MSK Special Tests Spine, Pelvis, TMJ Flashcards
What is the vertebral artery test?
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
What is Hautant’s test?
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
What is transverse ligament stress test?
integrity of transverse lig
supine, glide C1 ant
+dysfunction is soft end feel, dizziness, nystagmus, lump sensation in throat, nasuea
What is anterior shear test?
supine, glide C2-7 ant.
+dysfunction laxity of ligaments
dizziness, nystagmus…
What is Spurling’s test?
dysfunction/compression of cervical nerve root
laterall flex to each side, compress straight down
+pain/paresthesia in dermatomal pattern
What is maximal compression test?
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
What is the distraction test of the cervical spine?
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)
What is the shoulder abduction test?
indicates compression of neural structures within intervertebral foramen
sitting, patient places hand on top of head
+decrease symptoms in UL
What is Lhermitte’s sign?
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
What is the Romberg test?
identifies UMN lesion, balance
standing, EC 30 seconds
+excessive sway
What is rib springing?
rib mobility
prone, begin at upper rips, apply post/ant force at each rib.
repeat in sidelying
+pain, excessive motion, or restriction
What is thoracic springing?
AP glides to transverse processes
+pain, excessive motion, restriction
What is the Slump test?
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
What is the Lasegue’s SLR test?
dysfunction of neuro structures that supply LE
SLR until pain, slowly lower, passively DF ankle
+reproduction of pathological neuro symptoms when foot is DF
What is the Babinski test?
UMN lesion
glide reflex hammer along plantar surface of patients foot
+extension of big toe and splaying of other toes
What is the Quadrant test?
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
What is the Stork test?
Spondylolisthesis
SLS, trunk extension, repeat on other leg
+pain in LB when ipsilateral leg on ground
What is the McKenzie side glide test?
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
What is the Bicycle / van Gelderen’s test?
differentiates between intermittent claudication vs spinal stenosis
ride bike slumped and erect until onset of pain
+stenosis when patient can ride longer slumped
What is Gillet’s test?
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
What is the Ipsilateral anterior rotation test?
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
What is Gaenslen’s test?
SIJ dysfunction
sidelying, bottom leg in max hip and knee flex
PT passively extends hip of upper leg
+pain in SIJ
What is Goldthwait’s test?
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
What is TMJ compression test?
stabilise head with one hand. other hand pushes mandible superior, causing compressive load to TMJ
+pain in TMJ
