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NMS I > Cervical ROM and Orthopedic Tests > Flashcards

Cervical ROM and Orthopedic Tests Flashcards

1
Q

cervical flexion ROM

A

50

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2
Q

shoulder Flexion ROM

A

180

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3
Q

elbow flexion ROM

A

140

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4
Q

when patient spontaneously grasps the head with both hands when lying down or when rising from a recumbent position

A

rust sign

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5
Q

rust sign indicates

A
  • severe sprain
  • rheumatoid arthritis
  • fracture
  • severe cervical subluxation
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6
Q

reporting statement for rust sign

A

severe upper cervical (atlanto-axial) instability

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7
Q

examiner applies thumb pressure to mastoid process and gradually increases pressure until it becomes noticeably uncomfortable

A

libman’s sign

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8
Q

patient in a seated position and will place palm of the affected extremity on top of their head, raising the elbow to the level of the ear

A
  • bakody sign
  • positive reverse bakody sign
  • negative bakody sign
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9
Q

this test decreases traction of the lower part of the brachial plexus

A
  • bakody sign
  • positive reverse bakody sign
  • negative bakody sign
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10
Q

when the decrease in traction of the lower part of the brachial plexus relieves pain

A

bakody sign

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11
Q

when the decrease in traction of the lower part of the brachial plexus is exacerbated

A

positive reverse bakody sign

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12
Q

when the decrease in traction of the lower part of the brachial plexus yields no change in the patients symptoms

A

negative bakody sign

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13
Q

purpose of bakody sign

A

it is a position that the patient will assume if they are having severe radicular symptoms, indicates nerve root irritation

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14
Q

positive reverse bakody sign indication

A

TOS from interscalene compression

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15
Q

negative bakody sign indication

A

rules out a nerve root (IVF) encroachment and thoracic outlet syndrome

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16
Q

patient is asked to abduct the shoulder 90 degrees and then the elbow is put into full extension

A

bikele’s sign

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17
Q

purpose of bikele’s sign

A

to traction the brachial plexus

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18
Q

what does bikele’s sign indicate

A

that the arm pain in question is radicular in nature and goes into the arm

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19
Q

patient is asked to abduct both shoulders to 90 degrees and place the hands behind the head. the doctor then pulls the elbows back

A

brachial plexus tension test

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20
Q

doctor stands in front of the seated patient and patient is asked to take in a breath and bear down as if they were laboring during a strenuous defecation

A

valsalva’s maneuver

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21
Q

purpose of valsalva’s maneuver

A

test for SOL w/in spinal column

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22
Q

coughing, sneezing and straining during defecation may cause aggravation of radiculitis symptoms. this aggravation is due to the mechanical obstruction (SOL) such as a herniated or protruding IVD, spinal cord tumor, or spinal compression fracture

A

dejerine’s sign

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23
Q

derjerine’s sign can be caused by what three SOLs

A
  • herniated or protruding IVD
  • spinal cord tumor
  • spinal compression fracture
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24
Q

look at the clinical indications of dejerine’s sign on page 77

A

…

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25
Q

during the swallowing test the presence of pain or difficulty swallowing indicates what

A
  • SOL
  • ligamentous sprain
  • muscular strain
  • fracture
  • disc protrusion
  • tumor
  • osteophyte at the anterior portion of the cervical spine
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26
Q

what makes swallowing painful when the swallowing test is positive

A

it suggests esophageal irritation due to direct trauma or a retroesophageal SOL

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27
Q

doctor stands behind seated patient and occludes the external jugular veins at the level of the clavicles for 10-15 seconds. doctor then asks the patient to cough

A

naffziger’s test

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28
Q

purpose of naffziger’s test

A

to create a pooling of the venous sinuses that will cause an increase in cerebral spinal fluid pressure

29
Q

patient is in a seated position, doctor instructs the patient to rotate the head back and forth as fast as they can. if at any time the patient experiences symptoms the test is considered positive

A

barre-lieou test

30
Q

purpose of the barre-lieou test

A

to rule out vascular insufficiency, cervicogenic vertigo, and possible vestibular apparatus abnormality

31
Q

patient is supine they rotate and extend their head and count backwards from 20

A

dekleyn’s test

32
Q

purpose of dekleyn’s test

A

to rule out vascular insufficiency

33
Q

if dekleyn’s test is positive when head is rotated to the right and extended, which vertebral artery is compormised (buckled)

A

the right vertebral artery

34
Q

with the patient seated, the doctor exerts upward pressure on the patients head

A

distraction test

35
Q

what does generalized, increased pain indicate during the distraction test

A

muscle spasm

36
Q

what does relief of pain indicate during the distraction test

A

IVF encroachment or facet capsulitis

37
Q

purpose of the distraction test

A

to confirm IVF encroachment

38
Q

patient, seated, actively rotates head side to side. the doctor then exerts strong downward pressure with the head in the neutral position, noting any radicular pain. the doctor then rotates the patients head while exerting strong downward pressure

A

foraminal compression test

39
Q

purpose of the foraminal compression test

A

to confirm IVF encroachment and nerve root involvement

40
Q

if localized pain is solicited during the foraminal compression test what is indicated

A

foraminal encroachment

41
Q

if radicular pain is solicited during the foraminal compression test what is indicated

A

pressure on the nerve root and neurologic level must be evaluated

42
Q

patient seated, patient actively rotates the head from side to side. note pain. patient then actively laterally flexes the head from side to side. note pain. doctor then exerts strong downward pressure with the head in the neutral position. note pain. doctor then laterally flexes the patient’s head while exerting strong downward pressure. note pain. pressure should be maintained for 30-60 seconds

A

jackson compression test

43
Q

purpose of jackson compression test

A

to confirm IVF encroachment and nerve root involvement

44
Q

if there is pain on the opposite side of rotation during jackson compression test, what does that indicate

A

muscular strain

45
Q

if there is pain on the same side of rotation during jackson compression test, what does that indicate

A

facet or nerve root involvement

46
Q

patient seated, then instructed to approximate the chin to the shoulder (fully rotating the head) flex and then extend the neck.

A

maximum cervical compression test

47
Q

if pain on the concave side during the maximum cervical compression test, what does that indicate

A

nerve root or facet involvement (IVF encroachment)

48
Q

if there is pain on the convex side during the maximum cervical compression test, what does that indicate

A

muscular strain

49
Q

jackson’s compression test + a blow to the top of the head

A

spurling’s test

50
Q

patient seated, the doctor instructs them to drop their chin to their chest. the doctor then passively flexes the patients head

A

Lhermitte’s test

51
Q

purpose of the Lhermitte’s test

A

traction the posterior column of the spinal cord

52
Q

what is a positive Lhermitte’s test

A

when an electric shock like sensation radiating down the neck and spine. this is a sign of posterior column disease and a classic sign of MS

53
Q

a positive test shows the classic sign for MS

A

Lhermitte’s test

54
Q

while patient is sitting, cervical spine is actively moved through range of motion, then through passive range of motion, then through resisted range of motion

A

O’Donoghue maneuver

55
Q

purpose of the O’Donogue maneuver

A

to stress the musculature involved in the motino of the joint being tested

56
Q

pain during resisted range of motion during the O’Donogue maneuver indicates what

A

muscle strain

57
Q

pain during passive range of mostion during the O’Donogue maneuver indicates what

A

ligamentous sprain

58
Q

that patient is supine and the doctor passively flexes the patient’s head. the sign is present if flexion of both knees occurs

A

brudzinski part of the kernig/brudzinski sign

59
Q

when a positive brudzinski’s sign (both knees flex) what is indicated

A

meningitis

60
Q

the patient is supine and the doctor flexes hip and knee of either leg to 90 degrees respectively. doctor attempts to completely extend the leg

A

kernig part of the kernig/brudzinski sign

61
Q

when a positive kernig’s sign (opposite knee flexes) what is indicated

A

meningitis

62
Q

patient is seated and doctor stands behind and lateral to the mid-line of the side being tested. doctor laterally flexes the head away and while stabilizing the head an inferior force is placed on the ipsilateral shoulder

A

shoulder depression test

63
Q

purpose of the shoulder depression test

A

traction the brachial plexus and its nerve roots, cervical spine, and shoulder complex

64
Q

radicular symptoms solicited by the shoulder depression test are caused by what

A
  • fibrosis in the IVF
  • adhesions to the dural sleeve
  • tractioning the nerve root across osteophytes
  • edema or compression of the nerve root at the IVF
65
Q

radiating symptoms solicited by the shoulder depression test are caused by what

A
  • tractioning the nerves across a cervical rib

- soft tissue inolvement

66
Q

with patient supine the doctor places one hand on the sternum and exerts slight pressure so that no flexion can take place at either the lumbar or thoracic regions of the spine. the doctor places the other hand under the patient’s occiput and passively flexes the head toward the chest

A

soto-hall test

67
Q

when is the soto-hall test primarily employed

A

when a vertebral fracture is suspected

68
Q

this procedure produces a progressive pull on the posterior spinous ligaments starting at the ligamentum nuchae above and being transmitted downward to the interspinous ligaments until it reaches the spinous process of the involved vertebra where it acts as a lever compressing the body and producing pain

A

soto-hall test

69
Q

during soto-hall test when localized dull or sharp pain in the cervical spine is solicited what may radiate to the thoracic spine may be caused by what

A
  • sprain/strain
  • avulsion fracture
  • facet involvement
  • a sharp accentuation of pain with radiculopathy suggests a possible SOL

NMS I (5 decks)

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