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OCS Exam Questions With Complete SolutionsLatest Update
What is characteristic of a migraine HA? - correct 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
American College of Radiology would recommend what imaging modality for migraines - correct 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? - correct answers multiple audible pops
bilaterally at C1-2
If the Sharp Purser is (+) - why are you still skeptical about instability? - correct 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? - correct 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 - correct answers TRUE
What are 3 types of people who have an increased risk for upper cervical instability? - correct answers RA
Down's
hx of Cervical Spine Trauma
Is the VBI test validated? - correct 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? - correct answers Hypoglossal!
CN 12
What is associated with Alar Ligament Instability? - correct 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? - correct 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? - correct 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? - correct 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? - correct answers Transverse - prevents anterior movement of C1 on C2
Where are the joints of Luschka located? - correct 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? - correct 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? - correct answers
between the first and second cervical vertebra on the left
What are absolute contraindications for manual therapy? - correct 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? - correct answers radicular sx to mid-forearm
these people would do better with centralization techniques
severe spondylosis without radic are ok
, During Cervical Artery Dissection, which arteries would you suspect to be involved? - correct answers Vertebrobasilar,
which is the posterior arterial system perfusing the hindbrain and the internal carotid artery which is the anterior
arterial system perfusing the cerebral hemispheres and eyes
Trying to differentiate if a pt's dizziness is 2/2 to a cervical artery dissection or non-vascular vestibular dizziness. What
would you expect if te pt had dizziness 2/2 cervical artery dissection, rather that non-vascular vestibular dizziness -
correct answers -dizziness is reproduced with active cervical rotation and active trunk rotation with head stable
-if pt's dizziness is 2/2 vestibular disorder you'd expect dizziness to be reproducible with active cervical rotation but not
trunk rotation since the vestibular canals remain unchanged in this position
If your pt has neck pain starts to develop symptoms related to hindbrain ischemia, all of the following CN would likely be
involved expect - correct answers CN 1, 2
Acute dissection of Internal Carotid, what CN is involved? - correct answers CN 12
What CN's would NOT be effected with Internal Carotid Dissection? - correct answers CN 1 (olfactory)
2-4 can be
Which syndrome is common after Internal Carotid dissection and results is ptosis, miosis, anhidrosis and enopthalmosis?
- correct answers Horner's Syndrome
What kind of malignancy will cause radiculopathy in C8-T1 nerve distribution? What visceral structure? - correct answers
Pancoast Tumor
Heart
What is the best intervention for cervical radic? - correct answers Intermittent mechanical traction
What should you be thinking about when determining spondylosis vs radic? - correct answers AGE
older age suspect spondylosis over a HNP C8-T1
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