Title: Bone Wizardry / OMM Mastery / 2.Cervical Spine
Tags: #BW_OMM::Region::Cervical #BW_OMM::Type::Cloze BoneWizardry bonewizardry-free omm omt #Cervical #Anatomy #Muscles #motion #OA #AA #Bones #C2-C7 #Nerve #Root #Scalene #joints #ligaments #nerves
On every note of this deck, unless a note says otherwise:
Topic: Cervical Spine
Review Links: - Bone Wizardry cervical OMM
- Practice: Cervical Spine QBank
Show outside sources
- HVLA cervical vertebrae
- StatPearls Spurling test
- Cleveland Clinic Spurling test
- APTA cervical arterial dysfunction screen
- AAFP neck pain evaluation

Q: The cervical spine consists of [...] vertebral segments
A: 7
Q: [...] are foramina in the TP of C1-C6 that allows passage of the vertebral artery.
A: Foramen transversarium
Q: Foramen transversarium are foramina in the TP of [...] that allows passage of the vertebral artery.
A: C1-C6
Q: Foramen transversarium are foramina in the TP of C1-C6 that allows passage of the [...] artery.
A: vertebral
Bone Wizardry Lock: The vertebral artery runs through the transverse foramina of C1 through C6. C7 has a transverse foramen too, but the artery enters at C6, not C7.

Q: The scalenes side bend the neck to the same side with [...] contraction, and flex the neck with [...] contraction
A: unilateral; bilateral
Q: The [...] scalene will help elevate the first rib
A: anterior and middle
Q: The anterior and middle scalene will help elevate the [...] rib
A: first
Q: The [...] scalene will help elevate the second rib
A: posterior
Q: The posterior scalene will help elevate the [...] rib
A: second
Bone Wizardry Lock: Scalene tightness can elevate ribs 1 and 2, mimicking first-rib somatic dysfunction. Anterior and middle work rib 1; posterior works rib 2.

Q: With unilateral contraction, the sternocleidomastoid will sidebend [...] and rotate [...]
A: ipsilaterally; contralaterally
Q: With [...] contraction, the sternocleidomastoid will sidebend ipsilaterally and rotate contralaterally
A: unilateral
Q: With [...] contraction, the sternocleidomastoid will flex the neck.
A: bilateral
Q: With bilateral contraction, the sternocleidomastoid will [...] the neck.
A: flex
Comment: sidebend towards and rotate away*
Bone Wizardry Lock: The SCM rotates the head away from its own side. Pull the right SCM and the chin swings left. Both pulling together drops the chin to the chest.

Q: Shortening or restrictions within the SCM often results in [...]
A: torticollis
Bone Wizardry Lock: In torticollis, the head tilts toward the contracted SCM and the chin rotates to the opposite side. The deformity follows from what the muscle normally does.

Q: The [...] ligament extends from the sides of the dens to the lateral margins of the foramen magnum.
A: alar
Q: The [...] ligament of the atlas attaches to the lateral masses of C1 to hold the dens in place.
A: transverse
Q: The transverse ligament of the atlas attaches to the lateral masses of C1 to hold the [...] in place.
A: dens
Bone Wizardry Lock: Rupture of the transverse ligament allows the dens to shift posterior into the spinal canal, placing the cord at direct risk. Trauma screening for atlantoaxial instability exists for exactly this reason.

Q: The joints of Luschka are part of the vertebral bodies of [...]
A: C3-C7
Q: The joints of [...] help support the lateral side of the cervical discs and protect cervical nerve roots from disc herniation
A: Luschka
Q: The joints of Luschka play a pivotal role in cervical [...]
A: sidebending
Bone Wizardry Lock: Joints of Luschka occupy C3-C7. They protect nerve roots from lateral disc herniation and are the key driver of cervical sidebending. Know both jobs for radiculopathy and motion mechanics questions.

Q: There are [...] cervical nerve roots
A: 8
Q: The upper 7 cervical nerve roots exit [...] their corresponding vertebrae.
A: above
Q: The brachial plexus is made up of nerve roots from [...].
A: C5-T1
Comment 2: For example, the C7 nerve root will exit between C6 and C7. The last cervical nerve root (C8) will exit between C7 and T1.
Bone Wizardry Lock: Eight roots, seven vertebrae: C1 through C7 exit above their own vertebra, so C8 exits below C7. Brachial plexus is C5-T1. The numbering rule is what boards questions test when they specify a foramen level.

Q: The OA's primary motion is [...]
A: flexion and extension
Q: With the OA, sidebending and rotation occur on [...] sides with either flexion or extension
A: opposite
Comment 2: Remember it follows Fryette's law 1.
Bone Wizardry Lock: OA sidebending and rotation always go to opposite sides. That is Fryette's Law I. When you read an OA dysfunction diagnosis, the named sidebending side and the named rotation side will never match.

Q: The AA is considered to be C1 motion on [...]
A: C2
Q: The AA's primary motion is [...]
A: rotation
Comment 2: Clinically only rotation occurs at this joint. Therefore, if the AA is rotated right it means that the atlas (C1) is rotated right on the axis (C2).
Bone Wizardry Lock: The AA joint does one thing clinically: rotate. Atlas rotated right means C1 has turned right on C2. No sidebending coupling to sort through at this level.

Q: With the spinal segments C2-C7 sidebending and rotation occur to the [...] side
A: same
Bone Wizardry Lock: C2 through C7 follow Fryette's Law II: sidebending and rotation couple to the same side. This is the opposite of the OA, which is a common exam trap when both levels appear in the same question.

Q: [...] Translation = Force from Left to Right = Left Sidebending
A: Right
Q: Right Translation = Force from [...] to [...] = Left Sidebending
A: Left; Right
Q: Right Translation = Force from Left to Right = [...] Sidebending
A: Left
Bone Wizardry Lock: Translation direction names the force vector, not the sidebending side. Right translation means force travels left to right, producing left sidebending. Identify the force direction, then flip it to get the coupled motion.

Q: Suboccipital or paravertebral muscle spasms are usually associated with upper [...] or [...] problems on the same side.
A: thoracic; rib
Q: Suboccipital or paravertebral muscle spasms are usually associated with upper thoracic or rib problems on the [...] side.
A: same
Comment: Therefore, treat these areas first, then treat the cervical spine.
Bone Wizardry Lock: Suboccipital spasm is usually downstream of an upper thoracic or same-side rib somatic dysfunction. Clear the thoracic and rib lesion first. Treating the cervical before those areas typically does not hold.

Q: An acute injury to the cervical spine is best treated with [...] fascial techniques or [...] first.
A: indirect; counterstrain
Bone Wizardry Lock: Acute cervical injuries get gentle techniques first: indirect fascial release or counterstrain. HVLA is not used acutely. If the question specifies an acute presentation, choose the indirect column.

Q: When the joints of [...] degenerate and the facet joints hypertrophy, together they account for the majority of cervical nerve root compression.
A: Luschka
Q: Luschka joint degeneration combined with facet hypertrophy is the leading structural cause of [...] nerve root compression.
A: cervical
Bone Wizardry Lock: For boards, cervical radiculopathy from degenerative disease points to joint of Luschka changes and facet hypertrophy, not just disc herniation. Those two structures are the leading cause and the expected answer.

Q: Muscle that helps elevate the second rib: [...]
A: posterior scalene
Bone Wizardry Lock: The posterior scalene elevates rib 2. When rib 2 is stuck in an elevated position, the posterior scalene is the muscle holding it there. Target it when treating a second rib inhalation somatic dysfunction.

Q: Stenosis of the intervertebral foramen between C3 and C4 will affect the [...] nerve root
A: C4
Bone Wizardry Lock: Cervical roots exit below their named vertebra starting at C8. Stenosis of the C3-C4 foramen compresses the C4 root. Work it backward from the foramen level to name the root affected.

Q: The primary motion of the occiput on the atlas is [...]
A: flexion/extension
Bone Wizardry Lock: The OA is a flexion/extension joint primarily. When coupling does occur, sidebending and rotation go to opposite sides per Fryette's Law I. This is the reverse of C2-C7, where they couple to the same side.

Q: What nerve root is affected when there is a herniation of the disc between C6 and C7?
[...]
A: C7
Comment: Nerves exit above the corresponding vertebrae at C7. The C8 nerve root exits below.
Bone Wizardry Lock: Cervical nerves exit ABOVE their same-numbered vertebra, so the C7 root exits at the C6-C7 foramen. A disc herniation at C6-C7 compresses C7, not C6.

Q: A [...] occurs when you have changes in the distribution of a nerve root.
A: radiculitis
Q: A [...] occurs when you have lost the ability of a motor function.
A: radiculopathy
Comment: Irritation/Inflammation occurs.
Comment 2: For example, losing the ability to give someone the middle finger.
Bone Wizardry Lock: Radiculitis means the nerve root is irritated and shows sensory changes along its distribution. Radiculopathy means actual motor function from that root has been lost.

Q: What dermatomal layer is the pinky?
[...]
A: C8
Q: What dermatomal layer is the middle finger?
[...]
A: C7
Q: What dermatomal layer is the thumb?
[...]
A: C6
Bone Wizardry Lock: Thumb = C6, middle finger = C7, pinky = C8. Test all three digits when you suspect a cervical root lesion.

Q: If you induce a right translation (pushing from left to right) in the cervical spine, what way does the spine sidebend?
[...]
A: Left
Comment: When you translate to one direction, you're inducing sidebending to the other.
Bone Wizardry Lock: Right translation closes the right side and opens the left, producing left sidebend. This is the biomechanical basis for cervical HVLA positioning.

Q: [...]: injury to a muscle or its tendon
A: Strain
Q: [...]: injury to a ligament
A: Sprain
Bone Wizardry Lock: Strain injures the musculotendinous unit. Sprain injures a ligament. Both can occur together in cervical trauma and both guide which tissue you address with OMT.