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Upper Quarter Tests - 3
- Vertebral artery test
- Spurling’s test
- Distraction test
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What is test pictured?
What does it test?
Describe test
(+) sign = same or opposite artery is compressed?
- Vertebral artery test - VBI
- PROM head extension, side flexion & rotation to IPSI side
- Hold for 30 sec
- (+) OPPOSITE artery is compressed
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(+) Vertebral artery test - 5, 2 major
- Dizziness
- Nystagmus
- Disorientation
- Blurred speech
- Nausea/vomiting
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Name test; what is tested?; describe testing R side; (+)
- Spurling's test (foraminal compression test)
- Identifies dysfunction (typically compression) of cervical nn root
- Pt seated w/cervical R SB, R Rotation, Extension
- PT compression through head
- (+) Symptoms radiate below shoulder
- (-) Symptoms stay in shoulder area or neck
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(+) & (-) Spurling's test
- (+) Symptoms radiate below shoulder
- (-) Symptoms stay in shoulder area or neck
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Cervical - Facet Compression or Quadrant Test - ONLY FOR FACET COMPRESSION
- Describe testing R side
- (+)
- Pt seated w/cervical R SB, Extension, & L Rotation
- (+) Symptom reproduction
- (-) No symptom reproduction
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What is the difference between (+) spurling's & (+) quadrant test?
- (+) spurling's - symptoms radiate below shoulder = neuro
- (+) quadrant - symptom reproduction = facet
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Name test; what is tested?; describe; (+)
- Distraction test
- Compression of neural structures at intervertebral foramen or facet joint dysfunction
- Pt supine, PT holds head under chin & occiput & flexes head while distracting w/14 lb force
- (+) facet - DEC in symptoms in neck
- (+) foraminal - DEC in upper limb pain
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Lower Quarter Tests - 8
- Standing flexion test for lumbar spine
- Gillet’s test
- Long-sitting test
- Sitting flexion test
- SLR
- Prone knee bend (femoral nn stretch)
- Slump test
- Centralization phenomenon
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Name test; what is tested?; describe; (+)
- Standing flexion test
- Testing Iliosacral motion
- PT palpates both PSIS, ask pt to bend forward
- (+) PSIS that moves cranially or moves farthest
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Name test; what is tested?; describe; (+)
- Gillet’s test
- SI jt dysfunction
- Palpate PSIS, pt stands on 1 leg, w/opposite knee pulled toward chest
- (+) Dysfunctional side will NOT move
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Name test; what is tested?; describe; (+) Anterior innominate; (+) Posterior innominate
- Long-sitting test
- Differentiate bet posteriorly or anteriorly rotated innominate
- Pt supine, PT checks levels of malleoli
- Ask pt to sit up and checks levels of malleoli again
- (+) Anterior = Leg longer in supine, shorter in sitting
- (+) Posterior = Leg shorter in supine, longer in sitting
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Long-sitting test
- (+) Anterior innominate rotation
- (+) Posterior innominate rotation
- (+) Anterior = Leg longer in supine, shorter in sitting
- (+) Posterior = Leg shorter in supine, longer in sitting
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Name test; what is tested?; describe; (+)
- Sitting flexion test
- SI dysfunction
- Pt sitting w/feet in contact w/floor/ PT palpates PSIS
- Pt bends forward w/arms across chest & passes elbows between knees as if to touch floor
- (+) Blocked jt moves 1st &/or farther cranially
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Name test; what is tested?; describe; (+)
- SLR test (Lasegue's)
- Tests Sciatic nn
- PT passively flex hip of leg w/knee extended until pt complains of shooting pain into lower limb
- Slowly lower limb until pain subsides, then passively DF foot
- (+) Reproduction of symptoms w/DF
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SLR - To bias Tibial nn vs. Peroneal nn - what movements?
- Tibial nn - DF + Eversion
- Peroneal nn - DF + Inversion
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(+) SLR - bias of nn
- DF + eversion
- DF + inversion
- PF + inversion
- DF + eversion = Tibial nn
- DF + inversion = Peroneal (fibular) nn
- PF + inversion = Sural nn
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Name test; what is tested?; describe; (+) pain location
- Prone knee bend test (femoral nn stretch test)
- Upper lumbar spine nn root lesions (L1-L3)
- Pt prone, flexes knee while PT hyperextends hip
- (+) Pain in to lateral part of hip, upper lumbar spine, or anterior thigh
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(+) Prone knee bend - pain location
Pain in to lateral part of hip, upper lumbar spine, or anterior thigh
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Name test; what is tested?; describe; (+)
- Slump test
- Dysfunction of neurological structures supplying lower limb
- Pt sitting w/straight back
- Pt slumps into lumbar & thoracic flexion, while looking straight ahead
- Pt fully flexes neck and extends 1 leg
- Pt DF foot of extended leg
- (+) Reproduction of radicular pain
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Centralization phenomenon - tests what?
Identifies painful lumbar disc
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Name test; what is tested?; describe; end-feel should be what? (+)
- Transverse liqament stress test
- Pt supine, w/head supported on table
- Glide C1 anterior
- Should be firm end-feel
- (+) Soft end-feel; Dizziness; Nystagmus; Lump sensation in throat; Nausea
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Name test; what is tested?; describe; (+)
- Stork standing test
- Spondylolisthesis
- Pt standing on one leg + trunk extension
- Repeat w/opposite leg on ground
- (+) Pain in low back w/IPSI leg on ground
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Name test; what is tested?; describe; (+)
- Bicycle (van Gelderen's) test
- Intermittent claudication vs. spinal stenosis
- Ride bike w/straight back than w/slumped
- (+) for spinal stenosis - pt able to ride bike longer while slumped
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Tests to evaluate malingering back pain may include - 3
- Hoover test
- Burn's test
- Waddell's signs
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Name test; what is tested?; describe; (+)
- Hoover test
- Malngering back pain
- Pt supine/PT hands under pt's heels
- Pt raises 1 leg at a time - PT monitors P under non-raised leg
- If hard to do pt will push down non-raised leg to help
- (+) Malingering = lack of pushing down P in non-raised leg
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Burn's test - tests what? describe; (+)
- Malingering back pain
- Pt kneel & bend over a chair to touch floor
- Pts w/back pain & sciatica will be able to do this
- (+) Malingering= Pts w/non-organic back pain will not
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Name test; what is tested?; describe; (+)
- Lhermitte's sign
- Meningeal or dural irritation
- Dysfunction of spinal cord and/or UMNL
- Pt in long sitting
- PT passively flex patient's head & one hip, while keeping knee in extension
- Repeat w/other hip
- (+) Pain down spine & into upper or lower limbs
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Difference between Lhermitte’s sign & Soto-Hall
- Lhermitte - PROM head flexion
- Soot-Hall - AROM head flexion
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Romberg test - what is tested?; describe; (+)
- UMNL
- Pt stands feet together, eyes open than closes eyes for 30 seconds
- (+) Excessive swaying
- (+) w/eyes open - cerebellar ataxia
- (+) w/eyes closed - impaired proprioception (impaired dorsal columns)
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Valsalva's maneuver - what is tested?; describe; (+)
- Identifies a space-occupying lesion (herniated disc)
- Pt sitting
- Pt takes a deep breath & holds while "bearing down" as if having a bowel movement
- (+) INC LBP or neurological symptoms into lower extremity
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Name test; What is it testing? describe; (+)
- Prone instability test
- How well pt will respond (+) to spinal stabilization program
- Pt prone w/legs resting on floor
- PT applies PA P to lumbar spine
- Pt lifts legs & PT applies PA P to lumbar spine
- (+) pain w/P/palpation in resting position DEC in active position while palpating
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Name test; what is tested? Describe testing R foramen; (+)
- Quadrant test
- Differentiates bet compression of nn in foramen & facet dysfunction
- SB R + Ext + Rotation R
- (+) Referral goes below knee & & is described as burning
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Name test; what is tested? Describe testing R facet; (+)
- Quadrant test
- Differentiates bet compression of nn in foramen & facet dysfunction
- SB R + Ext + Rotation L(+) Referral DOESN’T go below knee
- (+) Localized to area in back OR glute region & anterior or posterior thigh
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Name test; what is tested?; describe; (+)
- Shoulder ABD test
- Compression of neural structures within foramen
- Pt sitting, asked to place 1 hand on top of head
- (+) DEC in symptoms into upper limb
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Hautant's Test - tests what?
Differentiates vascular vs vestibular causes of dizziness/vertigo
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Name test; what is tested?; (+)
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- McKenzie's Slide Glide Test
- Differentiates between scoliotic curvature vs. neuro dysfunction causing abnormal curvature (lateral trunk shift)
- (+) Reproduction of neuro symptoms as alignment of trunk is corrected
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