Cervical Special Tests

Question 1

Vertebral artery test - tests for what

Answer 1

Integrity of vertebrobasilar vascular system

Question 2

Vertebral artery test - how to perform

Answer 2

Pt supine with head supported over end of table - EO
Passively extend head and neck, hold for 30 sec
If no sx - passively rotate and SB with extension in both directions
Hold each position for 30 sec

Question 3

Flexion rotation test - tests for what

Answer 3

Cervical contribution to HA

Question 4

Flexion rotation test - how to perform

Answer 4

Pt supine
Passively perform max flexion of c spine and then fully rotate head in each direction
Pos if reproduction of HA or loss of 10 ROM from one side

Question 5

Transverse ligament stress test - tests for what

Answer 5

Integrity of trans ligament

Question 6

Transverse ligament stress test - how to perform

Answer 6

Pt supine with head supported on table
Glide C1 ant - should be firm end feel
Pos if soft end feel, dizzy, nystagmus, lump in throat, nausea

Question 7

Anterior Shear Test - Tests for what

Answer 7

Integrity of upper C spine ligaments and capsules

Question 8

Anterior shear test - how to perform

Answer 8

Pt supine with head supported on table
Glide C2-C7 anterior - should be firm end feel
Pos if laxity, lump in throat, nystagmus, dizzy, nausea

Question 9

Foraminal compression (spurling’s test) - tests for what

Answer 9

Dysfunction (typically compression) of cervical nerve root

Question 10

Foraminal compression (spurling’s test) - how to perform

Answer 10

Pt sitting with head SB toward uninvolved side
Apply pressure through head straight down
Repeat with head toward invovled side
Pos if pain/paresthesia in dematomal pattern

Question 11

Maximum cervical compression test - tests for what

Answer 11

Compression of neural structures at intervertebral foramen and/or facet dysfunction

Question 12

Maximum cervical compression test - how to perform

Answer 12

Pt sitting
Passively move head into SB and rot toward nonpainful side followed by extension
Repeat towards painful side
CAREFUL because similar to vertebral artery test
Pos if pain/paresthesia in dermatomal pattern or localized pain for facet

Question 13

Distraction test - tests for what

Answer 13

Compression of neural structures at intervertebral foramen or facet joint dysfunction

Question 14

Distraction test - how to perform

Answer 14

Pt sitting with head passively distracted
Pos if dec in sx in neck (facet condition)
Pos if dec in upper limb pain (neurological condition)

Question 15

Shoulder abduction test - tests for what

Answer 15

Compression of neural structures within intervertebral foramen

Question 16

Shoulder abduction test - how to perform

Answer 16

Pt sitting and asked to place one hand on top of their head - repeat with opp hand
Pos if dec in symptoms into upper limb

Question 17

Lhermitte’s sign - tests for what

Answer 17

Dysfunction of spinal cord and/or an UMN lesion

Question 18

Lhermitte’s sign - how to perform

Answer 18

Pt long sitting on table
Passively flex pt head and one hip while keeping knee in extension
Repeat with other hip
Pos if pain down into spine and into UE or LE

Question 19

Alar ligament test - tests for

Answer 19

integrity of alar ligament

Question 20

Alar ligament test - how to perform

Answer 20

Pt seated
Passively slightly flex the upper C spine and apply firm pincer grip to C2 SP
Palpate movement at C2 during passive upper cervical SB and/or rotation

Question 21

Modified sharp purser test - tests for what

Answer 21

Integrity of transverse ligament

Question 22

Modified sharp purser test - how to perform

Answer 22

Pt seated, passively flex upper c spine slightly and apply firm pincer grasp onto C2 SP
Apply post translation and extension force through forehead while assessing for excessive translation