Lecture 3 - Cervical Ortho's Flashcards Preview

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Flashcards in Lecture 3 - Cervical Ortho's Deck (17)
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1

patient places the palm of the affected arm on the top of their head, raising the elbow to about the level of the head

positive sign is = 

Bakody's sign

positive = decrease in limb pain 

nerve root irritation

2

the seated patients arm is held up and back, with the elbow flexed. the elbow is then extended

positive sign = 

Bikele's sign

positive = increase/provoke pain with root syndromes or TOS

3

seated patient abducts the arms fully, then externally rotates them. they then flex their elbows to place the backs of their hands against the back of their head 

positive sign = 

brachial plexus tension test

positive = exacerbation/reproduction of pain may be indicative of a root lesion, typically C5

4

exacerbation/provocation of radicular pain during sneezing, coughing, or straining during a bowel movement

 

Dejerine's Triad

5

examiner applies traction to the seated patients head, typically via a hand contact under the mastoids

positive = 

Cervical distraction 

positive = increased in pain indicated strain, decrease in arm symptoms may indicated root lesion, decrease in local neck pain may indicate facet synovitis/compression

6

Doc exerts downward pressure on the top of the patients head in 

- neutral 

- extension

- right and left rotation 

- right and left lateral flexion (aka ____ test)

- positive sign = 

Cervical compression tests

- neutral = disc and body

- extension = facet, close IVF

- rotation = ipsilateral foramen / root

- lateral = ipsilateral foramen / root

positive = local pain is facet in origin, radicular pain is root lesion

7

seated patients head is passively flexed

positive sign = 

L'Hermitte's test

positive = pain or paresthesia radiating down the spine or into the limbs; indicates cervical myelopathy

8

V1: seated patient rotates and extends the head toward the side of pain

V2: seated patient laterally flexes to the side of pain and then rotates to the same side

Maximum cervical compression test

- each aim to close down the IVF

- positive = local pain is facet lesion, radiating pain is root, scalene pain is TOS

9

patient seated, doc occludes the external jugular veins with a digital or index contact

positive sign = 

Naffziger's test

- swells the dura, pressure increases, + means disc but no level indicated

positive = local pain or any change in patients symptoms indicates spinal lesion, typically SOL

10

seated patient first goes through active resisted ROM, isometric contraction, then passive ROM

- positive signs = 

O'Donoghue Maneuver

positive = 

- pain during active ROM = strain

- pain during passive ROM = sprain

NOT A GREAT TEST

11

seated patient will hold on to the head with both hands, patient will support the head during seated supine transitions

positive = 

Rust's sign

positive = sign of instability, fracture, severe strain/sprain

neck hurts (whiplash)

12

patient seated, doc laterall flexes the head away from the side of pain, then depresses the shoulder

positive = 

Shoulder depression test

positive = local pain is myofascial/strain-sprain, radicular pain is root lesion via stretch injury or inflammation

13

patient supine, doc stabilizes the patient's sternum with one hand, while flexing the neck with the other 

positive = 

Soto-Hall 

positive = local pain is fracture, sprain/strain, radicular pain is root lesion, reflex flexion of the hips and knees is Brudzinski's sign of meningitis 

POOR TEST

14

patient seated with head/neck flexed, doc percusses the SP's and paraspinal soft tissues with a reflex hammer

positive signs = 

Spinous percussion

positives = local pain is fracture, mets, infection; local soft tissue pain is trigger points, strain; radicular pain is disc/root lesion

15

V1: patient seated, laterally flex head to side of complaint, then apply pressure on top of the head, if symptoms do not reproduce... extend the neck

V2: patient seated, laterally flex head to side of complaint, then use percussion 

Spurling's test

positive = local pain is facet lesion, radicular pain is root lesion

16

pain or dysphagia on drinking water

Swallowing test 

positive means = esophageal irritation due to sprain/strain, HNP, SOL

17

seated patient is asked to take a deep breath and then bear down

Valsalva Maneuver