Cervical tests Flashcards
Distraction test
Test for nerve root symptoms.
Hold head at sides, or at chin and occiput. Distract.
Positive:radicular symptoms relieved/decreased.
Bakody ‘s Sign
Tests for c4-5 or C5-6 nerve root involvement; extradural compression
(Differentiate based on dermatomes)
Abduct, elevate arm; rest on head.
Positive: Sx improve.
(If pain gets worse –> scalene triangle; TOS)
C4-5 dermatome
C4 shoulder, clavicle, upper scrap
C5 delt ant arm to thumb
C5-6 dermatome a
C5: delts, ant arm to thumb
C6: anterior arm, radial hand to thumb and index finger.
Scalene Cramp Tesr
Tests for Scalene TrP and/or TOS
Rotate head, drop chin into space behind clavicle. Hold for 60 seconds.
Positive: increase pain (TrP)
Radicular signs: TOS
Tinel’s for brachial plexus lesion
Taps along nerve trunks.
Local pain: underlying cervical plexus lesion
Tinel’s: tingling along nerve distribution
Neuroma: pain along peripheral nerve
VAT
Test for vertebral artery compression (CL)
Supine. Head extended, side flexed, IL rotation. Hold for :30
Positive: dizziness or nystagmus.
Anterior shear test
Aka Sagittarius stress test
Tests for integrity of ligaments and capsules
Supine. Direct C1 and then C2 (post arch and SP) anteriorly. Feel end feel.
Positive: nystagmus. Pupil ha he. Soft end feel. Face or lip paresthesia. Lump in throat
Transverse ligament stress test
Tests for integrity of transverse ligament.
Supine. Support occuput. Lift head and C0 together without flexion or extension.
Positive: soft end feel, neuro signs, excess movement.
Lateral shear test.
Test for instability of C1-C2 joint.
Supine. Push TVPs across each other.
Positive: excessive movement.
Alar ligament test
Tests integrity of alar ligament
Grip TVPs of axis. Attempt to side flex head and axis
Positive: excess side flexion/rotation.
Spurlings
Foramina Compression Test
Tests for: pressure on nerve root (maybe facet irritation too)
Test in: neutral;extension;extension and IL rotation
Positive: pain radiates down IL arm.
