Ch 14 special tests

Question 1

Upper Limb Tension Test

Answer 1

• tests for: hyper irritability of peripheral nerve (brachial plexus)
• procedure: A) ear to shoulder, passively lateral flex cervical spine to side not being tested and depress the shoulder girdle on test side B) abduct glenohumeral joint to 90 degrees applying tension to shoulder C) externally rotate glenohumeral joint 90 degrees with elbow in 90 degrees of flexion D) supinate the forearm and extend the wrist & fingers E) extend the elbow F) when symptoms are produced, bring cervical spine back to neutral
• positive test: provocation of symptoms & restricted ROM

Question 2

Babinski Test

Answer 2

• tests for: upper motor neuron lesions
• procedure: use a pen or back of reflex hammer to run up along the plantar aspect of the patients foot making an arc from the calcaneus medially to the ball of the great toe (normal = toes will curl)
• positive test: great toe extends and the other toes splay (move out to the sides)

Question 3

Cervical Compression Test

Answer 3

• tests for: nerve root impingement
• clinician: standing behind patient with hands interlocked over top of patients head
• procedure: apply a downward (compressive) force on the crown of the patient’s head
• positive test: patient has pain or reproduction in upper cervical spine, upper extremity, or both

Question 4

Spurling Test

Answer 4

• tests for: nerve root impingement
• clinician: standing behind patient with hands interlocked over the crown of the patient’s head
• procedure: A) passively move patient’s head into extension, if no symptoms are produced: B) add lateral flexion C) add axial compression to the cervical spine
• positive test: pain or reproduction of symptoms radiating down the patient’s arm

Question 5

Cervical Distraction Test

Answer 5

• tests for: nerve root impingement
• clinician: one hand under occiput and the other on top of the forehead stabilizing the head
• procedure: flex the patient’s cervical spine to a position of comfort, apply a traction force to the skull, producing distraction of the cervical spine
• positive test: patients symptoms relieved or reduced

Question 6

Shoulder Abduction Test

Answer 6

• tests for: nerve root compression or herniated disc
• procedure: instruct patient to actively abduct the arm so the hand is resting on top of the head, and maintains this position for 30 secs
• positive test: decrease in the patient’s symptoms secondary to decreased tension on the involved nerve roots