Cervical Ortho Exams 24%

Question 1

Csp: Where does 50% of flexion and extension occur

Answer 1

Between Occiput and C1 (C0-C1)

Question 2

Csp: Where does 50% rotation occur

Answer 2

C1 and C2

Question 3

While seated, the patient actively places affected arm’s palm on top of the head. The elbow should be at the level of the head.
What is this test & what is the positive indicator?

Answer 3

Bakody’s Test aka Shoulder Abduction Test
(+) = Relief of Pain
IVF Encroachment

Question 4

The seated patient actively rotates head from side to side. The doctor exerts downward pressure from the neutral position. The head is then rotated to each side with pressure.

Answer 4

Foraminal Compression Test
(+) = Radicular Pain / Localized Pain
Nerve Root Compression / Facet Syndrome

Question 5

What orthopedics exams test for Nerve Root Compression / Facet Syndrome?

Answer 5

1. Foraminal Compression Test
2. Jackson’s Compression Test
3. Maximum Cervical Compression Test
4. Distraction Test

Question 6

The pt is seated & the doctor laterally flexes the patients head to the right and applies downward pressure. The doctor then performs the same on the other side.

Answer 6

Jackson’s Compression Test
(+) = Radicular Pain / Localized Pain
Nerve Root Compression / Facet Syndrome

Question 7

Pt seated and actively rotates, laterally flexes, and hyperextends the neck to the right. If no pain the patient is asked to maximally laterally flex the neck. Repeat on the other side. No compression is applied.

Answer 7

Maximum Cervical Compression Test
(+) = Radicular Pain / Localized Pain
Nerve Root Compression / Facet Syndrome

Question 8

With the pt seated, the doctor exerts upward pressure on the patient’s head removing the weight of the pts head from the neck.

Answer 8

Distraction Test
(+) = Decreased Pain –> Nerve Root Compression
(+) = Increased Pain –> Sprain/Strain

Question 9

With the pt seated, the doctor depresses the patients shoulder while laterally flexing the cervical spine away from that shoulder. Repeat on the other side.

Answer 9

Shoulder Depression Test
(+) = Pain
Nerve Root Adhesion

Question 10

With the patient supine, the doctor places one hand on the sternum while passively flexing the pts head toward the chest.

Answer 10

Soto Hall Sign
(+) = Localized Pain
Fracture (if anterior pain)
Ligament Damage (if posterior pain)

Question 11

What cervical orthopedic exams would you do to check for a space occupying lesion?

Answer 11

Spurling’s Test
Valsalva Maneuver
Naffziger’s Test

Question 12

Patient actively maximally rotates and laterally flexes head to the affected side. The doctor delivers a vertical blow to the top of the patients head. (Can be done bilaterally or with the neck hyperextended).

Answer 12

Spurling’s Test
(+) = Pain in the neck, shoulder or arm
Space Occupying Lesion

Question 13

The doctor asks patient to take a deep breath and hold it while bearing down.

Answer 13

Valsalva Maneuver
(+) = Radicular Pain
Space Occupying Lesion

Question 14

Have the patient sit erect while the doctor holds digital pressure bilaterally over the jugular veins or puts a blood pressure cuff around the pts neck & pumps to 40mm/Hg, holds for 30 seconds. If no pain, the pt is instructed to cough. Contraindicated with vascular compromise.

Answer 14

Naffziger’s Test
(+) = Pain
Space Occupying Lesion