Tx Spine

Question 1

Spring Test

Answer 1

o PT prone, place reinforced thumb / thenar over Tx SPs and spring PA
o Local pain indicates facet joint involvement
o Radicular SSx indicate nerve root impingement
o Hyper/hypomobility at segment (wrt other segments) suggest dysfunction

Question 2

Quadrant

Answer 2

o PT seated, Overpressure through shoulders in flexion/extension with SB+Rotn L + R
o Local pain indicates facet Jt involvement
o Radicular pain indicates nerve root impingement

Question 3

Soto-Hall

Answer 3

o Pt supine, passive flexion of PT neck with stablisation at sternum
o Local pain indicates ligament / Mm / boney pathology
o Radicular SSx indicate disc pathology

Question 4

Percussion Test

Answer 4

o Pt seated in light flexion, percuss Cx SPs with reflex hammer
o Local pain- vertebral # without neurological compromise
o Radicular pain- vertebral # or disc pathology with neuro compromise → Also potential for ligamentous sprain to elicit local pain

Question 5

Brudzinski’s Sign

Answer 5

o Pt supine, active flexion of Pt neck
o Meningeal irritation suggested by involuntary knee flexion / Lx extension / pain in head / Cx / Tx regions
o Radiculopathy suggested by familiar leg pain

Question 6

Kernig’s Test

Answer 6

o Pt supine, passive flexion of knee and hip to 90 deg → active knee extension
o Meningeal irritation or radiculopathy indicated by diffuse pain in CD region +/- Cx/Lx extension or involuntary flexion of opposite hip & knee

Question 7

Brudzinski’s + Kernig’s Combined

Answer 7

o Pt supine, passive flexion of knee and hip to 90 deg → active knee extension and Cx flexion
o Meningeal irritation or radiculopathy indicated by diffuse pain in CD region +/- Cx/Lx extension or involuntary flexion of opposite hip & knee
• Note: Knee flexion alleviates SSx