Cervical Spine Specialty tests

Question 1

What is the compression test?

Answer 1

Place head and neck in neutral position, add an axial loading force downward

Look for upper extremity pain, paresthesias, or numbness

Question 2

Describe Spurling’s test

Answer 2

 Tests nerve root compression/irritation.

 Tested with axial force downward in

stages of (1) neutral, then (2) extension,

then (3) SB/rotation toward or away.

 If symptoms reproduced in one stage, do not proceed to next stages.

• High specificity

positive if the sx are reproduced

Question 3

What is a positive Spurling test? What does it indicate?

Answer 3

Positive test is a reproduction of the sx

Indicates a central neuropathy

Question 4

What is a neck distraction test?

Answer 4

Physician places one hand under the patient’s chin and places the other hand around the occiput. The physician slowly distracts the head.

Question 5

Describe Adson’s test

Answer 5

 Physician locates radial pulse on affected arm. While standing behind patient, physician then abducts, extends, and externally rotates the shoulder while palpating the radial pulse.

 First, patient’s head is extended and rotated toward affected side as they inhale and hold it. Then the patient’s head is extended and rotated away from affected side as they hold inhalation.

positive is a loss or change of pulse

Question 6

What is a positive Adsons test? What is a positive test indicative of?

Answer 6

Positive test is the loss of a radial pulse

A positive test is indicative of a thoracic outlet syndrome due to compression of the subclavian artery between the scalenes

Question 7

When the patient is looking toward you in the Adson’s test, and the pulse is lost, what is compressing the subclavian artery?

Answer 7

The first rib

Question 8

When a person is looking away from you during the Adson’s test, and the pulse is lost, what is compressing the subclavian artery?

Answer 8

The scalene muscles

Question 9

Describe the ROOS or EAST test

Answer 9

 Patient abducts shoulder to 90° and externally rotates with elbow flexed to 90°.

 Physician instructs patient to open and close fist for up to 3 minutes

positive test is reproduction of symptoms

Question 10

What is a positive Roos test and what is it indicative of?

Answer 10

Positive test is the reproduction of the sx

Indicates a thoracic outlet syndrome, specifically compression of a subclavian artery

Question 11

Describe the nuchal rigidity test

Answer 11

Patient supine. Place hands behind patient’s head, flex neck forward until chin touches chest.

positive is neck stiffness

Question 12

What is a positive Nuchal rigidity test and what does it indicate?

Answer 12

Positive test is marked neck stiffness/resistance to flexion

Indicates inflammation in the subarachnoid space (meningitis, subarachnoid hemorrhage)

Question 13

Describe a Brudzinskis sign?

Answer 13

Patient supine. Place hands behind patient’s head, flex neck forward until chin touches chest.

Positive if the patients knees touch their chest

Question 14

What is a positive Brudzinskis sign and what is it indicative of?

Answer 14

Flexion in hips and knees

Indicates inflammation in the subarachnoid space which could be meningitis

Question 15

Describe Kernig’s sign

Answer 15

Place patient supine and flex hip and knee to 90°. Attempt to passively extend the leg at the knee

Positive is increased resistance to extension and pain behind the knee

Question 16

What is a positive Kernig’s sign and what does it indicate?

Answer 16

Positive sign is increased resistance to extension and pain behind the knee

Indicative of meningeal or dural irritation