Cervical Tests for Vascular Insufficiency
Test
George's Screening Procedure
Procedure
Pt. Seated, history, bilateral blood
pressure, subclavian & carotid artery
bruit tests, vertebrobasilar artery
functional maneuver
Sign
(+)high risk history
(+)10mm Hg difference from side to
side or feeble radial pulse is indicativ
of subclavian stenosis
(+)subclavian or carotid bruit indicativ
of arterial stenosis
(+)vertigo, nystagmus, dizziness or
nausea during functional maneuvers
Vertebrobasilar artery
functional maneuver
Pt. Seated, active rotation &
(+)vertigo, nystagmus, dizziness,
hyperextension of head to each side for nausea, faintness indicates
3-5 seconds
vertebrobasilor artery insufficiency
indicative of vertebral, basilar artery
insufficiency
Barre-Leiou
Pt. Seated, active rotation of head from (+)vertigo, nystagmus, dizziness
side to side, slowly then accelerate
indicates vertebral artery insufficienc
Dekleyn's
Pt. Supine with head extended off the
end of the table, active rotation &
hyperextension, to each side for 15
seconds
Hallpike
Pt. supine with head extended off the
(+)vertigo, nystagmus, dizziness or
end of the table, passive extension,
nausea indicates vertebrobasilar arte
rotation & lateral flexion to each side for insufficiency
15 seconds
Hautant
Pt. Seated with arms forward & hands
supinated, active rotation &
hyperextention of head to each side
Underburgs
Pt. standing with arms forward & hands (+)drifting of arms or loss of balance
supinated, with eyes closed, active
indicates vertebrobasilar or carotid
rotation & hyperextention of head, Pt.
artery insufficiency
Then marches in place for 15 sec.,
repeat for opposite side
(+)vertigo, nystagmus, dizziness or
nausea indicates basilar artery
insufficiency
(+)drifting of arms indicates
vertebrobasilar insufficiency
Cervical Orthopedic Tests for Foraminal Compression
Test
Procedure
Pt. Abducts, externally rotates arm &
places hand on head
Pt. Seated, Dr. exerts compression on
head in neutral & rotated positions
Sign
(+)relief of radicular pain indicates
nerve compression
(+)local pain indicates foraminal
encroachment, radicular pain indicate
nerve compression
Jacksons Cervical Compression
Pt. Seated, Dr. exerts compression on
head in lateral flexion
(+)radicular pain indicates nerve
compression
Maximum Formaminal Compression
Pt. Seated, active rotation & hyperextention of head towards side of
involvement
(+)radicular pain indicates nerve
compression
Bakody Sign
Foraminal Compresion Test
Spurlings
Pt. Seated, head in neutral position,
Dr.places hand on top of pt. Head and
delivers a vertical blow to the hand
resting on head.(may repeat in lateral
flexion & extension)
Test
Supraspinatus Tendonitis Test
(Press Test)
Apley Scratch Test
Codman's Drop Arm
Impingement Sign
(+)radicular pain indicates nerve
compression
Shoulder Orthopedic Tests (supraspinatus)
Procedure
Sign
Pt. Seated, active abduction of
(+)pain or weakening in affected
shoulders to 90 degrees with slight
shoulder indicates tear in tendon
internal rotation, Dr. resists
abduction
Pt. Seated, reaches behind head from
above & below
Pt. Seated, passive abduction of arm
to just above 90 degrees, the arm is
then dropped
(+)pain indicates tendonitis in rotator
cuff (usually supraspinatus)
(+)pain or hunching of shoulder,
indicates rotator cuff tear
(supraspinatus tendon)
Pt. Seated, passive abduction &
internal rotation with forearm flexed.
(jamming of greater tuberosity against
anterior/inferior acromial surface
(+)pain indicates overuse of
supraspinatus
Shoulder Test for Bursitis
Test
Dawburn's
.
Procedure
Pt. Seated, Dr. palpates painful
subacromial bursa, & passively
abducts arm
Sign
(+)If pain disappears this indicates
bursitis
Shoulder Test for Dislocation
Test
Procedure
Pt. Seated & instructed to place hand
on opposite shoulder and touch elbow
to chest
Sign
(+)pain & inablility to perform indicate
dislocation
Anterior Apprehension
Pt. Seated, passive flexion of arm and
abduction & external rotation at
shoulder
(+)Pt. Apprehension indicates anterio
dislocation
Posterior Apprehension
Pt. Supine, passive flexion & internal
rotation of shoulder, Dr. then applies
posterior force at elbow
(+)apprehension indicates posterior
dislocation
Calloways
measure girth of affected shoulder
& compare to unaffected
look for lowering of axillary fold
(+)increased girth indicates dislocatio
Dugas
Bryants Sign
(+)dislocation on low side
General Shoulder Pathology Test
Test
Mazion Shoulder Maneuver
Test
Speeds Test
Procedure
Pt. Seated, Pt. Places hand on
opposite shoulder, moves elbow to
forehead
Sign
(+)intensifies & localized pain
Shoulder Orthopedic Tests (biceps tendon)
Procedure
Sign
Pt. Seated, resisted active flexion of
(+)test elicits pain in bicipital groove
arm. Pt. Supinates & extends forearm indicating tendonitis
during test. Dr. palpates tendon of long
head of biceps
Yergason's Test
Pt. Seated, wth elbow fixed to 90
degrees, Dr. stabilized elbow with one
hand & grasps the wrist of other hand
& resists external rotation & supination
(+)pain in intertubercular groove
indicates biceps tenosynovitis
Ludington's Test
Pt. Seated & places both hands behind (+)rupture of long heads if Dr. is unab
head with interlocked fingers, pt.
to feel tendon
Contracts & relaxes biceps while Dr.
feels for tendons
Abbot-Saunders
Pt. Seated, passive abduction, external (+)a palpable click indicates dislocati
rotation and lowering of arm, Dr.
of biceps tendon
Palpates long head tendon
Transverse Humeral Ligament
Pt. Seated, passive abduction of arm
with elbow flexed, shoulder is then
internally rotated & externally rotated,
Dr. palpates bicipital groove.
(+)If Dr. feels tendon snap in & out o
groove, indicates torn transverse
humeral ligament