Special tests

Question 1

When do you perform the Spurling test?

Answer 1

• if patient has a suspected nerve root symptoms
• test designed to provoke symptoms
• test is positive if pain is reproduced on the original AFFECTED side

Question 2

What are the four stages of the spurling test?

Answer 2

1) compression with head in neutral
2) compression with head in extension
3) compression with head in extension and rotation to the unaffected side
4) compression with head in extension and rotation to the affected side

Question 3

What is positive if it is reverse spurling?

Answer 3

pain is present in the UNAFFECTED side

Question 4

If reverse spurling is positive, what is it a tell tale sign for?

Answer 4

• a muscle spasm

- from tension myalgia and whiplash

Question 5

How do you perform the Cervical distraction test?

Answer 5

-one hand cradling the occiput
-one hand cradling the chin
-apply a traction force
(make sure patient is in supine)

Question 6

What determines a positive test for the cervical distraction test?

Answer 6

if symptoms reduce during testing

Question 7

With what patients is sensation deficits common in?

Answer 7

patients with muscle weakness and impairments

Question 8

What are the different ways to test for sensory testing?

Answer 8

• light touch
• monofilament testing
• vibratory sensation
• proprioception

Question 9

How is sensory testing directed or determined?

Answer 9

• patient’s history

- numbness, tingling, pins, and needles

Question 10

How do you perform the sensory tests?

Answer 10

• patient is comfortable
• vision is obscured
• explain test
• start in areas of impairment or absent sensation and progress toward normal

Question 11

What does the slump test test for?

Answer 11

neurological test for the lower limb

Question 12

What is step one of the slump test?

Answer 12

• patient asked to sit in a slumped position

- spine flexed and shoulders sag forward & and hold patients chin and head erect

Question 13

What is step two of the slump test?

Answer 13

-use one arm to apply overpressure across the shoulders

Question 14

What is step three of the slump test?

Answer 14

ask patient to actively flex cervical spine

Question 15

What is step four of the slump test?

Answer 15

apply over pressure to spine

Question 16

What is step five of the slump test?

Answer 16

extend knee, while holding cervical spine in flex

Question 17

What is step six of the slump test?

Answer 17

hold knee in extension and add ankle dorsiflexion

Question 18

What is step seven of the slump test?

Answer 18

patient will extend head, should relive symptoms

Question 19

How should the patient be positioned for the slump test?

Answer 19

patient sits on exam table, hands behind back and feet unsupported

Question 20

With the slump test, if symptoms reproduce at stage 3, do you continue on to stage 4?

Answer 20

no, the test is positive at stage three so you don’t need to go further

Question 21

With the centralization test, if a patient has difficulty right side bending how would you perform the test?

Answer 21

Have patient left side bend

Question 22

How many times should the patient repeat the movement for the centralization test?

Answer 22

5-20 times

Question 23

How should the patient be positioned for the centralization test?

Answer 23

either standing or in prone

Question 24

How do you perform the trendelenburg test/sign? What is it testing for? What determines a positive test?

Answer 24

• Have patient stand on one leg and non stance leg drops down
• tests for hip abductors
• positive if hip drops

Question 25

What patents is peripheral neuropathy common in?

Answer 25

diabetic patients

Question 26

What size of monofilament do you start with?

Answer 26

10g

Question 27

What location/s do you do the light and sharp touch?

Answer 27

you follow the dermatomes

Question 28

What location/s do you do the hot and cold sensation?

Answer 28

you follow the dermatomes

Question 29

What locations do you do the monofilament testing?

Answer 29

• bottom of foot
• plantar surface of great toe
• 3rd metatarsal head
• 5th metatarsal head

Question 30

What locations do you do the vibratory sensation tests?

Answer 30

bony prominences

Question 31

Why would you perform the vibration test?

Answer 31

used to screen for peripheral neuropathy and identify patients rights of developing foot complications

Question 32

Where do you start and move to for proprioception testing?

Answer 32

• great toe> ankle> knee

- move distal to proximal