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Methods 3

NWHSU Methods 3

QuestionAnswer
Dysphasia is difficulty speaking
Dysphagia is difficulty swallowing
Another name for neck stiffness is Nuchal rigidity
List 5 conditions that require Chiropractic caution Rheumatoid Arthritis Cancer Down Syndrome Alcoholism/Drug Abuse Immunocompromised state
Severe neck stiffness might mean meningitis is suspected... What are two tests you can use to check for meningitis. Brudzinski's or Kernig's sign
What film would you use to check for cervical instability Flexion-Extension films
What 3 radiographs should be obtained for a patient with radicular findings? APLC APOM LCN Oblique
What does APLC stand for Anteroposteior lower cervical
What does APOM stand for A-P Open Mouth
What does LCN stand for Lateral Cervical Neutral
Buffalo hump in the upper thoracic area is also known as Cushing's syndrome
Another name for Shingles Herpes Zoster
What test do you perform when a scoliosis is visible in the standing position Adams Test
7 Conditions to manage conservatively Uncomplicated compression fracture, mild to moderate idiopathic scoliosis that is not rapidly proressing, uncomplicated scheuermann's disease, facet syndrome, postural syndrome, T4 syndrome, other mechanical causes
What segmental levels are painful when the heart is involved C8-T5
What segmental levels are painful when the lungs are involved T3-T5
What segmental levels are painful when the stomach is involved T5-T8
What segmental levels are painful when the pancreas is involved T7-T9
What segmental levels are painful when the Gallbladder, liver, spleen, caecum, and duodenum are involved T6-T10
What segmental levels are painful when the appendix is involved T9-T11
What segmental levels are painful when the kidneys are involved T9-L2
3 tests used for cervical myospasm/strain Distraction test, maximum cervical compression test, O'Donoghue maneuver
Strain involves ________ muscles
Sprain involved _______ ligaments
This cervical test the patient is seated while the examiner exerts upward pressure on the patient's head. This pressure removes the weight of the patients head from the neck. Cervical Distraction Test
Increased pain from the cervical distraction test indicates muscle spasm
Relief of pain from the cervical distraction test indicates intervertebral foraminal encroachment or facet capsulitis
While in the seated position, the patient turns their chin toward their shoulder and extends their neck. The test is performed bilaterally. This test is Maximum Cervical Compression Test
During the Maximum cervical compression test pain on the concave side indicates nerve root or facet involvement
During the Maximum cervical compression test pain on the convex side indicates muscular strain
The patient is sitting, the cervical spine is actively moved through resisted range of motion and then through passive range of motion during what test O'Donoghue maneuver
Pain during resisted range of motion during the O'Donoghue maneuver (or isometric contraction), signifies what muscle strain
Pain during the passive range of motion during the O'Donoghue maneuver signifies ligamentous sprain
What two tests can be used to assess cervical sprain O'Donoghue maneuver and Rust Sign
The patient spontaneously grasps the head with both hands when laying down or when arising from a recumbent position is a positive sign for severe ______ ________, ________ ____, _________, severe ________ _______ and is called _____ _______ Ligamentous sprain, Rheumatoid arthritis, fracture, or severe cervical subluxation and is called Rust Sign
What 3 tests can you use for Cervical Facet/Capsulitis Cervical Distraction test, Jacksons Cervical Compression Test, Maximum cervical compression test
Patient is seated while they bend their head obliquely backwards and slightly rotated toward involved side. The examiner applies a downward pressure on the vertex. What test is this. Jacksons Cervical Compression test
A positive sign for the Jacksons cervical compression test is localized pain where? localized pain radiating down the arm
Apositive sign for jacksons cervical compression test indicates nerve involvement from a space-occupying lesion, subluxation, inflammatory swelling, exostosis of degenerative joint disease, CAPSULITIS, tumor, or disc herniation
4 main tests used for Cervical nerve root assessment (Radiculopathy) and 3 other tests Bakody sign/Shoulder abduction test, Spurling test, Distraction test, Upper limb tension test, Maximum cervical compression test, shoulder depression test, Dejerine sign
Symptoms of nerve root compression/radiculopathy Proximal root pain and neck pain, distal paresthesia in dermatome patterns, muscle weakness in one or several muscles supplied by a single root, loss of deep-tendon reflexes, muscle fasciculation, radiating pains that are further aggravated by moving neck
Patient is in the seated position and actively places the palm of the affected extremity on top of the head, raising the elbow to a height approximately level with the head is waht sign Bakody Sign
When radiating pain is lessened or disappears with hold arm out at shoulder level or placing hand on head this is what sign Bakody sign
What is suggested by a positive Bakody Sign Cervical nerve root compression
Patient is seated and the head is laterally flexed to one side and extended while the examiner places one hand on top of the patients head and gradually increases downward pressure in the vertex. What test is this? Spurling Test
describe parasthesia sensation of tingling, prickling,pins and needles
The spurling test closes the intervertebral foramina on the side of the flexion and reproduces the familiar pain or paresthesia in_______________ radiculopathy
ULTT stands for upper limb tensions test
The examiner pulls the shoulder down (Scapular depression), then pulls the arm out (Should abduction), forearm supinated in examiners one hand while the elbow is extended on the examiners leg. Have patient laterally flex head both ways. This test is? ULTT Upper limb tension test
If the upper limb tension test causes pain when the patient bend their head away from the examiner this is positive for radiculopathy
IF the upper limb tension test relieves pain when the patient bends their head toward the examiner this is a positive finding for radiculopathy
With the patient seated the examiner depresses the patients shoulder on the affected side and laterally flexes the cervical spine away from the shoulder. What test is this Shoulder Depression Test
A positive sign of radicular pain from the shoulder depression test indicates adhesions of the dural sleeves, spinal nerve roots or adjacent structures of the joint capsule of the shoulder
Having your patient cough or sneeze will aggravate radiculitis symptoms. This is known as Dejerine sign
Dejerine sign is present when one fo the following exists Herniated or protruding intervertebral disc, spinal cord tumor, spinal compression fracture
What 3 tests can be used for cervical intervertebral disc syndrome jacksons cervical compression test, spinal percussion test, valsalva maneuver
With the patient seated and the head slightly flexed the examiner percusses the spinous process and associated musculature of each of the cervical vertebra with a reflex hammer. What test? Spinal Percussion test
The spinal percussion test has positive findings of localized pain. What could this possibly indicate fracture or ligamentous sprain
If the spinal percussion test has positive finding of radicular pain this indicates possible disc lesion
The patient takes a deep breath and holds it while bearing down abdominally. What test is this? Valsalva maneuver
Pain findings from the valsalva maneuver indicate (Space occupying lesion) herniated disc, tumor, osteophyte
What two tests can be used for Dural irritation? Lhermitte sign, shoulder depression test
The patient is seated on the examining table and has their head flexed by the examiner. What test is this? Lhermitte Sign
If the Lhermitte sign has positive findings of sharp pain radiating down the spine into the upper and lower limbs this is dural irritation in the spine
Two tests for cervical fracture Spinal percussion test and rust sign
3 tests for cervical spinal tumor spinal percussion test, swallowing test, valsalva maneuver
While seated the patient is instructed to swallow. What test is this? Swallowing test
Prescence of pain or difficulty swallowing during the swallowing test indicates space occupying lesion, ligamentous sprain, muscular strain, fracture, disc protrusion, tumor, osteophyte at anterior portion of cervical spine
2 tests for meningitis Lhermitte Sign and Brudzinskis
The patient is in the supine position, and the examiner passively flexes the patients head. What test is this? Brudzinskis Sign
During the Brudzinski sign test if the patient flexes both knees and sometimes hips this indicates meningitis
Strength of a muscle is graded _ - _ 0-5
0/5 for muscle strength indicates no contraction
1/5 for muscle strength indicates muscle flicker, but no movement
2/5 for muscle strength indicates movement possible, but not against gravity
3/5 for muscle strength indicates movement possible against gravity, but not against resistance by the examiner
4/5 for muscle strength indicates movement possible against some resistance by examiner
5/5 for muscle strength indicates normal strength
Most common cause for a muscle to test weak is ____ pain
Deltoid tests what nerve C5
Biceps and Wrist Extensors test what nerve C6
Triceps, Wrist Flexors and Finger Extensors test what nerve C7
Finger Flexors test what nerve C8
Reflex testing is graded _-_ 0-4
Reflex testing of 0 is no response (abnormal)
Reflex testing of 1 is slight response but definitely not present (May be normal or abnormal)
Reflex testing of 2 is brisk response (normal)
Reflex testing of 3 is very brisk response (may be normal or abnormal)
Reflex testing of 4 is a tap elicits a repeating reflex (Clonus) (Always abnormal)
Clonus means repeated reflex (very quick shake motion)
Brachioradialis Relex tests which nerve (Strike side of radius) C6
Triceps Reflex tests which nerve (find fossa proximal to the olecranon process, stike tricep tendon) C7
Thumb is C_ (dermatome) C6
Index and middle finger are C_ (Dermatome) C7
Ring finer and pinky are C_ (Dermatome) C8
Lateral arm is C_ (Dermatome) C5
Medial Arm is __ (Dermatome) T1
3 Thoracic Outlet Tests Adson's, Writes, Costoclavicular
The examiner locates the radial pulse for the involved extremity. The patients head is rotated to the involved extremity. The patient extends the neck as the examiner external rotates and extends the patients shoulder. What test Adson's Test
Loss of the pulse during the Adson's test is a positive finding for interscalene compression
A true positive for Adsons test is reporduction of the patients arm complaints also known as ________ souza
Patient is seated with both arms hanging at the sides. The examiner find the radial pulse. Both arms, in turn are passively abducted to 180 degrees. Examiner notes angle where radial pulse diminishes on affected side. What test is this? Hyperabduction Maneuver (Writes test)
The Hyperabduction maneuer is significant for neurovascular compromise of the ________ artery axillary
The mechanics of the hyperabduction maneuver stretch which muscle pec minor
Many patients have cessation of the radial pulse on abduction without having hyperabduction syndrome being present. This is known as a _______ _______ false positive
A true positive for the hyperabduction maneuver is if their is reproduction of the patients arm complaint (Souza)
The radial pulse is palpated while the patients shoulders are drawn down and in extension. The patient flexes their head forward This test is Costo Clavicular Maneuver
If the pulse is lost during the costo clavicular maneuver this indicates costo clavicular origin is pinched. (True positive finding reproduce the patients arm complaint)
Two upper extremity arterial vascular supply tests Radial Pulse, Allen's test
4 things to check while taking the radial pulse Amplitude (Strength)*, Rate, Rhythm, Contour (Shape)
The patient is seated and instructed to make a tight fist to express blood from the palm. The examiner uses finger pressure to occlude the radial and ulnar arteries. The patient opens the closed fist and the examiner releases one artery at a time. Test? Allen's Test
During Allen's test if the pale skin of the palm flushes immediately after an artery is released this is a _______ sign. Negative
During Allen's test if the pale skin remains blanched for more than 5 seconds this is a ______ sign. positive sign
Nodding,or flexion and extension, occurs primarily between occiput and atlas
The upper cervical complex is unique in that that neither the atlanto-occipital articulation nor the atlanto-axial articulation have an intervertebral disc
Rotation occurs primarily between Atlas and Axis
When the cervical spine is hypolordotic, the cervical gravity line is likely to lie anterior to the body of C7
What ligament is probably the most important in the upper cervical spine? Rupture of the this ligament will result in an increased ADI space Transverse ligament
Patients with certain conditions must be evaluated carefully before administering an upper cervical adjustment. Name one non-traumatic cause of atlanto-occipital instability associated with an increased ADI space Down Syndrome, Rheumatoid arthritis, Neurofibromatosis, Psoriasis, Lupus
The apparent appearance of lateral flexion of the atlas on x-ray or with palpation indicates which of the following The atlas has ____________ rotated eccentrically
Articular anatomy and the ____ligaments limit rotation at CO-C1 to 5 degrees to each side. These ligaments are also called the "check" ligaments. Alar
On an APOM view, a wider lateral mass and narrower ADI space on the left with no offset of the lateral masses would indicate which of the following? right rotation of the atlas
Created by: T1NWHSU