Unit 3 Week 10 Lab (Spinal Red Flags)

Question 2

what are the precautions/contraindications for spinal mobilizations?

Answer 2

vertebrobasilar artery insufficiency
ligament instability (alar of transverse)
myelopathy
cauda equina syndrome
General: osteoporosis, bone and joint disease, fracture, pregnancy

Question 3

what subjective questions should you ask to look for red flags?

Answer 3

have you had any of the following: dizziness, drop attack, dysphagia, dysarthria, dipoplia?
are upper extremity symptoms bilateral?
are you having trouble walking, clumsiness, or lack of coordination?
is there a history of trauma?
is there a position or activity that makes it worse or better; or is pain constant an unchanged by position/activity?

Question 4

what are the signs of cervical myelopathy?

Answer 4

hyper-reflexive UE reflexes
upper motor neuron signs (hoffman’s sign, babinski’s reflex, clonus)
L’hermitte’s sign

Question 5

what is a positive hoffman’s sign?

Answer 5

flexion of the thumb IP joint

Question 6

what is a positive babinski’s sign?

Answer 6

splaying of toes, extension of great toe

Question 7

what is a positive finding of clonus?

Answer 7

the patient’s foot kicks back in a repeating jumpy pattern

Question 8

what is a positive L’hermitte’s sign?

Answer 8

an electrical sensation in the midline (occasionally to extremities)

Question 9

what two tests test for cervical instability?

Answer 9

modified sharp-purser’s test (transverse ligament) and alar ligament test

Question 10

what is a positive alar ligament stress test?

Answer 10

failure to feel movement
if the ligament is intact you will feel movement of the C2 pushing into finger/thumb

Question 11

what is a positive finding of the modified sharp-purser test?

Answer 11

feel for head to slide backwards

Question 12

what are the VBI signs?

Answer 12

5Ds and 3Ns
dizziness, drop attacks, diplopia, dysarthria, dysphagia, nausea, numbness, nystagmus