Final Practical (Exams) Flashcards
Spurlings Test
- place pts head in slight extension, then laterally flex pts neck 30° to affected side
- apply a downward axial compression
positive = when pain arising in the neck radiates in direction of corresponding ipsilateral dermatome
high spin and snout
Cervical Distraction Test
- patient is supine, PT is seated
- place hands around mastoid process , slightly flex pts neck and pull their head towards you
positive = when pt s/s are reduced with the distraction. must be s/s at rest for this test to work
Sharp-Purser Test
- performed first if upper cervical instability is suspected and performed with extreme caution
- pt sits with semiflexed neck, hands go on forehead and spinous process of axis
- positive = c1 will translate forward on C2 in flexion and pressure will reduce it. Laxity, reduction in s/s, clunk
Transverse Ligament Test
- can provoke symptoms that were reported in history but not currently present
- pt is supine, PT index fingers are on occiput and spinous process of C2. PT lifts head and C1 anteriorly without flexion/extension
- position is held for 10-20 seconds
Positive Transverse Ligament Test
- abnormal pupil response
- eye twitching or nystagmus
- soft end-feel
- muscle spasm
- dizziness
- nausea
- paresthesia of lip face or limb
- lump sensation in the throat
Alar Ligament
this ligament prevents coupling of rotation and lateral flexion in C0-C3
Alar Ligament Test
- can be performed seated OR supine
- stabilze SP and lamina of C2
- slight compression applied through crown of head
- passive lateral flexion applied through head
- testing contralateral alar ligament
- positive = excessive motion palpated
Should have (during alar ligament test)…
- almost no rotation when laterally flexed
- no lateral flexion when rotated
Cervical Flexion Rotation Test
- patient is in supine, cervical spine is fully flexed and resting against PT
- pts head is rotated from left to right
- positive = firm resistance, pain provoked, range limited before end range, reproduced s/s, or 10°difference from side to side, less than 32° of motion
- indicates limited rotation of C1 on C2 (AA motion)
Median Nerve ULNT
- shoulder depression and abduction to 110
- external rotation
- elbow extension
- forearm supination
- wrist extension
- fingers/thumb extension
- lateral neck flexion
testing C6-T1 nerve roots
Ulnar Nerve ULNT
- scapular depression
- shoulder abduction to 100°
- shoulder ER
- forearm pronation
- wrist and finger extension
- elbow flexion
- lateral neck flexion
testing C8-T1
Radial Nerve ULNT
- shoulder girdle depression
- shoulder abduction 20-30°
- shoulder IR
- forearm pronation
- wrist, finger, thumb flexion
- elbow extension
- lateral neck flexion
Cervical Repositioning
- pt in sitting, about 90cm from target
- with eyes closed, patient will rotate head. then they will try to rotate back to target, trying to get within yellow or green
- three trials are performed
- meaningful error = 4.5”
other errors include searching for position, overshooting, jerky patterns
DNF Endurance Test
1” off table while maintaining chin tuck
min of 20s, shows activation of OA flexion and DNF without SCM and abdominals
OA Flexion Testing
- posterior hand induces slight cervical flexion w/traction
- anterior hand on forehead, 20-30° of rotation, then bring into more retraction
- testing the side the head is rotated towards, and if there is restrictions
Cervical Rotation - Lateral Flexion Test
Rotate head away from affected side and laterally flex head
if 1st rib elevated/hypomobile, lateral flexion will be limited b/c 1st rib is blocking motion
