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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
Q

Prone extension

A

If kyphosis remains –> structural.

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26
Q

Spurlings test

A

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)

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27
Q

Scapula approximation test

A

Tests for: IL T1/T2 nerve root problems

Prone. Passive approximation of scapula

Positive: pain in scapular area

Tingles: TOS

28
Q

First thoracic nerve root stretch

A

Tests for: T1 nerve root issues

Seated. Passive abdication, external rotation, elbow flexion. Apply over pressure.

Positive: ulnar nerve pain

29
Q

Rib springing

A

Tests: quality of movement

Prone. Hands at costotransverse junction. Anterior pressure on outbreath

Uni or bilateral.

30
Q

Quadrant test

A

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
Q

Segmental instability test

A

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
Q

Dural slump test

A

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
Q

Straight leg raising test

A

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
Q

Lasegue’s sign

A

Finding of pain when unaffected leg is tested.

Indicates large disc protrusion medial to nerve root.

35
Q

SLRT: degrees of flexion

A

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
Q

Bowstring sign

A

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
Q

Well leg raising test

A

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
Q

Malingering test

A

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
Q

Babinski test

A

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
Q

Brudzinski-Kernig test

A

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
Q

Nachlas test

A

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
Q

Mckenzie’s slide/glide test

A

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
Q

Trendelenberg test

A

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
Q

Stork standing test

A

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
Q

Flamingo test

A

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
Q

Gillet’s test

A

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
Q

Ipsilateral anterior rotation test

A

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
Q

Ipsilateral prone kinetic test

A

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
Q

Squish test

A

Tests for: Posterior sacroiliac ligament integrity

Prone. Place hands on ASISs/iliac crests. Pressure down and medially 45°

Positive: pain

50
Q

Gapping test

A

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
Q

Thomas test

A

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
Q

Obers test

A

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
Q

Piriformis test

A

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
Q

Faber Test

A

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
Q

Sacroiliac Rocking Test

A

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
Q

Scouring test

A

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
Q

What are the two quadrant tests?

A

Scouring (for SI joint integrity)

Kemp’s (for lumbar facet lock, nerve root)

58
Q

Femoral shear test

A

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
Q

Ely’s test

A

Tests for: short and tight rectus femoris

Prone. Passive knee flexion.

Positive: hip flexion

60
Q

Hibb’s test

A

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
Q

Yeoman’s test

A

Test for: SI jt

Prone.
Passively flex knee to 90°. Extend hip.

Positive: localized SI joint pain.
Lumbar pain. Anterior thigh paresthesia.

62
Q

Superoinferior symphysis pubic stress test

A

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
Q

Gaenslen’s test

A

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
Q

Supine to Sit

A

Tests for functional leg length discrete. Rotation/torsion

Supine. Sit.

Short to long: post rotation (SLOP)
Long to short: anterior rotation.

65
Q

Chvostek

A

Tests for: pathology of CN VII (facial)

Tap parotid gland overlying masseter muscle.

Positive: facial twitch

66
Q

Jaw Reflex test

A

Tests for: pathology of CN V

Place fingers or thumb on chin. Use reflex hammer to tap.

Positive: mouth/jaw closes.

67
Q

In transverse ligament stress test, anterior force is applied to the TVP of:

A

C1

Spinal Tx 600 (9 decks)

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