Orthopedic Test – Head, Neck(cervical spine) and face

  1. For Bell’s palsy
    1. Chvostek’s test
      • To assess facial nerve
    2. Orbicularis oris strength test, AR
      • To confirm Bell’s palsy
      • Positive sign :  Patient cannot keep their eyes closed against therapist’s resistance.
  2. TMJ disorder
    1. Three- Kunkle test
      • To demonstrate the available active range of depression of the mandible
      • Positive sign: if the client can get only one knuckle or no knuckles at all between the incisors
    2. TMJ joint, AF ROM
      • To assess for the motion of the mandible at the temporomandibular joint
      • Positive sign: clicking, crepitus, asymmetry of motion and pain
  3. Muscle test
    1. Swallowing test
      • To see if the cause of the pain when swallowing, is trigger points on the SCM
      • Positive Sign: pain diminishes when the client swallows as you pincer grasp the most tender point
      • pain may be caused by throat infection, hematoma, bony protruberance of the cervical spine or tumor so client should be advised to see a medical doctor.
    2. Scalene cramp test
      • To reproduce the pain of active scalene trigger points
      • Positive sign : pain in the referred pattern for the scalene muscles
    3. Scalene relief test
      • To assess for the presence of active trigger points in the anterior scalene muscle.
      • Positive sign: reduction of pain
  4. Cervical spine test
    1. Vertebral artery test
      • To assess for circulation deficiency of the vertebral artery at the transverse foramen
      • Positive sign : vertigo, nausea, nystagmus
        • If the test is positive, the client’s head is smoothly and quickly returned to the neutral position. 
      • Do not perform further testing, refer the client to a physician.
    2. Spurling’s test
      • To assess for compression of a cervical nerve root or for facet joint irritation.
      • Positive sign
        •  if nerve root compression: radiating pain or other neurological sign(numbness)
        • if facet joint irritation : pain in local 
      • do not perform this test if the vertebral artery test is positive
    3. Cervical compression test
      • To assess for compression of a cervical nerve root or for facet joint irritation.
      • Positive sign
        •  if nerve root compression: radiating pain or other neurological sign(numbness)
        • if facet joint irritation : pain in local
    4. Cervical distraction test
      • To relieve pressure on the cervical nerve roots
      • Particularly following Spurling’s or cervical compression test)
      • Positive sign : reduction of the client’s pain
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