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Ortho tests > Cervical > Flashcards

Cervical Flashcards

1
Q

What does Spurlings

A

Local strain/sprain, Jt damage, facet irritation, cervical subluxation

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2
Q

Spurlings techniques

A

Rest elbows on shoulders
Apply force down
R + slight SB (don’t continue if pain)
+ E to unaffected side + comp
+ E to affected side + comp

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3
Q

+ve test for Spurlings

A

Radicular P and/or altered sensation in dermatomal distribution

Local neck pain- not +ve
Indicative of local sprain/strain, Jt damage, facet lock, mensicoid entrapment, cervical subluxation

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4
Q

Specificity of Spurlings

A

92%

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5
Q

Sensitivity of Spurlings

A

77%

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6
Q

What does Jacksons compression test for

A

Increased pressure on nerve roots, DJD, osteophytes, radiculopathy

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7
Q

Technique of Jacksons test

A

Pt rotate head to one side
Apply force down on head
Repeat with head rotated to other side

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8
Q

+ve Jacksons test

A

Peripheral P and/or altered sensation (radiation down arm- dermatomal)

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9
Q

What does distraction test for

A

Muscle, ligament, or capsule
Increased pressure on nerve roots
Facet irritation, DJD

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10
Q

Distraction technique

A

Cup chin, support occiput Lift head

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11
Q

+ve test for distraction

A

Inc local P- muscle, lig, Jt capsule damage
Dec peripheral P/numbness- decreased pressure on nerve root (relief)
Dec local P- facet impingmenet, DJD

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12
Q

-ve test for distraction

A

P, muscle spasm, ligament strain, muscle strain, Dura irritability, disc herniation

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13
Q

Lateral stability stress test of atlanto-axial Jt

A

Pt supine
Support occiput and left side of arch of atlas
= Lateral shear of atlas and occiput on axis to the right
Repeat on the other side
Excessive movement, and reproduction of symptoms suggests lateral instability of this Jt

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14
Q

Anterior translation stress of atlas on axis

A
  • Pt supine
  • Fix C2
  • Using thumb pressure over ant aspects of TP, lift head and atlas vertically
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15
Q

Csp instability clearing Qs

A
  • H/As?
  • Feeling like you need to hold your head up?
  • Reluctance to move head?
  • 5Ds, 3Ns, A
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16
Q

Improved neck exam

A

Palpation- bumps which are not tender indicate long term injury
Tenderness= inc inflammation/recent injury (fibrosis)- thickening/scarring of tissue
AROM- hold to allow tissue to relax

17
Q

PROM neck

A

o Flx- C2/3- just roll head (double chin). C3 onwards= normal. Look for deviation to either side
o Ext- relative to Flx
o SB- Go between sides, and palpate articular pillar/post-lat masses. C2/3 is slight. C3 onwards aplly slight Flx to counteract spinal mechanics
o Rot- pivot hand

18
Q

Adsons test

A

Vascular TOS
Abduct arm 30, maximally extend
See if radial pulse diminshes
Lacks inter-rater reliability

19
Q

Bikeles

A

Neurogenic TOS
Active test to bring on P+Ns
Wrap fingers round neck, full extension
Tagrtes median nerve
When symptoms felt, bring ear to shoulder- ask if there are any changes (should reduce P)

Not very useful as TOS mainly affects ulnar nerve

20
Q

+ve Bikeles

A

Reproduction of radicular symptoms –> N root tension, brachial plexitis, possibly meningitis

21
Q

Radial N test

A

Hand by side
Upper side of palm facing floor

22
Q

Ulnar N

A

Same as bikeles but palm faces up not around neck

23
Q

Brudzinskis sign set up

A

Pt supine with legs straight, examiner flexes Pts head and neck

24
Q

Brudzinskis interpretation

A

Involuntary hip and knee flexion –> meningeal irritation/inflammation (meningitis)

25
Q

L’Hermittes sign

A

Pt may be seated or supine
Pts head is passively flexed forward
Examiner may apply gentle pressure
Essential PROM with slight pressure

26
Q

L’Hermittes interpretation

A

Reproduction of radicular symptoms (sharp, shooting down spine or extremities) –> cervical radiculopathy

27
Q

Vertebralbasilar artery function test

A

Pt seated, eyes open, examiner does the following:
1. Observation for carotid or subclavian pulsations
2. Auscultations for bruits
3. Palpation with Pt rot and Ext head (bilaterally)

28
Q

Vertebralbasilar artery function test interpretation

A

+ve Pulsations, bruits, pre-syncope, vertigo, nystagmus, and/or nausea–> VBI VB Insufficiency)

29
Q

VBI Test

A

Pt supine or seated, examiner supports head and follows 3 steps:
1. SB of Pts neck
2. Rot of neck to same side
3. Ext of neck- then ask Pt to look at a fixed point on the ceiling- the position may be held for up to 30s and ask Pt to count backwards from 10

30
Q

VBI test interpretation

A

Pre-syncope, nystagmus, vertigo, slurred speech, visual changes and/or nausea–> VBI, cervicogenic vertigo, cervical instability w brainstem compression

Tingling or electrical arm P–> nerve root compression

31
Q

VBI test- clinical notes

A

Eyes must be open for nystagmus
Use prior to mobilisation or manipulation

32
Q
A
33
Q
A

Ortho tests (15 decks)

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