Cervical Spine Flashcards
Spinal Percussion Test
How to perform: Reflex hammer, patient trunk flexed, Tap SPs firmly, start with C2 and move below to C7
Testing for: fractures, neck pain, metastasis, radicular pain shooting down the arm
Positive test: Severe pain
Valsalva Maneuver
How to perform: Patient sitting, bearing down. Inflate lungs - increasing pressure. Take a deep breath in, hold breath and bear down. See face turning red.
Test for: Disc lesion, radicular pain, disc bulge herniations
Positive: Pain shooting down the arm
Rust’s Sign
Patients holding head to stabilize while going to lie down. Shows instability and radiculopathy
Bakody’s Sign
Arm resting on head due to nerve root irritation
Cervical Compression Test
How to perform: Patient sitting, stand behind closely. Interlace fingers on top of head and push down firmly with slow pressure. This closes spaces in the vertebrae. release slowly.
Test for: radiculopathy
Positive: radicular pain down the arm
Spurling’s Test
How to perform: similar to CCT but have patient flex head laterally to one side - closing IVFs laterally. Do this test to the sx side.
Test for: radiculopathy
Positive: radicular pain down the arm
Maximal Foraminal Compression Test
How to perform: Similar to CCT but have patient extend, laterally rotate and look up over shoulder. Narrow IVFs.
Test for: radiculopathy
Positive: Radicular pain down the arm
Positive findings of CCT, spurling’s and MFCT
- Nerve root compression (radiculopathy) - cervical disc herniation.
- Foraminal encroachments - osteophytes
- Space occupying lesions
Cervical Distraction Test
How to perform: Stand behind, lift head up with thenar eminence near mastoid processes. Bring elbows in, lift with legs, not trunk.
Positive: Less pain in neck
Test for: radiculopathy
Shoulder Depression Test
How to perform: Laterally flex head to side, stretch brachial plexus and nerve roots by pressing down on shoulder while stabilizing tilted head.
Positive: pain in arm/shoulder - pay attention to where pain is in arm and track back to nerve roots.
Test for: radiculopathy
Diagnostic Cluster for cervical radiculopathy
+ULTT of median nerve
Active cervical rotation
+Distraction test
+ Spurling’s Test
Soto Hall test
How to perform: Patient lying down, rests hand on sternum, doctor please hand on top of patients hand and flex head up.
Confirms suspicions of: vertebral fracture, joint or lig. injury, facet joint, disc lesions/derangement.
(+) Brudzinski’s Sign: reflexively bringing knees up - indicating meningitis.
