Spine Screen Flashcards
what is the typical flow of a spinal screen
observation
AROM
PROM/Overpressure
provocative testing
what can AROM tell us through observation
can be helpful to see compensations above/below joints
what are the cervical provocative tests
spurling’s
upper limb tension test of median
PA joint glide
provocative tests of the lumbar spine
quadrant test
limb tension SLR
PA jt glides
what descriptors are associated with AROM
quality
quantity
reactivity
what is important to remember when asking for AROM
all planes of motion need to be tested at the jt
main difference between PROM and Overpressure
P = taking out as much of the active component as possible
O = applying pressure beyond end range
where is overpressure applied? what does this help for?
end ROM
- assess end feel
when doing overpressure, what are we looking for
symptom reproduction
when are cervical special tests indicated
any pt with neck or UE symptoms
- need to rule in
describe spurling’s A vs B test
A - lateral flexion toward affected
B - lateral flexion toward affected / upward rotation away from affected
if a patient has high irritability, what is important to keep in mind when “clearing” the spine
may not need much to provoke symptoms, therefore positioning and light pressure may induce symptoms
what is important to remember about distraction test
must have resting symptoms or symptoms must have been provoked to see a positive
- cannot see if test causes a reduction of symptoms without any current symptoms
what is a positive on the cervical rotation test?
<60 deg
- decreased ipsilateral to affected side
why is the median tested in an UL tension test
has more nerve roots tested
if a patient feels nothing during neurodynamic testing, what does that indicate?
positioning may be off
pt should still feel a sensation near end ROM, without neuropathic issues
what is important to remember when doing PA jt provocation
curve of spine at different areas, need to press from P to A in line with the joint
cervical = kyphotic
lumbar = lordotic
SLR to test peroneal nerve
Peroneal
Inversion
Plantar Flexion
SLR to test tibial nerve
Tibial
Eversion
Dorsiflexion
SLR to test sural nerve
Sural
Inversion
Dorsiflexion
explain spurling’s test
- positioning
- protocol
- what a positive indicates
patient seated, head laterally flexed to affected side, over pressure is applied
reproduction of symptoms indicates a positve
- used in cervical radiculopathy cluster
explain cervical distraction test
- positioning
- protocol
- what a positive indicates
patient either seated or in supine, therapist behind or at the top of the head
grasp under pt’s occiput and apply upward distracting force
positive = elimination of patient symptoms indicating a compression within the c-spine
explain ULTT median
- positioning
- protocol
- what a positive indicates
patient supine with arm off of mat, therapist in between outstretched arm and mat
abduction with block of scapula
external rotation at shoulder
supinate elbow
extend wrist / abducting and extending thumb
– extension of elbow looking for tension or symptom reproduction
– will sensitize by laterally flexing neck away (worse) and towards (better)
positive = if symptoms are felt and sensitized
explain PA joint provocation
- positioning
- protocol
- what a positive indicates
patient prone with therapist on a side
find spinous process of lumbar or cervical spine
place thumbs laterally on each side
apply resistance level 1/2 and assess pain-spasm
compare unilaterally
