02 C-spine Lecture Special Tests Flashcards Preview

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Flashcards in 02 C-spine Lecture Special Tests Deck (44):
1

Tests for ligament instability and vascular

1. Sharp-Purser
2. Alar Ligament (occipital part)
3. Vertebral Artery test

2

Which tests for ligament instability are used if there's been trauma to the neck?

- Sharp-Purser
- Alar Ligament

3

What is the Sharp-Purser test testing?

integrity of the transverse ligament

4

Symptoms that may indicate Sharp-Purser test

dizziness
headaches
extreme pain

5

What type of test is Sharp-Purser?

relocation: trying to move C1 back on C2 to see if it removes symptoms

6

What should you do if someone is + for the Sharp-Purser test?

- must be very careful
- need to get them to a physician with recommendation for over mouth radiograph
- won't see this often

7

vertebral artery test
controversy: reason for

make sure arteries are doing their jobs before putting them in an end range position

8

vertebral artery test
controversy: reason against

- must put them in end ROM to actually do the test
- some likelihood of causing a stroke

9

What are the 5 D's?

- dizziness
- diplopia (double vision)
- dysphagia (difficulty swallowing)
- dysarthria (difficulty speaking)
- drop attacks (fainting)

**These are possible indications of insufficiency**

10

nystagmus

when eye goes to the corner and beats

11

In the vertebral artery test, if you're turning the head to the right, which artery are you testing?

left

12

General guideline for who needs the vertebral artery test

If the pt has the 5D's, do it. If not, it may not be necessary

13

What is the gold standard for diagnosis of VBI?

doppler ultrasound

14

During the VBI test, how far off the table does the pt need to be and why?

- if arms are off the table at 90˚ abduction
- Won't reach full extension if they're not off the table far enough

15

disc and nerve root tests

1. Compression
2. Distraction
3. Spurling
4. Repeated protrusion
5. Repeated retraction

16

Why is axial compression used to detect radiculopathy?

If you add axial compression, it will produce radicular symptoms down the arm if the nerve is irritated

17

How long should you hold for the axial compression test?

6 seconds

18

What is the purpose of the Spurling test?

corroborative test for compression

19

If you have a positive compression test, you should move on to ________

Spurling test

20

repeated tests are related to

"specific exercise"

21

reps for repeated protrusion and retraction tests

10 reps
see if distal symptoms are reproduced

22

For repeated protrusion and retraction tests, what does it mean if the symptoms are further away from midline?

the nerve is more irritated

23

What does retraction do the neck?

brings it out of lordosis

24

Which discs are the most commonly implicated in pathology?

C5/6
C6/7

25

If you have a positive compression test, what does this mean with respect to Spurling's test?

it's automatically positive

26

Disc and nerve root tests are for what type of symptoms?

radicular

27

ULTT: how many?

4

28

ULTT tests for what type of symptoms?

radicular

29

ULTT
What are you essentially doing for these?

- taking the nerve, putting pressure on it (stretching)
- see if it gets irritated

30

When should you stop the ULTT?

- when the symptoms are reproduced
- not necessarily going through the whole sequence

31

Which nerve are you testing?
ULTT1

median (anterior interosseous n.)

face the patient

32

Which nerve are you testing?
ULTT2

median n.

face away

33

Which nerve are you testing?
ULTT3

radial n.

face away

34

Which nerve are you testing?
ULTT4

ulnar n.

face the patient

35

What are the cervical stabilization tests?

1. Cranial cervical flexion test (CCFT)
2. Deep neck flexor endurance test

36

During the CCFT, why do you need to make sure you only use the upper cervical nod?

- want to get to deep neck flexors
- will activate the SCM if you flex completely

37

upper cervical mobility test

Cervical flexion-rotation test

38

purpose of the cervical flexion-rotation test

- bilateral comparison
- lead you to think manual therapy would be an appropriate trx if more than 10˚ asymmetry corresponds to headaches on the affected side

39

Tests for thoracic outlet syndrome

1. Adson Maneuver
2. Wrights Maneuver/Hyper-abduction
3. Capillary refill
4. Roos test

40

most important thing to remember with respect to thoracic outlet syndrome

ALWAYS 100% work proximal to distal
= clear the c-spine FIRST!

Only when you rule out c-spine as the culprit can you move on to thoracic outlet tests.

41

What nerve is commonly involved in thoracic outlet syndrome?

ulnar nerve - get symptoms in ulnar distribution

42

Which is a better indication of a positive in the Adson Maneuver?

reproducing symptoms (50% of patients get reduction in pulse)

43

capillary refill test
purpose

- more generalized usage for looking at vascular compromise in UE
- pts with shoulder surgeries

44

most commonly done special test for thoracic outlet syndrome

Roos test
this one is GOD AWFUL