MSK Special Tests Spine, Pelvis, TMJ

Question 1

What is the vertebral artery test?

Answer 1

integrity of vertebrobasilar vascular system

patient supine
extend head 30 seconds
extend and rotate
extend and rotate cradled off table

+dizziness, visual disturbance, diorientation, blurrred speech, nausea/vomiting

Question 2

What is Hautant’s test?

Answer 2

differentiates vascular vs vestibular

sitting, shoulders at 90 with palms up
sitting, shoulders at 90 with palms up and neck ext, rotate each direction, hold for 30 seconds

+arms lose position with neck ext/rotation = vascular

Question 3

What is transverse ligament stress test?

Answer 3

integrity of transverse lig

supine, glide C1 ant

+dysfunction is soft end feel, dizziness, nystagmus, lump sensation in throat, nasuea

Question 4

What is anterior shear test?

Answer 4

supine, glide C2-7 ant.

+dysfunction laxity of ligaments
dizziness, nystagmus…

Question 5

What is Spurling’s test?

Answer 5

dysfunction/compression of cervical nerve root

laterall flex to each side, compress straight down

+pain/paresthesia in dermatomal pattern

Question 6

What is maximal compression test?

Answer 6

compression of neural structures at intervertebral foramen and/or facet joint

sitting, passively sidebend and rotate toward nonpainful side, followed by extension. Repeat on painful side.

+pain/paresthesia in dermatomal pattern fo involved nerve root
+local pain in neck at facet joint

Question 7

What is the distraction test of the cervical spine?

Answer 7

indicates compression of nerual structures at the intervertebral foramen or facet joint dysfunction

sitting, distract head passively

+decrease in symptoms in neck (facet)
+decrease UL pain (neuro condition)

Question 8

What is the shoulder abduction test?

Answer 8

indicates compression of neural structures within intervertebral foramen

sitting, patient places hand on top of head

+decrease symptoms in UL

Question 9

What is Lhermitte’s sign?

Answer 9

identifies dysfunction of spinal cord and/or UMN lesion

Long sitting, passively flex head and one hip while keeping knee extended.
Repeat other side

+pain down spine and into UL and LL

Question 10

What is the Romberg test?

Answer 10

identifies UMN lesion, balance

standing, EC 30 seconds

+excessive sway

Question 11

What is rib springing?

Answer 11

rib mobility

prone, begin at upper rips, apply post/ant force at each rib.
repeat in sidelying

+pain, excessive motion, or restriction

Question 12

What is thoracic springing?

Answer 12

AP glides to transverse processes

+pain, excessive motion, restriction

Question 13

What is the Slump test?

Answer 13

dysfunction of neuro structures supplying lower limb

sitting on edge of table
patient slumps, passively flex neck, extend one knee, DF ankle, repeat other side

+reproduction of pathological neuro symptoms

Question 14

What is the Lasegue’s SLR test?

Answer 14

dysfunction of neuro structures that supply LE

SLR until pain, slowly lower, passively DF ankle

+reproduction of pathological neuro symptoms when foot is DF

Question 15

What is the Babinski test?

Answer 15

UMN lesion

glide reflex hammer along plantar surface of patients foot

+extension of big toe and splaying of other toes

Question 16

What is the Quadrant test?

Answer 16

identifies compression of neural structures at intervertebral foramen and facet dysfunction

standing.
foramen - side bend, rotate same direction, extend
facet - side bend, rotate opposite, extend to compress facet joint
repeat on both sides

+pain/paresthesia in dermatomal pattern for involved nerve root
+localised pain in facet dysfunction

Question 17

What is the Stork test?

Answer 17

Spondylolisthesis

SLS, trunk extension, repeat on other leg

+pain in LB when ipsilateral leg on ground

Question 18

What is the McKenzie side glide test?

Answer 18

differentiates between scoliotic curve vs neuro dysfunction causing abnormal curve

performed when lateral shift of trunk is noted.
PT pulls pelvis to bring pelvis and trunk into proper alignment

+reproduction of neuro symptoms when trunk realigned

Question 19

What is the Bicycle / van Gelderen’s test?

Answer 19

differentiates between intermittent claudication vs spinal stenosis

ride bike slumped and erect until onset of pain

+stenosis when patient can ride longer slumped

Question 20

What is Gillet’s test?

Answer 20

assess posterior movement of ilium on sacrum

thumb on PSIS while standing, other thumb on center of sacrum
march or forward flex

+no movement of PSIS as compared to sacrum

Question 21

What is the Ipsilateral anterior rotation test?

Answer 21

assess anterior movement of ilium to sacrum

thumb under PSIS, other thumb on center of sacrum level with first thumb.
patient extends leg

+no movement of PSIS compared to sacrum

Question 22

What is Gaenslen’s test?

Answer 22

SIJ dysfunction

sidelying, bottom leg in max hip and knee flex
PT passively extends hip of upper leg

+pain in SIJ

Question 23

What is Goldthwait’s test?

Answer 23

differs lumbar spine vs SIJ dysfunction

supine, fingers between spinal process of lumbar spine. other hand passively performs SLR

+pain present prior to palpation of movement in lumbar segments = SIJ dysfunction

Question 24

What is TMJ compression test?

Answer 24

stabilise head with one hand. other hand pushes mandible superior, causing compressive load to TMJ

+pain in TMJ