Lecture 3 - Cervical Ortho's Flashcards Preview

Tri 4 - Neuro Lecture > Lecture 3 - Cervical Ortho's > Flashcards

Flashcards in Lecture 3 - Cervical Ortho's Deck (17)
Loading flashcards...

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


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


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


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


Dejerine's Triad


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


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


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


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


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


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



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)


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


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

positive = 


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 



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


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


pain or dysphagia on drinking water

Swallowing test 

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


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

Valsalva Maneuver