Cervical Spine Injuries and Special Tests Flashcards
What is nerve root compression/radiculopathy?
Nerve root is compressed or damaged possibly from herniated disc, bone spurs, spinal degeneration or posture changes, injury (MVA).
Ssx of Nerve Root Compression/Radiculopathy
Pain anywhere from neck to fingers.
Abnormal sensations through upper limb (pins and needles, numbness, hot/cold).
Weakness through upper limb.
Spinal reflex changes.
Assessments for Nerve Root Compression/Radiculopathy
Spurlings compression test
Cervical distraction test
Shoulder abduction test
Valsalva
Spurlings Compression Test
Downward compression with head in neutral and lateral flexion to affected side.
Positive = radiating pain down arm.
Indicates nerve root impingement/radiculopathy.
Cervical Distraction Test
Positive = relief or diminished pain.
Indicates nerve root compression.
Shoulder Abduction Test
Positive = relief of symptoms
Indicates compression on C4-C5 or C5-C6 roots or possible herniated disc.
Valsalva
Positive = increased pain.
Indicates possible herniated disc
What is a brachial plexus injury?
Nerve bundle injury from compression or traction (stretched nerves).
Burners or stingers.
Rule out cervical radiculopathy first as they have similar symptoms (work you way down the line).
Ssx of Brachial Plexus Injury
Pain or weakness in upper limb.
Abnormal sensations through upper limb (pins and needles, numbness, hot/cold).
Grip strength weakness.
Assessments of Brachial Plexus Injury
Brachial plexus traction test
Brachial plexus tension test (Upper Limb Tension Test (ULTT))
Brachial Plexus Traction Test
Positive = increase in pain and ssx.
Indicates brachial plexus stretches is pain radiates to upper limb on side being stretched.
Indicates nerve root compression if pain on side of lateral flexion.
Brachial Plexus Tension Test (ULTT)
Positive = pain or increase ssx
Indicates brachial plexus or medial, radial, or ulnar nerve injury.
Also used as an assessment for thoracic outlet syndrome.
What is thoracic outlet syndrome (TOS)?
Compression of thoracic outlet (between first rib and clavicle).
Involves nerves, veins, and/or arteries.
Caused by posture changes, muscle tightness, trauma, repetitive motions, anatomical abnormalities.
Neurological, venous, or arterial TOS types.
Ssx of TOS
pain
numbness
tingling
weakness
changes in colour or temperature of the affected upper limb,
Assessments of TOS
Brachial plexus compression test (Morley’s test)
Adson test
Roos test
Upper Limb Tension Test (ULTT)
Brachial Plexus Compression Test (Morley’s test)
Positive = increase in pain or ssx
Indicates brachial plexus compression/TOS.
Adson’s Test
Positive = decreased/absent pulse strength
Indicates possible vascular TOS
Roos Test
Positive = inability to maintain position for 3 mins, pain, or increase in ssx.
ssx will occur almost immediately (~30 seconds).
Indicates possible TOS
-venous = fatigue, increased colour, swollen
-arterial = losing colour (White/cold)
-neural = pins and needles, pain, tingling
