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C/S special tests
| Question | Answer |
|---|---|
| Vertebral Artery test purpose | Assesses the integrity off vertebro-basilar vascular system |
| Vertebral Artery test description | With pt supine, examiner passively takes pt's head and neck into extension and side flexion. After this movement is achieved, the examiner rotates the pt's head to the same side and holds it for 30 sec |
| Vertebral Artery test results | Positive test provokes referring system if the opposite artery is affected |
| Hautant's test purpose | Differentiate dizziness or vertigo caused by articular problems from that caused by vascular problems |
| Hautant's test description | Pt sits & forward flexes both arms to 90. The eyes are then closed. Examiner watches for any loss of arm position. If arms move, the cause is nonvascular. Then rot or ext%rot neck, eyes closed, hold position. If arms waver. dysfunction is vascular. |
| Transverse ligament stress test purpose | test integrity of transverse ligament |
| Transverse ligament stress test description | Pt lies supine with head supported on table. Glide C1 anterior. Should be firm end feel. Position held for 10-20 sec to see whether symptoms occur, indicated a positive test. |
| Transverse ligament stress test results | Positive symptoms include soft end feel; m spasm; dizziness; nausea; paresthesia of lip, face, or limb; nystagmus, or lump sensation in the throat |
| Sharp purser test purpose | Determine subluxation of the atlas on the axis |
| Sharp purser test description | Examiner places 1 hand over pt's forehead while thumb of other hand placed over SP of axis to stabilize it. Pt asked to slowly flex the head; while this is occurring, the examiner presses backward with the palm |
| Sharp purser test results | Positive: examiner feels head slide backward during the movement. Slide backward indicates that the subluxation of atlas has been reduced, and the slide may be accompanied by a clunk, |
| Anterior shear test purpose | Test the integrity of the supporting ligamentous and capsular tissues of the cervical spine |
| Anterior shear test description | Pt lies supine with head in neutral, resting on the bed. Examiner applies an anterior force through posterior arch of C2 or SP of C2 to T1 or B through the lamina of each vertebral body. In each case, normal end feel is tissue stretch with an abrupt stop |
| Anterior shear test result | Positive signs, esp when upper C/S is tested, include nystagmus, pupil changes, dizziness, soft end feel, nausea, facial or ip paresthesia, and a lump sensation in the throat |
| Foraminal compression (Spurling's test) purpose | Identifies dysfunction (compression) of cervical nerve root |
| Foraminal compression (Spurling's test) description | Pt bends of side flexes the head to unaffected side first, followed by affected side. Examiner carefully presses straight down on the head |
| Foraminal compression (Spurling's test) result | Dermatome distribution of pain and altered sensation can give some indication as to which nerve root is involved |
| Maximal cervical compression test purpose | Identify compression or neural structures at intervertebral foramen of facet joint dysfunction |
| Maximal cervical compression test description | Pt side flexes head and rotates it to same side. The test is repeated to the other side. A positive test: pain radiates to arm. If head extends, side flex, and rot, and compression, intervertebral foramina close maximally. |
| Maximal cervical compression test result | extension, side flexion, and extension: if pain o concave side: nerve root or facet joint. Pain on convex side: muscle strain. |
| Distraction test purpose | identify compression of neural structures at intervertebral foramen or facet joint dysfunction |
| Distraction test description | Pt sitting and distract head passively |
| Distraction test result | Positive: decrease in symptom in neck (facet condition) or decrease in upper limb pain (neurological condition) |
| Shoulder abduction test purpose | Test for radicular symptoms, esp involving C4-C5 nerve roots |
| Shoulder abduction test description | Pt sitting/supine, and examiner passively or pt actively elevates arm through abduction so hand/forearm rests on top of hand |
| Shoulder abduction test results | Decrease or relief of symptoms indicates a cervical extradural compression problem, such as herniated disc, epidural vein comrpession, or nerve root compression, usually in C4-c5 OR c5-C6 area |
| Lhermitte sign purpose | Identifies dysfunction of spinal cord and upper motor lesion |
| Lhermitte sign description | Pt is in long sitting. Examiner passively flexes pt's head and one hip simultaneously with leg kept straight |
| Lhermitte sign result | Positive: sharp, electric shock-like pain down the spine and into upper or lower limbs; it indicates dural or meningeal irritation in the spine or possible cervical myelopathy |
Created by:
ecosio
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