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Spinal Tx 600 > Special Tests > Flashcards

Special Tests Flashcards

1
Q

Distraction test

A

Tests for: nerve root symptoms

Seated.
Hand under chin and at occiput, or by ears. Slowly lift head.

Positive: radicular symptoms relieved or diminished

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2
Q

Traction Test

A

Tests for: pressure on nerve roots

Supine. Place hand on chin and occiput. Gently traction

Positive: symptoms alleviated.

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3
Q

Upper limb tension tests.

A

Test for test neurological tissue of the upper limb.

Four steps:

  1. Shoulder depression
  2. Shoulder abduction 10-110°
  3. Forearm, wrist, fingers taken to end range.
  4. Finally move elbow.
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4
Q

ULTT 1

A

Tests median nerve, anterior interosseus
C5-7

Abduction 110°
Supination
Extension: elbow, wrist, digits
Flexion:

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5
Q

ULTT 2

A

Median nerve, musculocutaneous nerve, axilllary nerve

Abduction 10°
Supination
Extension: elbow, wrist, digits
Flexion: –

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6
Q

ULTT 3

A

Radial nerve

Abduction 110°
Pronation
Extension: elbow
Flexion: wrist (with ulnar dev), digits

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7
Q

ULTT 4

A

Ulnar nerve, C8-T1

Abduction 10-90° (hand to ear)
Supination or pronation
Extension: wrist (with radial Dev), digits
Flexion: elbow

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8
Q

Bakody’s sign

A

AKA Relief test, Shoulder Abduction Test

Tests for: C4-5 or C5-6 nerve root involvement. Extradural compression problem.

Abduct arm, flex elbow, rest arm on head. Passive or active.

Positive: decrease in symptoms

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9
Q

If shoulder abdication test increases pain?

A

Pressure increasing in inter scalene triangle (TOS)

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10
Q

Scalene cramp test

A

Tests for scalene TrP
TOS

Seated
Rotates head to affected side, tucking chin into space behind clavicle

Positive: increased pain (IL scalene TrP); radicular signs (TOS)

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11
Q

Valsalva test

A

Tests for increased intrathecal pressure (space-occupying lesion – herniation, tumor, osteophyte)

Sit. Lean forward. Take deep breath and bear down.

Positive: increases pain

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12
Q

Tinel’s sign for brachial plexus lesion

A

Tests for brachial
Plexus lesion

Seated. Neck slightly side flexed.

Tap along nerve trunk.

Positive if:
Local pain –> underlying cervical plexus lesion
Tinel’s signs –> lesion intact and recovery occurring
Pain along peripheral nerve: neuroma and disruption of nerve continuity.

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13
Q

Tinel’s sign

A

Tingling in distribution pattern of peripheral nerve

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14
Q

Vertebral artery test

A

Tests for: vertebral artery compression (CL)

Supine.
Passively position head and neck into extension, side flexion, IL rotation.

Positive: dizziness, nystagmus

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15
Q

Anterior shear test

A

AKA sagittal stress test

Tests for: integrity of supporting ligaments, capsular tissues, of C spine.

Supine.
Apply anterior force through posterior arch of C1 and SP of C2-T1, or bilaterally through the laminar of each vertebral body b

Positive: nystagmus, pupil changes, dizziness, soft end feel, facial or lip paresthesia, lump in throat.

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16
Q

Transverse ligament stress test

A

Tests for: instability of the transverse ligament of C1

Supine
Support occiput. Place fingers in space between occiput and C2.
Lift head and C1 together. Hold for 10-20 seconds.

Positive: soft end feel, muscle spasm, dizziness, nausea, paresthesia of lip, face or limb, nystagmus, lump in throat.

*some discomfort normal

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17
Q

Tests for cervical instability

A

Anterior shear
Transverse ligament stress test
Lateral shear test
Alar ligament test

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18
Q

Lateral shear test

A

Tests for: instability of atlanto-axial joint

Supine.
Use radial side of 2nd MCPs to push TVPs of C1 and C2 across each other

Positive: excessive movement

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19
Q

Alar ligament test

A

Tests for integrity of alar ligament

Supine
Stabilize axis around SPs or TVPs. Attempt to side flex head and axis

Positive: excessive side flexion (a little flexion with strong capsular end feel normal).

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20
Q

Swallowing test

A

Tests: if SCM TrPs at the cause of pain while swallowing

Seated.
Pincer grasp SCM. Locate and apply firm pressure to most tender point.
Swallow.

Positive: pain diminishes

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21
Q

Rib motion test

A

Rib depression/elevation.

Assess upper middle lower ribcage during inhalation and exhalation

Rib stops moving earlier/moves less during inhalation: depressed

Rib stops moving earlier/moves less during exhalation: elevated

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22
Q

Costovertebral expansion test

A

Tests for costovertebral joint movement; rib motion

Place tape around 4th intercostal space. Or axilla (apical), nipple line (xiphisternal) and tenth rib (lower thoracic)

Inhale and exhale.

Normal: 3-7.5 cm difference.

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23
Q

Testing mobility of rib relative to thoracic vertebra

A

One thumb on TVP, one thumb on ribs.

Forward flex head or thorax.

Normal: rib rotates anteriorly and tubercle stays at same level of TVP.

If rib elevates relative to TVP: hypermobile

If rib movement stops before Tspine: hypomobile.

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24
Q

Skyline test

A

Tests for structural scoliosis

Forward flexion. Observe from behind.

Look for hump on convex side and hollow on concave side.

If hump decreases with flexion: functional

Increased angulation: structural kyphosis

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25
Prone extension
If kyphosis remains --> structural.
26
Spurlings test
AKA foraminal compression test Tests for: cervicular radiculitis ``` Client laterally flexes head to unaffected side Compress in neutral Compress in extension Compress in extension and rotation Repeat on affected side Stop if there's pain ``` Positive: radiating pain down IL arm (along dermatome)
27
Scapula approximation test
Tests for: IL T1/T2 nerve root problems Prone. Passive approximation of scapula Positive: pain in scapular area Tingles: TOS
28
First thoracic nerve root stretch
Tests for: T1 nerve root issues Seated. Passive abdication, external rotation, elbow flexion. Apply over pressure. Positive: ulnar nerve pain
29
Rib springing
Tests: quality of movement Prone. Hands at costotransverse junction. Anterior pressure on outbreath Uni or bilateral.
30
Quadrant test
AKA: kemp's test Tests for: facet lock/nerve irritation in the lumbar spine. Narrows intervertebral foramen Standing. Examiner behind, holding shoulders. Applies overpressure. Guide into spinal extension, lateral flexion, rotation to side of pain. Positive: local pain (facet lock); reproduction of neurological symptoms
31
Segmental instability test
Tests for lumbo-pelvic instability (spondylolisthesis) Prone, torso on table, feet on floor. Pressure to posterior lumbar spine or to a specific SP. lifts legs. Positive: pain with pressure that is relieved when legs lift.
32
Dural slump test
Tests for: mechanical movement of neurological tissue ``` Seated. Hands behind back. Slumps with chin in neutral Overpressure on shoulders. Cervical flexion Knee extension; passive dorsiflexion Overpressure to c-spine. Cervical extension. ``` Stop when symptoms reproduced. Positive: reproduction of symptoms.
33
Straight leg raising test
AKA Lasegue's test Tests for: SI joint integrity; disc herniation and/or peripheral nerve involvement; Dura mater or spinal cord lesion Supine. Move leg into hip flexion, medially rotation, adduction; keep knee extended. If pain reproduced, decrease hip flexion until better. Active cervical flexion Passive dorsiflexion. ``` Positive: pain at 70°; neurological symptoms in back (disc herniation), posterior thigh (peripheral nerve) or both. Increased pain (dura mater/spinal cord lesion). ```
34
Lasegue's sign
Finding of pain when unaffected leg is tested. Indicates large disc protrusion medial to nerve root.
35
SLRT: degrees of flexion
0-35°. Slack in sciatic arborization. No dural movement. 35° sciatic nerve tensioned 35-70°. Sciatic roots tense over IVD. Rate of deformation decreases as angle increases. 70° no further deformation of roots. Pain is probably joint pain.
36
Bowstring sign
Test for: pressure on sciatic nerve after positive SLR Supine. Knee slightly flexed (20°) Thumb/finger pressure to popliteal area. Positive: reproduction of radicular symptoms.
37
Well leg raising test
Tests for: space occupying lesion medial to nerve root. SLR test in which unaffected leg is lifted Positive: radicular signs in affected leg (which is still on table)
38
Malingering test
AKA Hoover test Tests for: malingering Supine. Hands each under calcaneus. Ask client to lift one leg, keeping knees extended. Positive: no pressure is felt under opposite heel even though they say they're attempting to lift leg.
39
Babinski test
Tests for: UMN or LMN lesion Run pointed object along sole of foot Positive: extension of big toe and splaying of other toes. BL: UMN. Unilateral: LMN
40
Brudzinski-Kernig test
Tests for: meningeal irritation, dural irritation, nerve root involvement. Supine: flex neck (chin to chest) -- Brudzinski Flex hip with knee extended -- Kernig Positive: neck/LB discomfort, relieved by knee and or hip extension LB/neck/head pain relieved by knee flexion
41
Nachlas test
Tests for L2-3 nerve root lesion (femoral) Prone. Flex knee for 45-60 seconds Avoid hip rotation Positive: unilateral neurological pain in lumbar area, buttock, or posterior thigh.
42
Mckenzie's slide/glide test
Tests for: ? Use shoulder to block lower thorax while pulling pelvis. Positive increased neurological symptoms. If evident scoliosis, test convex side first. Also tests if Sx causing the scoliosis.
43
Trendelenberg test
Tests for weakness of hip abductors (esp glute med) Stand on one leg. Positive: hip drops or lifts too much. Test is for stance leg not lifted leg.
44
Stork standing test
Tests for: integrity of pelvic joints; stability and proprioception Stand in tree pose. Positive: pain or inability to obtain test position (joints); difficult balancing
45
Flamingo test
Tests for: lesions in pubic symphysis or SI joint. Stand on one leg. Lifted leg barely above ground. Positive: pain in pubic symphysis or SI joint.
46
Gillet's test
AKA sacral fixation test AKA ipsilateral posterior rotation test Tests for: hypomobile SI joint Standing One thumb on PSIS of test leg, the other parallel on sacrum. Flex test leg. Positive: PSIS moves minimally or upwards
47
Ipsilateral anterior rotation test
Tests for; SI joint hypomobility. Standing Thumb on PSIS of test side. Other thumb parallel on sacrum. Extend leg. Positive: PSIS doesn't move, or moves inferiorly
48
Ipsilateral prone kinetic test
Tests for: SI joint hypomobility; possible posterior rotation or outflare Prone. Thumb on PSIS, other parallel on sacrum. Extend same side hip. Positive: PSIS doesn't move or moves inferiorly.
49
Squish test
Tests for: Posterior sacroiliac ligament integrity Prone. Place hands on ASISs/iliac crests. Pressure down and medially 45° Positive: pain
50
Gapping test
AKA Transverse anterior stress test Tests for: integrity of anterior stress test Supine. Hands crossed, places on ASISs. Pressure down and out. Positive: pain -- unilateral glute or posterior leg.
51
Thomas test
Tests for: contraction of hip flexors. Supine, one leg flexed to chest. Positive: Hip flexor: thigh off table Rectus femoris: knee extended past 90° ITB:J sign. Leg abducts.
52
Obers test
Tests: TFL and ITB contracture Side lying. Pelvis stabilized. Passively extend and abduct hip (so ITB passes over greater trochanter) Slowly lower. Positive: leg remains abducted Tenderness over greater trochanter: trochanteric bursitis Neurological signs when knee flexed: femoral nerve path.
53
Piriformis test
Tests for short and tighten piriformis. Piriformis syndrome. Side lying. Stabilize pelvis. Flex test hip TO 60° (not 45, not 90) with knee flexed and apply downward pressure. Positive: pain in piriformis. Pain in buttock wth sciatic paresthesia.
54
Faber Test
AKA Figure 4, Patrick's, Jensen's Tests for: hip joint pathology, iliopsoas spasm, SI joint involvement Supine. Place in figure 4 position. Positive: knee remains above opposite leg.
55
Sacroiliac Rocking Test
AKA knee to shoulder test AKA sacrotuberous ligament stress test Tests for: SI joint and sacrotuberous ligament integrity Supine. Flex knee and hip fully. Addict hip. Rock SI joint by flexion/abduction of hip towards opposite shoulder. May also Palpate sacrotuberous ligament. Positive: pain in SI joint. Ligament tender to palpation.
56
Scouring test
AKA quadrant test Supine Passively flex knee and hip. Adduct hip to resistance. Maintain resistance and take hip into abduction. Positive: irregular/bumpy movement
57
What are the two quadrant tests?
Scouring (for SI joint integrity) Kemp's (for lumbar facet lock, nerve root)
58
Femoral shear test
Tests for: SI joint Supine. Passive hip flexion (slight), abduction, lateral rotation 45° from midline. Apply compressive force through long axis of femur. Palpate PSIS for movements Positive: SI jt pain or discomfort.
59
Ely's test
Tests for: short and tight rectus femoris Prone. Passive knee flexion. Positive: hip flexion
60
Hibb's test
AKA Prone gapping test Tests for: integrity of posterior SI ligaments. Also symmetry and movement. Prone. Stabilize pelvis. Flex knee to 90°. Medially rotate to end range. Palpate SI joint for degree of opening, quality of movement. Positive: SI pain. Asymmetrical movement.
61
Yeoman's test
Test for: SI jt Prone. Passively flex knee to 90°. Extend hip. Positive: localized SI joint pain. Lumbar pain. Anterior thigh paresthesia.
62
Superoinferior symphysis pubic stress test
Tests for pathology of public symphysis, integrity of joint Supine. Place heel of one hand over superior pubic ramus of one pubic home and inferior ramus of the other. Shear Positive: pain
63
Gaenslen's test
Tests for: SI joint integrity Side lying. Lower leg flexed to chest. Test leg extended. Positive: Pain in SI joint Alternative: client can test self in a diagonal Thomas position
64
Supine to Sit
Tests for functional leg length discrete. Rotation/torsion Supine. Sit. Short to long: post rotation (SLOP) Long to short: anterior rotation.
65
Chvostek
Tests for: pathology of CN VII (facial) Tap parotid gland overlying masseter muscle. Positive: facial twitch
66
Jaw Reflex test
Tests for: pathology of CN V Place fingers or thumb on chin. Use reflex hammer to tap. Positive: mouth/jaw closes.
67
In transverse ligament stress test, anterior force is applied to the TVP of:
C1

Spinal Tx 600 (9 decks)

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