Upper Extremity-Cervical/Thoracic Spine Special Tests and Misc.

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Upper Extremity-Cervical/Thoracic Spine Special Tests and Misc.
2014-11-12 22:18:45
upper extremity cervial spine special tests

upper extremity spine special tests
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  1. Brachial Plexus Stretch Test
    • P: sitting
    • E: behind athlete, one hand on lateral aspect of head on affected side, the other on affected side shoulder
    • Pr: passively apply lateral neck flexion away from affected side creating a stretch
    • +: radiating pain down arm; bi lat
    • I: brachial plexus stretch injury
  2. Brachial Plexus Compression Test
    • P: sitting
    • E: behind athlete, one hand on lateral aspect of head on non-affected side, the other on the affected shoulder
    • Pr: laterally flex the neck toward the affected side
    • +: radiating pain down affected arm; bi lat
    • I: brachial plexus compression injury
  3. Cervical Compression Test
    • P: sitting
    • E: behind athlete, both hands on top of their head
    • Pr: apply an axial load to the cervical spine
    • +: associated pain to nerve root
    • I: nerve root impingement
  4. Spuling's test
    • P: sitting
    • E: behind athlete, both hands on top of head
    • Pr: slightly extend and laterally flex the neck and then apply an axial load
    • +: radiating pain to the shoulder and arm on the flexed side
    • I: nerve root impingement
  5. Vertebral Artery Test
    • P: lying supine with head off the table
    • E: at the head of the athlete, both hands supporting their head
    • Pr: extend, laterally flex and rotate the neck (in the same direction of the flexion), instructing them to keep their eyes open
    • +: dizziness and or nystagmus
    • I: vertebral artery is occluded through compression
  6. Shoulder Abduction Test
    • P: sit/stand, shoulder abducted 90 and hand placed on side of head
    • E: observing
    • Pr: instruct athlete to apply medial pressure while resisting with their head
    • +: decrease of symptoms
    • I: nerve root compression (herniated disk)
  7. Deep Tendon Reflexes
    • Biceps--C5 and 6
    • Brachiradialis C6
    • Triceps C7
  8. Myotomes
    • C1- none
    • C2- neck flexion
    • C3- neck lateral flexion and extension
    • C4-shoulder shrug
    • C5-shoulder abduction
    • C6- elbow flexion/wrist extension
    • C7-elbow extension/wrist flexion
    • C8-ulnar deviation/thumb extension
    • T1- finger abduction and adduction
  9. Kyphosis
    • increased thoracic curve
    • scapulae that are protracted which produces rounded shoulder appearance
    • usually associated with forward head
  10. Foreward Head
    • if there's a kyphotic curve there will be a compensatory change in position of head and neck
    • patient extends cervical spine to keep eyes level
    • short and strong neck extensors
    • long and weak neck flexors
    • the head is in forward position
  11. Swayback
    • anterior shifting of entire pelvis, resulting in hip extension
    • thoracic shifts posterior
    • decreased lordosis
    • increased kyphosis
  12. Lordosis
    • increase curve in lumbar spine
    • increase in both anterior tilt of pelvis and hip flexion
    • lordosis+kyphosis+forward head=kypholordotic posture
    • Can result from obseity, osteoporosis, spondylolisthesis
  13. Scoliosis
    • lateral curvature
    • abnormal curve in one direction and compensatory curve in opposite direction
    • functional: non-spinal defect (leg length, muscle imbalance or nutrition deficits). May straighten when bending
    • structural: defect in bony structure of spine. Remains twisted while bending over
  14. Flatback
    • caused by decrease lumbar curve and increase in posterior pelvic tilt and hip flexion
    • patient appears stooped forward, difficulty standing up straight
    • can occur as a result of degenerative arthritis or from a spinal fusion
  15. Sternocleidomastoid-Origin
    • Sternal head: top of manubrium
    • Clavicular head: medial one third of clavicle
  16. Sternocleidomastoid-Insertion
    Mastoid process of temporal bone and the lateral portion of superior nuchal line of occiput
  17. Anterior Scalene-Origin
    transverse processes of 3-6 cervical vertebrae (anterior tubercles)
  18. Middle Scalene-Origin
    transverse processes of 2-7th cervical vertebrae (posterior tubercles)
  19. Posterior Scalene-Origin
    transverse processes of 6 and 7th cervical vertebrae (posterior tubercles)
  20. Anterior and Middle Scalene-Insertion
    first rib
  21. Posterior Scalene- Insertion
    second rib