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NMS 1 Test 2
NMS Stachenotes
59
Anatomy
Post-Graduate
01/19/2012

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Cards

Term
Cervical ROM
Definition
Flexion 50 degrees
Extension 60 degrees
Lateral 45 degrees
Rotation 80 degrees
Term
Thoracic ROM
Definition
Flexion 50 degrees
Rotation 30 degrees
Term
Lumbar ROM
Definition
Flexion 60 degrees
Extension 25 degrees
Lateral 25 degrees
Term
Shoulder ROM
Definition
Flexion 180 degrees
Extension 50 degrees
Abduction 180 degrees
Adduction 50 degrees
Rotation 90 degrees internal and external
Term
Elbow ROM
Definition
Flexion 140 degrees
Extension 0 degrees
Supination 80 degrees
Pronation 80 degrees
Term
Wrist ROM
Definition
Flexion 60 degrees
Extension 60 degrees
Ulnar 30 degrees
Radial 20 degrees
Term
Rust's Sign
Definition
Procedure: If patient grasps ;head with both hands when lying down or arising from lying down, this is a positive sign.
Reporting Statement: Rust sign is present
Clinical Indication: suggests ligament, muscle damage, or possible fracture. X-Ray
Term
Libman's Sign
Definition
Procedure: The examiner applies thumb pressure to the mastoid process and gradually increases the pressure until the patient states that it is becoming noticeably uncomfortable.
Reporting Statement: Libman's sign demonstrates (low/normal/high) tollerance to pain.
Clinical Indication: Useful for interpretation of palpation findings in later exams.
Term
Bakody Sign
Definition
Purpose: The position a patient will assume if experiencing severe radicular symptoms.
Procedure: Patient, in a seated position, will plave palm of the affected arm on top of their head, raising the elbow to the level of the ear.
Function: This position decreases the traction of the lower part of the brachial plexus.
Findings: Sign that the patient has symptom of nerve root irritation.
Term
Positive Reverse Bakody Sign
Definition
The pain of the patient's chief complaint is exacerbated. This indicates a thoracic outlet syndrome from interscalenecompression.
Term
Negative Bakody Sign
Definition
The patient experiences no change in the pain or there is no pain complaint in the neck and/or arm.
Clinical indication: Differentiate an IVF encroachment from a thoracic outlet syndrome.
Term
Bikele's Sign
Definition
Purpose: With the patient being placed in a position that will traction the brachial plexus and it's nerve roots
Procedure: The patient is asked to abduct the shoulder to 90 degrees and then the elbow is put into full extension
Function: This stresses the brachial plexus
Findings: This pain is radicular in nature going into the arm
Term
Brachial Plexus Tension Test
Definition
Purpose: Traction the brachial plexux and its nerve roots
Procedure: Patient abducts both shoulders to 90 degrees and places hands behind head. Dr. then pulls elbows back.
Function: Stresses the brachial plexus
Findings: Pain is radicular in nature going into the arm.
Term
Valsalva's Maneuver
Definition
Pupose: Tests for SOL's in spinal column that communicate with meninges.
Procedure: Stand in front of seated patient. Ask them to breath in and bear down.
Explanation: Patient is placing exhalation force against a closed glottis, increasing intra-thecal pressure within the spinal cord
Findings: Sharp pain at level of lesion indicates SOL
Term
Dejerine's Sign (triad)
Definition
Procedure: Caughing, sneezing, and straining during defecation, may cause aggravation of radiculitis symptoms.
Report: Dejerine's sign present, suggesting SOL mass at C _ leve4l.
Clinical Indication: Sudden increase in intrathoracic and intraabdominal pressure block the venous flow causing distension of veins in epidural space forcing dura toward cord, stretching nerve roots, causing pain.
Term
Swallowing test
Definition
Purpose: Test for SOL's, ligament sprain, muscular strain, fracture, tumor, or other throat abnormality.
Procedure: Seated patient swallows. Pain or difficulty experienced indicates SOL, ligamentous spran, muscular strain, fracture, disc protrusion, tumor, or osteophyte at the anterior portion of the cervical spine.
Report: Positive swallowing test indicates dysphagia.
Clinical Indication: Suggests esophageal irritation due to direct trauma or retrosophageal SOL
Term
Naffziger's Test
Definition
Purpose: Create pooling of the venous sinuses that will cause an increase in cerebral spinal fluid pressure
Procedure: Stand behind seated patient, occlude external jugular veins @ clavical for 10-15 sec. Ask patient to cough.
Function: Backing up of venous flow along with cough accentuates the intra-thecal pressure.
Findings: Sharp accentuation of pain at the level of the lesion
Term
George's Test
Definition
Purpose: Rule out vascular insufficiency
Procedure: Seated patient. Palpate radial pulse, bilaterally. BP bilateral. Palpate carotid and subclavian arteries, auscultate for pulsations and bruits. Patient then rotates and hyperextends head to one side, then other. During rotation and extension patient counts backward from 20.
Reporting: Test is positive if maneuver reveals bruits, vertigo, dizziness, visual disturbances, nausea, syncope, and nystagmus.
Term
Distraction Test
Definition
Purpose: Confirm IVF encroachment
Procedure: Seated patient, examiner exerts upward pressure on patients head.
Reporting: Distraction positive if pain is reduced.
Clinical indication: Increased pain indicates muscle spasm, relief of pain indicates intervertebral foraminal encroachment or facet capsulitis.
Term
Jackson Compression Test
Definition
Purpose: Confirm IVF Encroachment and nerve root involvement
Procedure: Seated patient rotates head from side to side; note pain. Patent laterally flexes head from side to side; note pain. Push down on patients head in neutral position; note pain. Laterally flex patients neck with downward pressure; note pain.
Reporting: Jackson cervical compression is positive on the (R/L) and elicits pain in the C_ dermatome.
Clinical indication: Pain on the side opposite rotation suggests muscular strain, while pain on the side of rotation suggests facet or nerve root involvement.
Term
Spurlung's Test
Definition
Purpose: Confirm IVF encroachment and nerve root involvement
Procedure: Seated patient rotates head from side to side; note pain. Patient laterally flexes head from side to side; note pain. Patent laterally flexes head from side to side; note pain. Push down on patients head in neutral position; note pain. Laterally flex patients neck with downward pressure; note pain.
Term
Lhermitte's Test
Definition
Why: test for multiple sclerosis
How: Seated patient drops their chin to their chest. Dr. passively flexes the patients head.
How's it work? Causes sudden traction of the spinal cord, causing electric shock-like sensation radiating down the neck and spine.
Term
O'Donoghue maneuver
Definition
Why? Tests for muscle strain or ligamentous sprain in the cervical spine.
How: Seated patient, actively move cervical spine through ROM, then passively move it through ROM with resistance.
Interpret: pain during passive ROM indicates ligament sprain, pain during resisted ROM signifies muscle strain.
Term
Kernig/Brudzinski Sign
Definition
Why? Tests for meningitis
How: Supine patient. Dr passively flexes patient's head. Kernig includes Dr. flexing hip and knee of either leg to 90 degrees and then attempting to completely extend the leg.
Interpret: If both knees flex when patients head is flexed, the test is positive. If the knee cannot be exteded due to pain, the sign is present. These indicate meningeal irritation.
Term
Shoulder Depression Test
Definition
Why: Traction the brachial plexus, looking for fibrosis, adhesion, nerve roots tractioned, or edema.
How: Seated patient. Dr. latterally flexes head away from tested side and pushes down on shoulder of tested side.
Term
Allen's Test
Definition
Term
Adson's Test
Definition
Term
Modified Adson's Test
Definition
Term
Halstead's Test
Definition
Term
Allen's Maneuver
Definition
Term
Roo's Tests (Hostage)
Definition
Term
Wright's Test
Definition
Term
Costoclavicular manouver (Eden's) Test
Definition
Term
Apley's Test
Definition
Term
Apprehension Test
Definition
Term
Codman's Sign
Definition
Term
Dawbarn's Sign
Definition
Term
Dugas' Test
Definition
Term
Impingement Test
Definition
Term
Speed's Test
Definition
Term
Supraspinatus Press Test
Definition
Term
Yergason's Test
Definition
Term
Load and shift Test
Definition
Term
O'Brien's Test
Definition
Term
Lift off Test
Definition
Term
Elbow Flexion Test
Definition
Term
Tinel's Test at the Elbow
Definition
Term
Cozen's Test
Definition
Term
Golfers Elbow Test
Definition
Term
Lift Test
Definition
Term
Ligament Instability Test
Definition
Term
Mill's Test
Definition
Term
Tinnel's Test at the wrist
Definition
Term
Phalen's Test
Definition
Term
Froment's Test
Definition
Term
Pinch Grip Test
Definition
Term
Bunnell-Littler Test
Definition
Term
Finkelstein's Test
Definition
Term
Mannkopf's Test
Definition
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