How does the sharp-Purser test work?
A posteriorly directed force is applied by the hand on the forehead, while the hand on the spinous process of C2 just stabilizes. There should be a firm end-feel. A positive test occurs if there is a sliding movement of the head or a decrease in symptoms (often neuro symptoms; “clunk” may occur).
How do you assess for atlantoaxial instability?
The patient is asked to slowly flex the head performing a slight cervical nod, at the same time the examiner presses posteriorly on the patient’s forehead. A sliding motion of the head in relation to the axis indicates atlantoaxial instability.
How do you test for transverse ligaments?
Lift the head straight up in a vertical plane (not flexion, more of a protraction motion). The test is positive if the patient experiences some feelings of weakness, dizziness, numbness, nystagmus, or an odd feeling in the back of the throat. There is normally a firm end-feel.
How is cervical spondylosis tested?
Imaging tests
- Neck X-ray. An X-ray can show changes in the spine, such as bone spurs, that indicate cervical spondylosis.
- MRI . Using radio waves and a strong magnetic field, MRI can produce detailed images that can help pinpoint areas where nerves might be pinched.
- CT myelography.
What is Foraminal compression test?
A physical examination technique which reduces the opening of the foramen which may demonstrate if there is pressure upon the exiting spinal nerve. The test is done to detect spinal nerve root involvement, a herniated disc, bulging disc, or foraminal stenosis.
How do you perform a vertebral artery test?
Technique
- Place patient in supine and perform a passive extension and side flexion of the head and neck.
- Perform passive rotation of the neck to the same side and hold for approximately 30 seconds.
- Repeat test with head movement to the opposite side.
What is a positive Spurlings test?
A positive Spurling test indicates you have nerve root compression. This pain can affect your neck, shoulder, or arms. It sometimes feels similar to muscle weakness. If you think you have a pinched nerve, or cervical radiculopathy, a positive Spurling test can help your doctor with a diagnosis.
What is cervical distraction test?
The Cervical Distraction Test is a diagnostic test for the presence of Cervical Radiculopathy.
What are the 5 Ds and 3 ns?
“5 D’s And 3 N’s”: Diplopia, dizziness (vertigo, light-headedness, giddiness), drop attacks, dysarthria, dysphagia, ataxia of gait, nausea, numbness and nystagmus.
What is Wallenberg test?
The Vertebral Artery Test or Wallenberg Test is a physical exam for vertebral artery insufficiency. Commonly, the VA test involves cervical spine motion to an end-range position of rotation, extension or a combination of both. At this point, the physician assesses for vertebrobasilar insufficiency (VBI) symptoms.
How is a Spurling test performed?
The examiner turns the patient’s head to the affected side while extending and applying downward pressure to the top of the patient’s head. A positive Spurling’s sign is when the pain arising in the neck radiates in the direction of the corresponding dermatome ipsilaterally. It is a type of cervical compression test.
How do you perform a Spurling?
The traditional Spurling test is done by putting pressure on your head. You may feel pain or strange sensations. Your doctor will keep the pressure going until the end of the test. The test will stop sooner if you feel pain or discomfort.
What is sharp Purser test?
Sharp-Purser Test. Purpose: To assess the integrity of the transverse ligament/upper cervical spine instability. Test Position: Sitting.
Should Sharp-Purser test be performed first before other ligament tests?
Aspinall suggests that if upper cervical instability is suspected, the Sharp-Purser test should be performed first before any of the other ligamentous tests.
How does the sharp-Purser test work for Cervical Spondylitis?
The Sharp-Purser Test decreases symptoms by increasing the vertebral canal space. It does this by moving the atlas posteriorly relative to the axis (assuming there is a damaged transverse ligament).
How accurate is the sharp-Purser test for subluxation?
Diagnostic Accuracy: Sensitivity: .69; Specificity: .96; -LR: .32; +LR: 17.3 (“Clinical assessment of atlantoaxial instability using the Sharp-Purser test”; article suggests diagnostic criteria is applied when subluxation is >4 mm.).