Cervicothoracic Special Tests Flashcards
(25 cards)
What are the two tests for Vertebral Basilar Insufficiency?
Vertebral Basilar Insufficiency test
Wallenberg’s Position
How to perform the VBI test and what is a positive?
PT performs end-range cervical rotation, hold for 10 seconds, go back to neutral for 10sec, then rotate fully to other side for 10 sec.
positive = initiation of dizziness, diplopia, dysphasia, drop attacks, nausea, nystagmus
How to perform Wallenberg’s Posiion and what is a positive?
Pt’s head is rotated to one side w/ extension. hold for 30sec. repeat on opp. side
positive = initiation of dizziness, diplopia, dysphasia, drop attacks, nausea, nystagmus
What are the three tests for Cervical Radiculopathy?
- Compression Test
- Spurling’s Test
- Distraction Test
How to perform the Compression test and what is a positive?
PT stands behind Pt w/ elbows on shoulders and applies a downward force
positive = reproduction of symptoms
How to perform the Spurling’s test and what is a positive?
PT stands behind Pt w/ elbows on shoulders and applies a downward force with the Pt’s head side flexed to the painful side
positive = reproduction of symptoms
How to perform the Distraction test and what is a positive?
PT stands behind Pt w/ grip on occiput and elbows on shoulders, providing slight traction
positive = reduction of symptoms
What are the three tests for Cervical Instability?
Modified Sharp Purser
Alar Ligament
Tectorial Membrane
How to perform the Modified Sharp Purser and what is a positive?
Pt in sitting w/ head slightly flexed.
PT stabilizes C2 w/ pincer grasp, then provides a posterior translation force w/ other palm on Pt’s forehead
Positive = reproduction of myelopathic sx during forward flexion / decrease in sx during anterior-posterior movement / excess displacement during AP movement
How to perform the Alar Ligament Test and what is a positive?
Pt’s head slightly flexed
PT stabilizes C2 spinous processes w/ pincer grasp
Passive side flexion/rotation by PT to feel C2 movement
positive = failure to feel movement of C2 process during side flexion/rotation
How to perform the Tectorial Membrane Test and what is a positive?
PT places one had in suboccipital region w/ bottom three fingers placed against spinous processes of cerv. spine
W/ other hand, PT provides a posterior/upward force on mastoid processes
positive = excessive translation between occiput and C1-C2
What are the three tests for Cervicogenic Headaches?
- Cervical Flexion Rotation Test
- C0, C1-2, C2-3 Joint Mobility Assessment
- Neck Flexor Endurance Test
How to perform the Cervical Flexion Rotation test and what is a positive?
Pt actively moves neck into max flexion
PT applies full rotational force to both sides
positive = loss of 10° or greater
How to perform the C0, C1-2, C2-3 Joint Mobility Assessment and what is a positive?
PT applies a downward force with thumbs on the C1 transverse process
(right and left), the C2–3 facet (right and left) and the C2–3 facet with the head rotated
toward the targeted side
positive = reproduced pain and hypomobility
How to perform the Neck Flexor Endurance Test and what is a positive?
PT puts Pt’s head about 1” lifted off the table and instructs them to hold a chin tuck (make a double chin and keep it).
PT lets go of Pt’s head and Pt has to hold that position in air
positive = if Pt can’t hold the position for over a second
What are the five tests for Thoracic Outlet Syndrome?
Roos
Wright Test
Adson’s Test
Hyperabduction Test
Tinel’s Sign
How to perform the Roos and what is a positive?
Pt sits upright w/ hands abducted/externally rotated to 90°
PT then instructs Pt to open/close hands rapidly for 1min
Positive = reproduction of symptoms
How to perform the Wright Test and what is a positive?
PT instructs Pt to sit upright and palpates Pt’s radial pulse.
PT tells Pt to hyperabduct their shoulders and flex their elbows to 90 degrees, while turning their head toward the unaffected side.
Pt holds this position for 1–2 minutes.
Positive = if Pt experiences paresthesia or a decrease in the radial pulse.
How to perform the Adson’s Test and what is a positive?
PT instructs Pt to sit upright with arms placed at 15 degrees of abduction and palpates Pt’s radial pulse.
PT tells Pt to inhale deeply, hold their breath, tilt their head back, and rotate their head so their chin points toward the examined side.
PT records if the radial pulse diminishes or occludes and asks Pt about paresthesia.
Positive = if there is a change in radial pulse and/or Pt reports paresthesia.
How to perform the Hyperabduction Test and what is a positive?
PT instructs Pt to sit upright with arms at their sides and assesses Pt’s radial pulse
PT instructs Pt to abduct their arms above 90 degrees and fully externally rotate them, maintaining a neutral head position.
Pt holds this position for 1 minute.
PT palpates the radial pulse in the hyperabducted position and notes any changes (no change, diminished, or occluded) and asks about sensation changes
Positive = if there is a change in radial pulse and/or Pt reports paresthesia.
How to perform the Tinel’s Sign and what is a positive?
PT instructs Pt to sit upright with arms at their sides.
PT taps the supraclavicular fossa using a reflex hammer.
Positive = if Pt reports tenderness in the supraclavicular fossa, indicating thoracic outlet syndrome.
What are the three tests for Thoracic Pain Provocation and Mobility
- First Rib Spring Test
- Thoracic Spring Test
- Rib Spring Test
How to perform the First Rib Spring Test and what is a positive?
PT instructs Pt to lie in a supine position.
PT passively rotates Pt’s head toward the rib being assessed.
PT places their hand posterior to the first rib and applies downward pressure in a ventral and caudal direction (toward the opposite hip or shoulder).
PT assesses the opposite side for comparison.
Positive = if the rib is found to be stiff compared to the other side.
How to perform the Thoracic Spring Test and what is a positive?
PT positions Pt prone.
PT applies spring testing in a posteroanterior direction using their thumbs, with elbows locked, over the spinous processes of the thoracic spine.
Positive = if Pt experiences pain, hypomobility or stiffness, or excessive mobility (hypermobility) compared to adjacent segments.
