Cervical Special Tests

Question 1

What does the Spurlings test assess?

Answer 1

Compression test used during a musculoskeletal assessment of the Cervical spine when looking at intermittent nerve root Radiculopathy.

Question 2

How would the Spurling’s test be performed?

Answer 2

Interlock fingers and laterally flex patients head 30 degrees towards the affects side.
An axial force is applied inferiorly ensuring no more Flexion occurs.

Question 3

When would a Cervical Distraction test be used?

Answer 3

When Radiculopathy down the arms is constant. If symptoms are intermittent this test isn’t beneficial

Question 4

Why would a Cervical Distraction test be used?

Answer 4

To help distract and lift the vertebrae off of the impinged nerve

Question 5

How would a Cervical Distraction test be performed?

Answer 5

Place one hand behind the Occipit and the other underneath the Chin. The posterior hand will be lifting whilst the chin is just being stabilised.

Question 6

What does the Upper Limb Tension Test 1 Assess?

Answer 6

Stress onto the:

• Median Nerve
• Anterior Interosseous Nerve
• C5-C7 Nerve Roots

Question 7

How to perform the Upper Limb Tension Test 1?

Answer 7

• Depress Shoulder
• Raise Arm up to 110 degrees
• Flex elbow to 90 degrees
• Laterally Rotate Shoulder
• Extend Patients Wrist and Fingers
• Slowly Extend Elbow until Symptoms are Provoked.

To confirm the neurological structures are being assessed, tension can be taken off Elbow Ext and the patient can Laterally Flex their head in the opposite direction.

Question 8

What does the Upper Limb Tension Test 2 Assess?

Answer 8

• Median Nerve
• Axillary Nerve
• Musculocutaneous Nerve

Question 9

How to perform the Upper Limb Tension Test 2?

Answer 9

• Shoulder Depression with Hip
• Abduct Arm to 10 degrees
• Flex Elbow to 90 degrees
• Extend Wrist and Fingers
• Slowly Extend Elbow until Symptoms are Provoked.

Question 10

What does the Upper Limb Tension Test 3 Assess?

Answer 10

• Radial Nerve

Question 11

How to perform the Upper Limb Tension Test 3?

Answer 11

• Depress Shoulder with Hip
• Abduct Arm to 10 degrees
• Flex Elbow to 90 degrees
• Pronate Wrist and Flex Fingers
• Slowly Extend Forearm until Symptoms are Provoked.

Question 12

What does the Upper Limb Tension Test 4 Assess?

Answer 12

• Ulnar Nerve

- C8-T1 Nerve Roots

Question 13

How to perform the Upper Limb Tension Test 4?

Answer 13

• Depress Shoulder
• Shoulder Abduction to 90 degrees
• Pronate Forearm
• Extend Wrist and Fingers
• Lateral Rotation of Shoulder
• Bring Fingers Towards Ear until Symptoms are Provoked.

Question 14

What does the Cervical Flexion-Rotation Test Assess?

Answer 14

C1-C2 Joint Dysfunction

Atlanto-axial articulation

Question 15

How to perform the Cervical Flexion-Rotation Test?

Answer 15

• Patient is Relaxed in Supine
• Examiner Fully Flexes the Cervical Spine with the Occiput
• Patients head is Slowly Rotated Left and Right
• If resistance is encounter, pain provoked, or range is limited then the test is considered positive with limited rotation of C1-C2.

Question 16

When all 4 Special tests are considered positive what is the probability of Cervical Radiculopathy?
What’s the Probability if 3 are positive?

Answer 16

• 90%

- 65%

Question 17

What is the Cervical Transverse Ligament Test?

Answer 17

• Test Cervical Instability within the Transverse ligament
• It should be performed before any other exam
• Shows the the Atlas and Axis fit together
• Place hand under Occipital Bone and stabilise hand on forehead then gently Raise until end feel or patient feels weakness or dizziness.