Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MSK1 > 7.4: Cervical Spine - Special Tests > Flashcards

7.4: Cervical Spine - Special Tests Flashcards

1
Q

PT places 1 hand under the chin and the other one the Occiput of the pt then slowly lifts the pt’s head

A

Distraction Test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Increased pain on distraction may be the result of

A

Muscle spasm, ligament sprain, muscle strain, dura irritability, or disc herniation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Compression test with 3 stages

A

Spurling’s Test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

First stage of spurling

A

Compression of the head in neutral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Other name for spurling’s

A

Foraminal Compression Test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

2nd stage of spurling

A

Compression with head in extension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Spurling’s Final stage

A

Compression with head in extension and rotation to the unaffected side

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When to use spurling

A

when pt complains of radicular Sx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Provocative Tests for neurologic symptoms

A

Spurling’s

Jackson’s

Maximum Cervical Compression Test

Upper Limb Neurodynamic Test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Positive Sign for distraction test

A

pt’s Sx are relieved or decreased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

positive sign for spurling’s

A

provocation of Sx

Symptoms radiates into the arm into which head is side flexed during compression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Spurling’s test may lead to Sx of what conditions?

A

Stenosis

Spondylosis

Osteophytes

Trophic, Arthritic, or Inflammed Facet Joints

Herniated Disc

Vertebral Fx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

During spurling’s test, if pain or other symptoms is felt on the contralateral side of the head’s side bending direction, what is it called?

A

Reverse Spurling’s Sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Reverse Spurling’s Sign is indicative of what?

A

Muscle Spasm in conditions such as:

Tension Myalgia

Whiplash Associated Disorders (WADs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

test where pt side flexes and rotates head to the same side

A

Maximum cervical compression test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

In maximum cervical compression test, if the pain is felt on the concave side, it indicates what?

A

Nerve root or facet joint pathology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

In maximum cervical compression test, if the pain is felt on the convex side, what does it indicate?

A

muscle strain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

The position should be held for how long if using maximum cervical compression test for testing the artery

A

20-30 seconds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Modification of Spurling’s where pt rotates the head to one side then PT carefully presses straight down to the head

A

Jackson’s Compression Test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

T/F: In the compression tests, dermatomal distribution of the Sx will not determine the nerve root involved

A

False

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

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

A

Bakody’s/Shoulder Abduction (relief) test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Starting position of pt in Bakody’s

A

Sitting or Supine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How to do Bakody’s

A

PT passively or pt actively elevates the arm through abduction so that the hand/forearm rests on top of the head

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Decrease of Sx in Bakody’s indicates what?

A

herniated disc

Epidural vein compression

Nerve root compression

All of which are usually in the C4-C5 or C5-C6 area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Abduction of the arm decreases the ______ of the neurological pathway and ______ on the lower nerve roots

A

Length of the neurological pathway and pressure on the lower nerve roots

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Increase in pain during bakody indicates what?

A

Increasing pressure in the interscalene triangle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Special Test equivalent to the straight leg test in the lumbar spine

A

Upper Limb Neurodynamic (Tension) Test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Contraindications for ULNT?

A

cauda equina or spinal cord lesions

neurological signs are worsening or in the acute stage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Essential force to be applied on the shoulder during ULNT

A

Depression force

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Why is depression force in ULNT essential?

A

so that even in abduction, the shoulder girdle remains depressed

if the shoulder is not held in depression, the tests are not likely to work

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Position of ULNT 1

A

Shoulder - Depression and abduction (110 deg)

Elbow - extension

forearm - supination

wrist - extension

fingers - extension

cervical spine - contralateral side flexion

32
Q

Position of ULNT 2

A

Shoulder - depression, abduction (10*), and ER

Elbow - extension

forearm - supination

wrist - extension

fingers - extension

cervical spine - contralateral side flexion

33
Q

Position of ULNT 3

A

Shoulder - depression, abduction (110*), and IR

elbow - extension

forearm - pronation

wrist - flexion and ulnar deviation

fingers - flexion

cervical spine - contralateral side flexion

34
Q

Position of ULNT 4

A

Shoulder - depression, abduction (10 to 90 deg), and ER

Elbow - flexion

Forearm - supination or pronation

Wrist - extension and radial deviation

Fingers - extension

Cervical Spine - contralateral side flexion

35
Q

What is tested in ULNT 4

A

Ulnar nerve, C8 and T1 nerve roots

36
Q

What is tested in ULNT 3

A

Radial nerve

37
Q

What is tested in ULNT 2

A

Median nerve, musculocutaneous nerve, axillary nerve

38
Q

What is tested in ULNT 1

A

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

39
Q

Normal sensations in ULNT

A

Deep ache/stretch in the cubital fossa (99%)

Deep ache/stretch into anterior and radial aspect of forearm and radial aspect of hand (80%)

Tingling to the fingers supplied by the appropriate nerve (nerve bias)

Stretch in the anterior shoulder

Above responses increased with contralateral cervical side flexion and decreased with ipsilateral cervical side flexion

40
Q

Positive indications for ULNT

A

Production of pt’s Sx (most important)

A sensitizing test in the ipsilateral quadrant alters the Sx

Different Sx between right and left (contralateral quadrant)

41
Q

Modification of the ULNT

A

brachial plexus tension test

42
Q

procedure for brachial plexus tension test

A

Sitting pt abducts arms c elbow extended, stopping at the onset of Sx

Then PT holds this position while pt flexes their elbows so that the hands lie behind their head

43
Q

What is stressed in the brachial plexus tension test

A

Primarily the Ulnar nerve, and C8-T1 nerve roots (Similar to ULNT4)

44
Q

Test used to determine the effect of increased pressure in the spinal cord

A

Valsalva Test

45
Q

Maneuver for Valsalva Test

A

Pt is asked to take a deep breath while bearing down (as if moving the bowels)

46
Q

Positive indication for valsalva test

A

increased pain that may be caused by increased intrathecal pressure

47
Q

what are possible causes of a positive valsalva test

A

space-occupying lesions such as herniated discs, tumors, stenosis, or osteophyte formations

48
Q

Why should the valsalva test be done with caution

A

Pt may become dizzy and pass out during or shortly afterward the test if the procedure blocks the brain’s blood supply

49
Q

What is romberg test used for

A

upper motor lesion

50
Q

Procedure for romberg test

A

pt is in standing and is asked to close the eyes for 20-30 seconds

51
Q

positive indication for romberg

A

pt’s body sways excessively or pt loses balance

52
Q

T/F: Vertebral Artery (Cervical Quadrant) Test and the special test for VBI have the same procedure

A

True

53
Q

Procedure for Vertebral artery (cervical quadrant) test

A

pt is in supine while PT passively takes pt’s head and neck into extension and side flexion

PT then rotates the neck to the same side as the side flexion and holds position for approx. 30 sec

54
Q

Positive indication for Vertebral artery (cervical quadrant) test

A

Provoking sx if the opposite artery is affected

dizziness and nystagmus indicates compression of the vertebral artery

55
Q

Tests for cervical instability

A

Sharp-Purser

Transverse (lateral) shear test

Lateral flexion alar ligament stress test

Rotational alar ligament stress test

Transverse ligament stress test

56
Q

Procedure for lateral flexion alar ligament stress test

A

Pt lies in supine c head in the neutral position > PT stabilizes the axis c a pinch grip around the spinous process & lamina > PT attempts to side flex the head and axis

57
Q

What is to be expected during lateral flexion alar ligament stress test for normal individuals

A

Minimal side flexion with a strong capsular endfeel and a solid stop

58
Q

Procedure for Lateral (transverse) shear test

A

Pt lies in supine c head supported > PT places their 2nd MCP joint of one hand against the transverse process of the atlas and the 2nd MCP of the other hand over the opposite transverse process of the axis > PT’s MCPs are then pushed together causing shear of one bone on the other

59
Q

What is to be expected during the lateral shear test for normal individuals

A

Minimal motion and no Sx

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

60
Q

Why is lateral shear test used

A

to determine the instability of the atlantoaxial articulation caused by odontoid dysplasia

61
Q

T/F: The lateral shear test can also be used to test the other cervical spine levels

A

True

62
Q

Procedure for the rotational alar ligament stress test

A

Pt is in sitting > PT grips lamina and spinous process of C2 between their finger and thumb > PT then passively rotates the head left or right moving to the “no Sx” side first while stabilizing C2

63
Q

Positive indication for Rotational Alar Ligament Stress Test

A

More than 20 to 30 degrees of rotation without C2 moving

64
Q

What does a positive Rotational Alar Ligament Stress test indicate?

A

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

65
Q

What does excess motion in Rotational Alar Ligament and Lateral Flexion Alar Ligament Stress Test indicate

A

instability is due to an increase in the neutral zone in the joint

66
Q

Why is Sharp-Purser Test done

A

to determine sublaxation of the atlas on the axis

67
Q

What will happen if the transverse ligament that maintains the position of the Odontoid process on the C1 is torn

A

C1 will translate forward on C2 during flexion

68
Q

procedure for Sharp-purser test

A

PT places one hand on pt’s forehead while the thumb of the other hand over the spinous process of C2 (first palpable spinous process after occiput) > ask pt to slowly flex the head while PT presses the head backward with the palm

69
Q

Positive indication for Sharp-Purser test

A

PT feels the pt’s head sliding backward

70
Q

What to do if PT feels the pt’s head sliding backward during Sharp-Purses

A

IMMEDIATELY STOP

71
Q

Tests for Thoracic Outlet Syndrome

A

Adson’s

Military Brace (Costoclavicular Syndrome) test

Wright test

72
Q

Procedure for Wright test

A

Pt’s arm is hyperabducted so that the hand is brought over the head c elbow and arm in the coronal plane c shoulder in ER

73
Q

Positive indications for the TOS special tests

A

Disappearing Radial Pulse

74
Q

Procedure for Adson’s

A

PT palpates for the radial pulse > pt’s head rotates to the side that is tested > pt then extends the head & PT puts the shoulder into extension and ER > pt is asked to take a deep breath

75
Q

Procedure for Military Brace/Costoclavicular Syndrome Test

A

PT palpates the radial pulse then draws the pt’s shoulder down and back

MSK1 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions