Cervical Spine Exam - Positives & Indicators

Question 1

Valsalva Maneuver

Answer 1

Positive: Radiating pain from site of the lesion (usually recreating the complaint in cervical or lumbar area of the spine)Indicates: Space occupying lesion (e.g. disc pathology)

Question 2

Foraminal Compression Test

Answer 2

Positive: Exacerbation of localized cervical painIndicates: Foraminal encroachment or facet pathology without nerve root compressionPositive: Exacerbation of cervical pain with a radicular componentIndicates: Foraminal encroachment or facet pathology with nerve root compression

Question 3

Spinal Percussion Test

Answer 3

Positive: Local painIndicates: Possible fractured vertebrae, ligamentous involvement (spinous pain), and muscular involvement (muscular pain)Positive: Radiating painIndicates: Possible disc pathology

Question 4

Soto-Hall Sign

Answer 4

Positive: Generalized pain in the cervical region, which may extend down to the level of T2Indicates: Non-specific test for structural integrity of cervical region

Question 5

Shoulder Depression Test

Answer 5

Positive: Localized pain on either side being testedIndicates: Localized Pain: Dural sleeve adhesions, and muscular adhesions/contracture, or spasm, or ligamentous injuryPositive: Radicular pain on either sideRadiating pain on side being testedIndicates: Neurovascular bundle compression, dural sleeve adhesions, or thoracic outlet syndromePositive: Radiating pain on opposite side being tested: Indicates: Foraminal encroachment with nerve root compression

Question 6

Swallowing Test

Answer 6

Positive: Difficulty in swallowingIndicates: Space occupying lesion at anterior portion of cervical spine. Possibly esophageal or pharyngeal injury, anterior disc defect, muscle spasm or osteophytes etc.

Question 7

Kernig Sign

Answer 7

Positive: Inability to fully extend the leg and/or pain (usually in the neck region)Indicates: Meningeal irritation/meningitis

Question 8

O’Donoghue Maneuver

Answer 8

Positive: Pain during passive range of motionIndicates: Ligamentous sprain (Passive range of motion stresses ligaments)Positive: Pain during resisted range of motionIndicates: Muscle/tendon strain (Active range of motion stresses muscles & tendons)

Question 9

Cervical Distraction Test

Answer 9

Positive: Diminished or absence of painIndicates: Foraminal encroachment (local pain diminishes), nerve root compression (radicular pain diminishes)Positive: Increase of cervical painIndicates: Muscular strain, ligamentous sprain, myospasm, facet capsulitis