Cervical/Thoracic Orthopedic Tests Flashcards
Bakody’s Sign
Pt places hand on top of head to check for reduction of symptoms.
(+) reduction of symptoms by reducing tension on cervical nerve root –> Nerve Tension or Cervical Radiculopathy
Barre-Lieou Sign
Pt seated, slowly rotates head from side to side
(+) pre-syncope, vertigo, nystagmus, visual changes &/or nausea = VBI (Vertebral Artery Syndrome)
Strongly indicates buckling of ipsilateral vertebral artery and vertebrobasilar insufficiency
Bracial Plexus Tension Test
Pt seated, passively elevate straight arm & externally rotate & hold in position just before onset of symptoms; then laterally flex head away & extend wrist.
(+) Reproduction of radicular sx w/ wrist extension –> cervical radiculopathy (usually C5 NR)
DeJerine’s Triad
Coughing, sneezing or straining may aggravate radiculitis symptoms, which results from mechanical obstruction of the spinal fluid flow (herniated IVD, spinal tumor, compression fracture)
DeKleyn’s Test
Pt supine, support head & ask pt to extend, laterally flex & rotate. Observe eyes; position held for up to 45 seconds.
(+) pre-syncope, nystagmus, vertigo, slurred speech, visual changes and/or nausea –> VBI, vertebral artery syndrome
Cervical Distraction
(+) if it relieves pt’s peripheral symptoms — Nerve root compression may be relieved, IVF encroachment, csp radiculopathy
(+) increases local pain — muscle, ligament, capsule damage
(+) decreases local pain — facet impingement
Jackson’s Compression Test
+ if localized pain radiates down arm
Indicates nerve involvement from space occupying lesion, subluxation, inflammation, DJD, tumor or disc herniation
Lhermittes Sign
Sharp pain radiating down the spine and into upper or lower limbs is positive sign
Indicates dural irritation
Shoulder Depression Test
Positive if radicular pain is produced or aggravated
Indicates adhesions of dural sleeve, spinal nerve roots, or adjacent structures of joint capsule of the shoulder
Soto-Hall Sign
Positive if pt experiences severe local pain
Indicates subluxation, disc lesion, sprain/strain, vertebral fx, or meningeal irritation
Valsalva Maneuver
Increased pain caused by increased intrathecal pressure
Schepelmann Sign
Pain created on concave side caused by intercostal neuritis
If pain is created on convex side, diagnosis is intercostal myofascitis
Costoclavicular Test
Positive if pulse is lost
Suggests thoracic outlet syndrome
Adson Test
Positive if pulse is lost
If negative, repeat and have pt rotate head to uninvolved extremity
Allen’s Maneuver
If pulse disappears it is positive for thoracic outlet syndrome
