Special Orthopedic Tests : Cervical Spine

Question 1

Scalene Cramp Test

Answer 1

Process :
- Client seated, rotates head & pulls chin into hollow above clavicle
+ve Sign :
- Pain increases in scalene TrP distribution
+ve Indicates :
- Scalene TrP

Question 2

Vertebral Artery (Cervical Quadrant) Test

Answer 2

Process :
1. Client supine
2. Examiner passively extends, laterally flexes & then rotates neck to same side
3. Hold for 30 seconds
+ve Sign : Dizziness, nystagmus, nausea, dysarthria, sensory changes, nausea
+ve Indicates : Opposite side artery compromised

Question 3

Lateral Flexion Alar Ligament Stress Test

Answer 3

Process :
1. Client supine, examiner stabilizes axis via wide pinch grip around SP & lamina
2. Attempts to laterally flex head & axis
+ve Sign : Excessive movement
+ve Indicates : Alar ligament damage, cervical instability

Question 4

First Rib Mobility Test #1

Answer 4

Process :
1. Client supine and takes deep breaths
2. Examiner palpates 1st rib bilaterally & notes movement of both ribs & any symmetry
+ve Sign : Asymmetry
+ve Indicates : 1st rib hypomobility or hypertonic scalenes on same side

Question 5

First Rib Mobility Test #2

Answer 5

Process :
1. Client prone
2. Examiner palpates the first rib using the thumb, reinforced by the other thumb, the examiner pushes the rib caudally, noting the amount of movement, end feel and presence of pain
3. The other first rib is tested in a similar fashion, and the two sides are compared
+ve Sign : Asymmetry, pain, reduced movement
+ve Indicates : 1st rib hypomobility or hypertonic scalenes on same side

Question 6

Kemp’s Test

Answer 6

Process :
1. Client seated, extends & rotates head and neck
2. Examiner passively carefully presses straight down on head
+ve Sign : Local, sharp, stabbing pain on test side
+ve Indicates : Facet joint irritation/restriction