Methods 5-Cervical Orthos

Question 1

Bakody’s Sign

Answer 1

• Decrease in discomfort suspect a cervical herniated disc, epidural vein compression or nerve root compression.
• Commonly C5-C6 - relieving the suprascapular nerve

Question 2

Distraction Test (Cervical)

Answer 2

-Local pain suspect sprain, strain, spasm or facet capsulitis
-Relief of pain suspect disc defect or foraminal encroachment

Question 3

Foraminal Compression Test

Answer 3

-Local or radicular pain suspect cervical cord disease, meningitis, osteophytes, mass
-Sudden electrical tingling sensation felt along the spine and/or extremities suspect cervical myelopathy or multiple sclerosis

Question 4

Shoulder Depression Test

Answer 4

-Local pain on tested side suspect muscular adhesions, spasm or ligamentous injury
-Radicular pain tested side suspect compressed
neurovascular bundle, dural sleeve adhesions, or TOS (Brachial plexus injuries are usually d/t traction injuries resulting from lateral flexion away from side of involvement
-Pain elicited opposite tested side suspect foraminal
encroachment, facet pathology or disc defect

Question 5

Adson’s Test

Answer 5

-Diminished pulse amplitude: Suspect hypertrophied scalenus anticus, cervical rib, or mass
-Paresthesia or radiculopathy: Suspect compression of the neural component of the brachial plexus

Question 6

Allen Test

Answer 6

-Observe the return of blood flow to the hand –
pink coloring and distended veins
-Delay of 10seconds in returning a pinkish color
to the hand indicates arterial insufficiency

Question 7

Roos Test

Answer 7

-Paresthesia or radicular pain suspect narrowed
costoclavicular space or hypertonic anterior scalene muscles

Question 8

Costoclavicular Maneuver

Answer 8

-Diminished pulse amplitude: Suspect compression of the vascular portion of the neurovascular bundle–
clavicle or first rib fracture, dislocation of clavicle, hypertrophied subclavius muscle
-Paresthesia or radicular pain: suspect compression of brachial plexus or axillary vein

Question 9

Wright’s Test

Answer 9

-Diminished pulse amplitude suspect compression of the axillary artery– deformed coracoid process or hypertrophied pectoralis minor muscle

Question 10

O’Donoghue Maneuver

Answer 10

• Pain with passive ROM may indicate ligament sprain – alar, transverse, supraspinatous, interspinous, intertransverse, posterior longitudinal and anterior longitudinal, ligamentum flavum and articular capsule
• Pain during resisted ROM may indicate muscle strain

Question 11

Jackson Test

Answer 11

-#1 laterally flex and apply S-Ipressure; progress by
extending neck w/ lateral flexion and pressure
-Local pain suspect facet joint involvement
-Radicular pain suspect lateral disc defect, degenerative intervertebral disc or foraminal encroachment

Question 12

Lhermitte Sign

Answer 12

-Local pain suspect foraminal encroachment without nerve root pressure or capsulitis
-Radicular pain suspect disc defect or foraminal encroachment
-Myelopathy suspected if sharp, radiating pain or paresthesia along spine or into extremities

Question 13

Valsalva Maneuver

Answer 13

-Local pain suspect disc defect, mass, osteophyte or
other space occupying lesion of the cervical canal
or foramen

Question 14

Soto-Hall Test

Answer 14

-Local pain suspect ligament, muscular, or osseous pathology (e.g. fracture) or cervical cord disease
-Radicular pain suspect disc defect
-This test can also be done with patient’s arms above head