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MSK > 2.3 Cervical Spine Special Tests > Flashcards

2.3 Cervical Spine Special Tests Flashcards

1
Q

SPECIAL TESTS For Neurological Sx

A

Foraminal Compression (Spurling’s) Test
Maximum Cervical Compression Test
Jackson’s Compression Test
Distraction Test
Bakody’s Test (C4-C5 affectation)
Upper Limb Tension Test / Elvey Test

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2
Q

T OR F: Tests for Neurological Symptoms are designed to provoke neurological symptoms in most cases, but they do not necessarily tell where the pathology is originating.

A

TRUE

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3
Q

Tests for neurological symptoms that involve movement of the nerve

A

neurodynamic tests

assess the sensitivity of nerve roots and peripheral nerves to movement and tension caused by the movement

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4
Q

Pt bends or side flexes the head to the unaffected side first, then the affected
side & PT carefully presses straight down the head

A

Foraminal Compression (Spurling’s) Test

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5
Q

3 stages of Spurling’s Test

A

Head in neutral
Head in extension
Head in ext and rotation

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6
Q

Foraminal Compression (Spurling’s) Test may indicate what?

A

cervical radiculitis

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7
Q

implies pain in the dermatomal distribution
of the nerve root affected

A

Radiculitis

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8
Q

if the pain is felt in the opposite side during Spurling’s Test

A

Reverse Spurling’s Sign

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9
Q

Pt side flexes the head and rotates it to the same side

A

Maximum Cervical Compression Test

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10
Q

In Maximum Cervical Compression Test, pain on the concave side indicates _____ (2), whereas pain on the convex side indicates _____ (1)

A

nerve root or facet joint pathology

muscle strain

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11
Q

How many seconds should the Maximum Cervical Compression Test (c extension) to elicit VBI?

A

20-30 seconds

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12
Q

Modification of the foraminal compression test where Pt rotates the head to one side and PT then carefully presses straight down the head

A

Jackson’s Compression Test

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13
Q

used for patients who have complained of radicular symptoms in the history and show radicular signs during the examination

A

Distraction Test

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14
Q

In distraction test, PT places 1 hand under ___ with the other around the ____

A

pt’s chin; occiput

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15
Q

What indicates a (+) distraction test?

A

Pain is relieved or decreased when head is lifted;
Indicates relief of pressure pressing on the nerve roots

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16
Q

used to test for radicular symptoms, especially those involving the C4 or C5 nerve roots

A

Shoulder Abduction (Relief) Test/Bakody’s Sign

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17
Q

patient is sitting or lying down, and the examiner passively or the patient actively elevates the arm through abduction so that the hand or forearm rests on top of the head

A

Shoulder Abduction (Relief) Test/Bakody’s Sign

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18
Q

What indicates a (+) Bakody’s Sign?

A

decrease in or relief of symptoms

may indicate a cervical extradural compression problem, such as a herniated disc, epidural vein compression, or nerve root compression, usually in the C4–C5 or C5–C6 area

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19
Q

In Bakody’s sign, abduction of the arm _______ the length of the neurological pathway and ______ the pressure on the lower nerve roots? (increases or decreases)

A

decreases the length
decreases the pressure

20
Q

T OR F: In Bakody’s Sign, if the pain increases with the positioning of the arm, it implies that pressure is increasing in the brachial plexus.

A

FALSE

it implies that pressure is increasing in the INTERSCALENE TRIANGLE.

21
Q

equivalent to the straight leg raising (SLR) test in the lumbar spine

A

Upper Limb Neurodynamic Tension Tests (ULNT) / Brachial Plexus Tension or Elvey Test

22
Q

T OR F: Modification of the position of the shoulder, elbow, forearm, wrist, and fingers places greater stress on specific nerves (nerve bias).

A

TRUE

23
Q

ULNT 1 nerve bias

A

Median nerve, anterior interosseous nerve, C5, C6, C7

24
Q

ULNT 2 nerve bias

A

Median nerve, musculocutaneous nerve, axillary nerve

25
Q

ULNT 3 nerve bias

A

Radial nerve

26
Q

ULNT 4 nerve bias

A

Ulnar nerve, C8 and T1

27
Q

Special Tests for Instability

A

SALT
Sharp-Purser Test
Alar Ligament Stress Test
Transverse Ligament Stress Test
Lateral Shear Test

28
Q

Sharp-Purser Test is a test to determine subluxation/forward translation of the ___ on the ____?

A

ATLAS (C1) on AXIS (C2)

29
Q

What is used for atlanto-axial instability?

A

Sharp-Purser Test

30
Q

Sharp-Purser Test

PT places one hand on forehead, and one on ____

Pt flexes the head while PT applies _____ pressure on forehead

A

spinous process of C2

posterior pressure

31
Q

What indicates a (+) Sharper-Purser Test?

A

(+) sliding back of the head (subluxation of the atlas has been reduced)

may be accompanied by a clunk

32
Q

In Transverse Ligament Stress Test, Pt lies in supine with the PT supporting the pt’s occiput with their palm and _____ fingers

A

3rd to 5th fingers

33
Q

In Transverse Ligament Stress Test, PT places their index fingers where?

A

in the space between the pt’s occiput and C2’s
spinous process

done in order for the PT’s fingers to overlie the neural arch of C1

34
Q

T OR F: In Transverse Ligament Stress Test, head and C1 are then carefully lifted anteriorly together, allowing no flexion or extension

A

TRUE

35
Q

how many seconds do you hold the anterior shear in the Transverse Ligament Stress Test?

A

10-20 seconds

36
Q

(+) Transverse Ligament Stress Test indicates?

A

hypermobility at the atlantoaxial articulation

37
Q

Determine the instability of the atlantoaxial articulation caused by odontoid dysplasia

A

Lateral (Transverse) Shear Test

38
Q

In lateral shear test, PT places the ___ MCP joint of one of their hands against the transverse process of the _____ and the MCP joint of their other hand against the opposite transverse process of the _____

A

2ND MCP joint one of their hands against the transverse process of the ATLAS

against the opposite transverse process of AXIS

38
Q

T OR F: Pain on the affected is an indication of a (+) lateral shear test

A

FALSE

Pain is normal d/t compression of soft tissues against the bone

(+) Lateral shear test = Increased motion or production of spinal cord/vascular symptoms

39
Q

In Lateral Flexion Alar Ligament Stress Test, PT stabilize the ____ with a ____ grip around the _____ (2).

A

PT stabilize the AXIS/C2 with a WIDE PINCH grip around the SPINOUS PROCESS and LAMINA

40
Q

T OR F: Lateral Flexion Alar Ligament Stress Test is an active test.

A

FALSE

Lateral Flexion Alar Ligament Stress Test is PASSIVE test with the PT passively side flexing the head & axis

41
Q

What test?

PT grips the lamina and spinous process of C2 between the finger and thumb

While stabilizing the C2, PT passively rotates the head left or right moving to the no symptom side first

A

Rotational Alar Ligament Stress Test

42
Q

What is considered (+) Rotational Alar Ligament Stress Test?

A

More than 20 to 30 degrees rotation without the C2 moving

Indicative of injury to the contralateral alar ligament especially if the lateral flexion alar ligament stress test is positive in the same direction

43
Q

What is the position of the patient’s head & neck in verterbral artery/cervical quadrant test?

A

extension, side flexion, rotation to same side then hold for 30 seconds

44
Q

What is considered (+) verterbral artery/cervical quadrant test?

A

Provokes referring symptoms if the OPPOSITE side artery is affected

MSK (7 decks)

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