Flashcards in OSCE 2- tests (2) Deck (39)
Valsalva's maneuver procedure
doctor stands in front of seated patient
patient is asked to take a breath and bear down as if they were laboring during a strenuous defecation
why would a patient become dizzy during valsalva's maneuver?
decreased cerebral blood supply
what are the findings with valsalva?
a sharp accentuation of pain at the level of the lesion usually indicates a space occupying lesion
note the location of the pain; it will help to identify the etiology of the pain
what is the procedure of the swallowing test? What does this indicate?
while seated, the patient is instructed to swallow
presence of pain or difficulty swallowing indicates a...
space occupying lesion
osteophyte at the anterior protion of the cervical spine
what is the procedure of Naffziger's test?
doctor stands behind a seated patient and occludes the external jugular veins at the level of the clavicles for 10-15 seconds. the doctor then asks the patient to cough
what are the findings of naffziger's?
sharp accentuation of pain at the level of the lesion
note the location of the pain
procedure for barr'e-Lie'ou test?
while patient is in a seated position, the doctor instructs the patietn to rotate the head back and forth as fast as they can. if at any time the patient experiences symptoms, the test is positive
what is the purpose of the barr'e-Lie'ou test?
to rule out vascular insufficiency, cervicogenic vertigo, possible vestibular apparatus abnormality
what is the proceudre of the vertebrobasilar arteyr functional maneuver?
while patient is in seated position, the doctor auscultates the carotid and subclavian arteries bilaterally
the doctor then palpates the carotid and subclavian arteries bilaterally. if no assymetrical or diminished pulsations are felt or no bruits exist, the doctor instructs the patient to rotate and hyper-extend the head to one side.
during full rotation and extension patient should coudn backward from 20 by 1's. patient should then repeat the rotation and hyperestension on the other side and repeat
any symptoms indicates positive test
what is the reporting statement for vertebrobasilar artery functional maneuver?
considered positive if either maneuver reveals bruits.
a positive finding indicates a buckling of the ipsilateral vertebral artery
vertigo, dizziness, visual disturbances, nausea, syncope and nystagmus are all positives
if it is positive on the right, the finding is on the right
what symptoms suggests possible subclavian artery stenosis or occlusion?
a difference in how many mmHg between two systolic BPs and a feeble or absent radial pulse on the side of the feeble pulse
procedure for deklyn's test?
while patient is lying supine, doctor instructs the patient to rotate and hyper-extend the head to one side. during full rotation and extension the patient should cound back wards from 20 by 1's
repeat on the opposite side
rotating head causes compression of vertebral arteries
test is positive if patient has symptoms
what are the clinical indications for deklyn's test?
rotation and hyper-extension protion of this rests places motion-induced compression on the vertebral arteries.
symptoms=positive= vertebral, basilar, carotid artery stenosis or compression
what is the procedure for the distraction test?
with the patient seated, the doctor exerts upward pressure on the patient's head. this removes the weight of the patient's head from teh neck
hold for 30-60 seconds
what does generalized, increased pain for the distraction test?
what does relief of pain indicate with the distraction test?
intervertebral foraminal encroachment
what is the purpose of the distraction test?
confirm IVF encroachment
what is the procedure for the foraminal compression test?
with the patient in the seated position the patient actively rotates the head from side to side. note pain and the location of the pain is present. the doctor then exerts strong downward pressure with the head in the neutral position, noting any radicular pain. doctor then rotates neck while exerting strong downward pressure on the head
what is the purpose of the foraminal compression test?
to confirm IVF encroachment and nerve root involvement
what is the procedure of the jackson compression test?
patient in seated position, the patient actively rotates the head from side to side. note pain. patient laterally flexes head, note pain. doctor exerts downward pressure on the head in a neutral position, note pain. doctor laterally flexes the patient's neck wil exerting strong downward pressure on head. note pain. pressure maintained for 30-60 sec
what is the purpose on the jackson compression test?
confirm IVF encroachment and nerve root involvement
what is the reporting statement for jackson compression test?
positive on the right elicits pain in the cervical dermatome
what is the maximum cervical compression test procedure?
while in the seated position, the patient is instructed to approximate the chin to the shoulder while fully rotating th ehead, laterally flex and then extend the neck
the test is performed bilaterally
pain on teh concave side indicates nerve root or facet involvement.
pain on convex side indicates muscular strain. note location of pain
what is the purpose of the maximum cervical compression test
to confirm IVF encroachment and nerve root involvement
procedure for spurling's test
with the patient seated, patient actively rotates the head from side to side. note pain. if no pain continue
patient actively laterally flexes the head from side to side. note pain, if no pain continue
doctor exerts strong downward pressure with head in neutral position, note pain, if none, continue
doctor laterally flexes and extends the patient's neck as far as tolerated, while exerting strong downward pressure on the head. note pain, if no pain continue
pressure maintained for 30-60 seconds
then doctor delivers a vertical blow to the uppermost portion of the crainum
what is the purpose of spurling's test?
confirm IVF encroacment and nerve root involvement
procedure for lhermitte's test
with patient seated the doctor instructs them to drop their chin to their chest. doctor then passively flexes the patient's head
purpose of lhermitte's test
traction the posterior column of the spinal cord
findings of lhermitte's test
electroc shock like sensation radiating down the neck and spine is a sign of posterior column disease of the spinal ord and also a classic sign of MS
note location of pain