Physical Medicine Part 1 Flashcards
What is the indication for use of Adson’s and Reverse Adson’s ?
TOS
What is a contraindication for Adson’s and Reverse Adson’s?
Dislocated shoulder
How is Adson’s and Reverse Adson’s (Halstead) performed?
Pt points arm away from body 45 degree angle. Dr. stands behind and takes both radial pulses simultaneously, while pt lat rotates and extends neck either direction for 30 sec. (Adson’s maneuver is performed in the arm pt looks towards, whereas Reverse Adson’s is performed in the arm pt looks away from)
What is the positive sign for Adson’s and Reverse Adson’s (Halstead)?
Disappearance of pulse (related to tight scalenes)
What is the indication for cervical spine compression (Spurling’s, Foraminal Compression) Test?
Nerve root symptoms
What is a contraindication for cervical spine compression?
If pain is elicited, do not proceed
What is the technique for performing cervical spine compression?
Press straight down on patient’s head: bend head laterally to each side w/compression down in each position; then w/ lateral bending and extension combined.
What are the 3 positive cervical spine compression test responses?
- Straight down, unilat pain = severe nerve root inflammation
- Side bend pain (on side of compression) = nerve root compression
- Side bend pain (opposite side of compression) = nerve root contraction
What is the indication for Cervical Spine Distraction Test?
Radicular symptoms
What is a contraindication for cervical spine distraction test?
If pain is elicited, do not proceed
What is the technique for the cervical spine distraction test?
Place one hand on each side of the pt’s face, use occiput and sides of head to pull upward on their head
How is the cervical spine distraction test interpreted?
Pain: ligament or non-contractile tissue injury
Relief of pain: Nerve root impingement
What is the indication for East (Roos) test?
Neurological deficit, restriction of arterial flow to the arm
What is the technique for East (Roos) test?
Pt abducts arm to 90 degrees and lat. rotates shoulder. Pt then flexes elbow to 90 degrees so they are behind the frontal plane. Open and close hands slowly for 3 minutes.
What is positive East (Roos) test?
Profound weakness of the arm w/numbness and tingling of the hand or inability to keep arm in starting position for 3 minutes.
What does a positive East (Roos) test indicate?
TOS on affected side
What is the indication for Soto-Hall test?
Neck pain
What is the technique for Soto-Hall test?
Pt supine, examiner puts pressure on pt’s sternum, then progressively flexes neck, moving chin toward sternum
What is a positive Soto-Hall test and what does it indicate?
Neck pain; indicates cervical discopathy or herniation, meningitis, or spurring or fraction of affected vertebra
What is the indication for the Shoulder Depression Test?
Brachial plexus lesions
What is the technique for the shoulder depression test?
Apply downward pressure to shoulder while flexing pt.’s head to opposite side
What is a positive shoulder depression test?
Increased pain = irritation or nerve root compression
What is the indication for Valsalva?
Determine effect of increased pressure on spinal cord
What is a warning for use of valsalva?
Pt may become dizzy or my LOC from restriction of blood flow to brain during the test