Do:  w/ every cervical test

1.  Pt SS w/ good posture

2.  Palpate C2 (beneath prominent occiput)

3. Pt to SB L/R - does SP move right away?

Cleared if YES

Do if:  + but unconfirmed compression test during screen 

Purpose:

To test for the presence or absence of cervical radiculopathy. - shooting pain down the arm

Description:

The patient is seated. The examiner sidebends the neck towards the

affected side and applies compression force straight down toward table

Positive Test:

The test is considered positive if symptoms are reproduced.

Shoulder Abduction Relief Test

1.  Pt SS or standing

2.  Place pt’s forearm at top of head, palm down

Symptoms relieved - POSITIVE for C4/C5/C6 nerve root compression OR C-radiculopathy OR epidural vein compression OR herniated C disc

Transverse ligament test (holds dens in place) 

1.  Pt supine

2.  Support occiput w/ palms, fingers 3-5

3.  With fingers 1-2, support arch of C2

4.  Lift head and feel for C2 to come with it

5.  Hold 10-20 sec; watch eyes

+ if symptoms reproduced; no treatment

Sharp-Purser Test

(OA Joint)

Do:  w/ any cervical problem

Description:

1.  The patient is seated in a semiflexed position.

2.  The examiner places the palm of one hand on the patient’s forehead and index finger of the

other hand on the spinous process of the axis

3.  Posterior pressure is applied through the forehead.

Positive Test: for c-spine instability if a sliding motion of the head posterior occurs ("feeling it clunk back into place"). This is often accompanied by a reduction in symptoms.

Do if:  + Spurling's Compression Test

1.  The patient is supine and the examiner is seated.

2.  The examiner grasps under the chin and occiput while slightly flexing the patient’s neck and applies a distraction force

+ test for cervical radiculopathy if symptoms relieved

Pain increased?  Not radiculopathy--> likely ligamentous or muscular

+ Upper limb tension test

+ Spurling's test

+ Distraction test

C rotation is <60 degrees to painful side

Cervical Rotation Lateral Flexion Test

(CRLF)

Test for:  C-radiculopathy

1.  Pt. SS

2.  Rotate pt head maximally

3.  Flex head, moving ear to chest, maximally

+ if < 60 degrees of flex

Upper Limb Tension Test A (ULLT)

Pt supine; do good side first

• Scapular depression

• Shoulder abduction

• Forearm supination, wrist and finger extension

• Shoulder lateral elevation

• Elbow extension

• Contralateral/ipsilateral cervical side bending

The test is positive for overall nerve involvement / median nerve involvement or cervical radiculopathy if one or more of the following occurs:

• Symptoms reproduced

• Side to side difference in elbow extension greater than 10 degrees

• Contralateral cervical side bending increases symptoms, or ipsilateral side bending decreases symptoms