunctions may occur in the neutral, flexion or extension positions
- The somatic dysfunction is determined by examining three components:
- Lateral articular pillar – the side with the more prominent (posterior) lateral articular pillar is the side of rotation
- Translation at that vertebral segment – translation induces side bending, so restriction in translating right-to-left implies restriction in side bending to the right
- Symmetry with neutral, flexion, and extension positions – the lateral articular pillars even out in the patient’s position of ease, and become more asymmetric in the other two positions
DIAGNOSING THE CERVICAL SPINE | |||||||
| REGION | MOTION TESTING EXAMPLE | DIAGNOSIS EXAMPLE | |||||
| OA |
| N SRRL | |||||
| AA |
| RR | |||||
| C2–C7 |
| F SRRR | |||||
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