ortho tests
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| O'Donaghue's Maneuver (seated) | Cervical ROM testing is performed
*Pain w/ Passive ROM = Ligamentous Sprain
*Pain w/ Resisted ROM = Muscle Strain
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| Soto-Hall (supine) | Cervial spine of patient is passively flexed while the sternum is stabilized
*Non-specific
*Any ligamentous or muscular injury to the post aspect of c-spine would produce pain
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| Shoulder Depression Test (seated) | Shoulder is depressed while head is laterally flexed toward opposite side.
*Radicular Pain = Dural Sleeve Adhesions (convex) or Foraminal Encroachment (concave)
*Local Pain = Local Tissue Irritation
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| Cervial Distraction (seated) | Examiner gently grasps both sides of the patient's head and exerts steady upward axial distraction.
*Generalized Inc. Pain = Muscle Spasm
*Relief of Pain = IVF Encroachment or Facet Capsulitis
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| Foraminal Compression (seated) | The patient's head is rotated and an axial compressive force is applied.
*Local Pain = Foraminal Encroachment
*Radicular Pain = Nerve Root Compromise
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| Jackson Compression Test (seated) | An axial compressive force is applies w/ the patient's head laterally flexed.
*Local Pain = Foraminal Encroachment
*Radicular Pain = Nerve Root Compromise
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| Maximum Cervical Compression (seated) | The patient is instructed to rotate and hyperextend their head.
*Local Pain (concave) = Facet Involvement
*Radicular Pain (concave) = Nerve Root
*Local Pain (convex) = Tissue Involvement
*Radicular Pain (convex) = Dural Sleeve Adhesions
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| Modified Spurling's Test (seated) | The head is slowly rotated and extended with gradual axial compression applied to the head.
*Inc. in local neck pain = Facet Capsulitis or Foraminal Encroachment
*Radicular Complaints = Foraminal Encroachment is compromising a nerve Root
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| Bakody Sign (seated) | The patient presenting with neck and arm discomfort presents with the involved arm abducted and placed on the top of their head.
*Dec. pain when in this position = Nerve Root Compromise
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| Allen's Test (seated; perform prior to other TOS tests) | The patient's arm is lying on their thigh. They are instructed to open and close their fist ending with their fist closed. The radial and ulnar arteries are then occluded with one being released at a time.
*Asseses collateral circulation.
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| Adson's Test (seated) | The radial pulse is palpated with the arm hanging at the side. The patient is instructed to rotate and extend their head to the side of palpation and to take a deep breath in.*Dec. in strength of pulse = comprs of the neurovas. bndl btwn mid & ant scalene
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| Costoclavicular Maneuver (seated) | The examiner palpated the radial pulse. The patient flexes their head while the examiner extends the shoulder.
*Dec in pulse strength = Neurovascular compression btwn clavicle and 1st rib
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| Wright's Test (seated) | Radial pulse is palpated with the arm resting at the side and palpation continues as the arm is abducted to 180 deg.
*Reduction in pulse = neurovascular compression under the pec minor ms.
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| Roos Test (seated) | The patient hold their arms at 90deg of abduction and ext rot. They're asked to open and close their fists repeatedly until symptoms occur or for up to 3mins.
*Reproduction of pain indicates Neurovascular Compression (just not the source)
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| Valsalva Maneuver (seated) | The patient is instructed to place their thumb in their mouth and to blow as if they were trying to blow up a balloon.
*Radicular Pain = Indicative of a space Occupying lesion
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| Beevor's Sign (supine) | The supine patient flexes their head. When the abdominal ms contract, the umbilicus should remain in its location.
*If umbilicus migrates = ms weakness is present suggesting a T10 cord compression
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| Schepelmann's Sign (seated) | The seated patient laterally flexes to each side.
*Pain Concave Side = Intercostal Neuralgia
*Pain Convex Side = Intercostal Myofascitis
*Any thoracic or rib pathology may result in pain.
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| Cervical Compression (seated) | The seated patient keeps head in tne neutral position, direct downward compression is applies to the patient's head. *Local pain= Facet capsulitis or foraminal encroachment. *Radicular Pain= Nerve Root Compromise
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| Dejerine's Sign | The patient reports that coughing, sneezing, or straining at the stool causes an inc. in nerve root or cord compression signs. *SOL
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| Lhermitte's Sign (seated) | The neck is passively flexed. *Sharp electric shock sensation= Cord myelopathy
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| Naffziger Test (seated) | The examiner holds digital pressure over the jugular veins bilaterally for 30-40 secs; the patient is then instructed to cough. *Radicular pain = SOL
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| Halstead Maneuver (seated) | The radial pulse is palpated and traction is applied to the arm while the patient extends their head. *Reduction in pulse= Neurovascular compression by a cervical rib or by the anterior scalenes
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| Bikele's Sign (seated) | The patient holds their arm in an abducted position with the elbow flexed. They are instructed to extend the arm. *Radicular Pain= Brachial plexus neuritis.
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| Swallowing Test (seated) | The patient is instructed to swallow. *Pain= Esophageal irritation due to a mass in the anterior aspect of the cervical spine.
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| Rust's Sign (any position) | The patient holds their head while moving, particularly while changing position. *Severe sprain or instability of the neck.
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| Brudzinski's Sign (supine) | The patient's head is passively flexed. *The sign is positive if flexion of both knees occurs= Meningitis
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| Brachial Plexus Tension Test (seated) | Examiner supports the arms while the patient fully abducts and gradually externally rotates the arms. The elbows are flexed and the neck is flexed. *Radicular Symptoms= C5 nerve root syndrome
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| Spinal Percussion Test (supine) | The neck is flexed and the sp are percussed with a reflex hammer. Pain=may indicate sp fracture or underlying disease processes
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| Libman's Sign (seated) | The examiner applies pressure to the mastoid processes. *Provides an indication of the patient's pain threshold (malingering)
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| Mannkopf's Sign (any position) | The examiner estb. the resting pulse rate. The area of complaint is then stimulated. *Inc pulse pressure= normal response *No change in pulse rate= maybe suggestive of nonorganic pain (malingering)
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| Magnuson's Test | The patient is asked to point to the area of pain. Later in the exam the patient is agian instructed to point to the area of complaint. *Findings should be consistent *A significant change in the location of pain may be suggestive of nonorganic pain
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| Adam's Position | The patient with scoliosis bends fwd at the waist. *curve straightens= neg sign suggesting functional scoliosis *Deformity present= pos sign suggesting structural scoliosis
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| Amo's Sign | The patient attempt to sit up from a supine or side lying position. *Local thoracolumbar or thoracic pain= ankylosing spondylitis, sever sprain, or IVD lesion
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Created by:
vfaulkner@nwhealth.e
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