VERBALS Flashcards
(37 cards)
L HERMITTE SIGN
+ : Electric shock like sensations down the spine and or through extremities i : Dural irritation, severe spinal cord injury, inflammation, or degeneration
KERNIG SIGN
+ : Inability to fully extend the leg and/or pain (usually in neck region) i : Meningeal irritation/meningitis
BRUDZINSKI SIGN
+ : Involuntary knee flexion i : Meningeal irritation or nerve root lesion (classic test for meningitis)
SOTO HALL SIGN
+ : Generalized pain in cervical region, which may extend down to the level of T2 i : Non-specific test for structural integrity of cervical region
FORAMINAL COMPRESSION TEST
+ : 1) Exacerbation of localized cervical pain 2) Exacerbation of cervical pain with a radicular component i : 1) Foraminal encroachment or facet pathology without nerve root compression 2) Foraminal encroachment or facet pathology WITH nerve root compression
JACKSON COMPRESSION
+ : 1) Exacerbation of localized cervical pain 2) Exacerbation of cervical pain with a radicular component i : 1) Foraminal encroachment without nerve root pressure or facet pathology 2) Foraminal encroachment with nerve root compression (one would then want to evaluate the myotome, reflex and dermatome of the nerve root involved)
MAXIMAL CERVICAL COMPRESSION
+ : Pain on the concave side i : Foraminal encroachment with or without nerve root compression (based on presence or absence of radicular component)
VALSALVA MANEUVER
+ : Radiating pain from site of lesion (usually positive in cervical or lumbar area of the spine) i : Space Occupying lesion (e.g. disc pathology)
CERVICAL DISTRACTION TEST
+ : 1) Diminished or absence of local cervical pain 2) Diminished or absence or radiating pain 3) Increase of cervical pain i: 1) Foraminal encroachment without nerve root compression 2) Foraminal encroachment with nerve root compression 3) Muscular strain, ligamentous sprain, myospasm or facet capsulitis
BAKODY SIGN (shoulder abduction test)
+ : Decrease or absence of radiating pain i : Cervical foramina compression, nerve root entrapment (usually C5/C6 level because this motion elevates the supra scapular nerve and relieves traction on the upper brachial plexus)
ADAM SIGN
+ : 1) A “C” or “S” shaped scoliosis is observed to straighten 2) A “C” or “S” shaped scoliosis does not straighten (look for rib humping, muscular imbalance, and symmetry in hand length) i: 1) Negative: evidence of a functional scoliosis, trauma or subluxation 2) Positive: evidence of a pathologic or structural scoliosis
SCHEPELMANN SIGN
+ : Pain on the concave or convex side i : Pain on the concave side indicates intercostal neuritis (thoracic dermatomes can be evaluated in the corresponding intercostal spaces) while pain on the convex side indicates fibrous inflammation of the pleura (or possible intercostal myofascitis)
BEEVOR SIGN
+ : Superior or inferior movement of the umbilicus i : Superior movement of the umbilicus is indicative of a spinal cord lesion at the level of T11-T12 or lower abdominal weakness. Inferior movement of the umbilicus is indicative of nerve root involvement T7-T10
ROOS TEST aka E.A.S.T (elevated arm stress test)
+ : Ischemic pain, heaviness of the arms, or numbness and tingling of the hand i : Thoracic outlet syndrome on side involved (Evan’s considers this test to be most accurate for TOS evaluation)
ADSON TEST
+ : Pain and/or paresthesia, decreased or absent pulse amplitude , pallor i : Compression of neurovascular bundle by scalenus anticus or cervical rib
COSTOCLAVICULAR MANEUVER aka EDEN TEST
+ : Pain and/or paresthesia, decreased or absent pulse amplitude, pallor i : Compression of the neuromuscular bundle between the clavicle and 1st rib
HYPERABDUCTION MANEUVER aka WRIGHT TEST
+ : Pain and/or paresthesia, decreased or absent pulse amplitude, pallor. i : Compression of the axillary artery by pectoralis minor or coracoid process. TOS
TINEL ELBOW SIGN
+ : Pain and/or tenderness at the site being tapped and paresthesia in the ulnar nerve distribution area (fingers 4, and 5) i : Neuroma of the ulnar nerve
FROMET PAPER SIGN
+ : The patient is seen to flex the thumb thereby recruiting the median nerve to compensate for apparent weakness i : Ulnar nerve paralysis (weakness or palsy of the adductor polices muscle)
PHALEN SIGN and REVERSE PHALEN SIGN aka “Prayer Sign”
**** Hold for 60 seconds ***** + : Reproduction of pain and/or paresthesia in the median nerve distribution area (1st, 2nd, 3rd, and lateral 1/2 of 4th digit) i : Median Neuritis, possibly Carpal Tunnel Syndrome
TINEL WRIST SIGN
+ : Reproduction of pain, tenderness and/or paresthesia in the median nerve distribution area (thumb, 2nd, 3rd, and lateral 1/2 of the 4th digit) i : Median neuritis, possibly Carpal Tunnel Syndrome
MINOR SIGN
+ : Knee flexion of the affected leg while supporting upper body weight (hand on back or thigh) on unaffected side i : Sciatica, lumbosacral or sacroiliac joint lesion
BELT TEST (Supported Adam Test, Supported Forward Bending Test)
+ : Low Back Pain i : 1) Pain while bending with the sacrum stabilized and unstabilized = Lumbar involvement 2) Pain during sacrum non-stabilized bending, and no pain during sacrum stabilized bending = pelvic involvment
MILGRAM TEST
+ : Inability to perform test and/or low back pain i : Weak abdominal muscles or space occupying lesion
