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Special Tests in The Spine

Special Tests in The Spine. Tara Jo Manal PT,OCS, SCS. C1 Upper Cervical Flexors and Extensors C2 Upper Cervical Rot. C3 Scaleni C4 Diaphragm C5 Biceps (mm and Reflex) Infra/Supraspinatus C6 Brachioradialis (mm and Reflex) Wrist Extensors

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Special Tests in The Spine

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  1. Special Tests in The Spine Tara Jo Manal PT,OCS, SCS

  2. C1 Upper Cervical Flexors and Extensors C2 Upper Cervical Rot. C3 Scaleni C4 Diaphragm C5 Biceps (mm and Reflex) Infra/Supraspinatus C6 Brachioradialis (mm and Reflex) Wrist Extensors C7 Triceps Brachii (mm and Reflex) Wrist flexors Finger Extensors Abductor Pollicis brevis C8 Flexor Digitorium Adductor Pollicis Abductor digiti minimi T1Interossei Posterior Head “Shawl” Shoulder and Lateral arm Radial Forearm Thumb/Index Finger Dorsal Forearm Middle/Index Finger Ulnar Forearm 4th and 5th digits Medial Arm Cervicothoracic Nerve Root

  3. Vertebral Artery Test • Combined Movements to stress test the cervical spine • Symptoms: • Dizziness -Tinnitus • Lightheadedness • Nystagmus -Parathesia • Dysarthria - Diplopia • Dysphagia

  4. Vertebral Artery Preliminary Test • Patient is sitting. Sustain cervical extension for 10 seconds. • Sustain Rotation (L and R) 10 seconds • IF POSITIVE STOP • If the testing is negative progress to standard position.

  5. Vertebral Artery Standard Test • Patient is supine. Sustain cervical extension for 10 seconds. • Sustain Rotation (L and R) for 10 seconds • Combine Extension with Rotation (L and R) for 10 seconds. • Test the patient in the manipulation position • IF POSITIVE STOP, do not manipulate

  6. Cervical Distraction • Nerve Root Compression • Radicular pain is decreased, test is positive

  7. Cervical Compression Test • Pressure downward on head • Test is positive if pain is evoked

  8. Spurling A • Seated • Neck Side bent to the ipisilateral side • 7kg of overpressure applied • Presence of pain, parasthesial or numbness

  9. Spurling B • Seated • Extension • Sidebending and Rotation to the ipsilateral side • 7kg of axial pressure is applied

  10. Sharp –Purser Test • Neck in semi flexion • Palm of one hand on forehead • Index finger on Spinous process C2 • Posterior force through forehead • Posterior slide is + for AA instability

  11. Shoulder Abduction Sign • Most common nerve root compression at C5-6 • Decrease in symptoms is positive response

  12. Median Nerve Testing • Shoulder Retraction and Depression • Shoulder Extension • External Rotation • Elbow Extension • Forearm Supination • Wrist/Finger Extension • Cervical SB and Rot Away

  13. Upper Limb Tension Testing A • Scapular Depression • Shoulder Abduction • Shoulder ER • Elbow Extension • Forearm Sup • Wrist and Finger Extension

  14. Radial Nerve Testing • Proximal as for Median • Shoulder Internal Rot • Forearm Pronation • Wrist Flexion • Ulnar Deviation • Finger Flexion

  15. Upper Limb Tension Testing B • Supine in 30º Abd • Scap Depression • Shoulder IR • Elbow Extension • Wrist and Finger Flexion • Opposite Cervical SB and Rot

  16. Ulnar Nerve Testing • Shoulder Retraction • Shld Ext and ER • Elbow Flexion • Forearm Supination • Wrist Extension and Radial Deviation • Finger Extension • Cervical SB and Rot away

  17. T1 Nerve Root Stretch • Abduct to 90º • Flex pronated arms to 90º • Flex elbows and place behind the neck • Pain in scapular area is T1- Pain in Ulnar distribution is Ulnar

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