Cervical Spine Pathologies and Special Tests颈椎病和特殊试验.ppt

Special Tests Cervical Compression Test: Attempts to duplicate patient’s symptoms by ↑ pressure on cervical nerve roots. Do NOT perform test until cervical fracture, dislocation, or instability has been ruled out. Special Tests Spurling Test (Foraminal Compression): Patient position: Seated ATC position: Standing behind the athlete with hands interlocked over crown of patient’s head Procedure: Patient laterally flexes the head while a compressive force is placed along patient’s cervical spine Positive test: Radiating pain down patient’s arm Implication: Nerve root impingement Special Tests Spurling’s Test: Attempts to compress a cervical nerve root. Do NOT perform until a cervical fracture, dislocation, or instability has been ruled out. Special Tests Cervical Distraction Test: Patient position: Supine (relaxes the muscles acting on the cervical spine) ATC position: At head of patient with one hand under the occiput and the other on top of the forehead (stabilizing head) Procedure: Apply traction on patient’s head, causing distraction of cervical spine Positive test: Relief or reduction in symptoms Implications: Compression of the cervical facet joints and/or stenosis of neural foramina Cervical Distraction Test: Attempts to relieve patient’s symptoms by ↓ pressure on cervical nerve roots. Do NOT perform test until cervical fracture, dislocation, or instability has been ruled out. Special Tests Vertebral Artery Test: Patient position: Supine ATC position: Seated at head of the patient with hands placed under the occiput to stabilize the head Procedure: Passively extend and laterally flex the cervical spine (1) Head is rotated toward the laterally flexed side and held for 30 seconds (2) Positive test: Dizziness, confusion, nystagmus, unilateral pupil changes, nausea Implication: Occlusion of the cervical vertebral arteries Vertebral Artery Test: Used to assure the competency of the vertebral artery prior to initiating treatment or rehabilitation techniques