Special Tests for Neurologic Examination

Ideal for students and clinicians to access quick clinical information, Special Tests for Neurologic Examination offers invaluable evaluation and assessment tips and techniques for neurologic conditions commonly found in patients. Organized in an easy-to-use format, this book is the perfect guide for practicing clinical skills and reviewing for licensure and certification examinations.

Dr. James R. Scifers describes and illustrates special tests for the upper extremity, lower extremity, and spine. This resource provides performance criteria for each special test, important information on specificity and sensitivity, and valuable references for further investigation.

Inside you’ll find:

• Techniques for dermatome, myotome, reflex screening, and concussion testing
• Examples of various concussion grading scales and neuropsychological tests
• Special design that facilitates use of the book as a user-friendly study guide and quick clinical reference
• Data on test specificity and sensitivity to assist clinicians in determining the value and strength of various clinical examination procedures
• Additional resources for further study and exploration

A facilitative and comprehensive approach to learning, practicing, and reviewing neurologic special tests makes Special Tests for Neurologic Examination a must-have for students and clinicians alike. With a focus on commonly used evaluative procedures for differentiating and diagnosing neurologic disorders, the book serves as a valuable companion to the popular Special Tests for Orthopedic Examination.

Contents

Dedication
Acknowledgments
About the Author
About the Contributor
Preface
Foreword by John M. Hauth, EdD, ATC
Introduction

Section One: Head
Chapter 1: Cranial Nerve Assessment
Cranial Nerve I: Olfactory Nerve
Cranial Nerve II: Optic Nerve
Cranial Nerve III: Oculomotor Nerve
Cranial Nerve IV: Trochlear Nerve
Cranial Nerve V: Trigeminal Nerve
Cranial Nerve VI: Abducens Nerve
Cranial Nerve VII: Facial Nerve
Cranial Nerve VIII: Acoustic Nerve
Cranial Nerve IX: Glossopharyngeal Nerve
Cranial Nerve X: Vagus Nerve
Cranial Nerve XI: Spinal Accessory Nerve
Cranial Nerve XII: Hypoglossal Nerve

Chapter 2: Concussion Grading Scales/Coma Scales- Jill A. Manners, MS, LAT, ATC
Glasgow Coma Scale
Rancho Levels of Cognitive Functioning
Levels of Consciousness
Galveston Orientation and Amnesia Test (GOAT)
American Academy of Neurology Grading Scale
Cantu Concussion Grading Guidelines
Colorado Medical Society Concussion Rating Guidelines
Torg Concussion Grading Guidelines
University of North Carolina Concussion Grading Scale

Chapter 3: Concussion Testing- Jill A. Manners, MS, LAT, ATC
Romberg Test
Tandem Test
Finger-to-Nose Test
Proprioceptive Finger-to-Nose Test
Serial Seven Test
Past-Pointing Test
Neurological Control Test-Upper Extremity
Neurological Control Test-Lower Extremity
Balance Error Scoring System (BESS) Test

Chapter 4: Neuropsychological Tests
Computerized Assessments
ImPACT
HeadMinder
CogSport
Pencil-and-Paper Tests
Standard Assessment of Concussion (SAC) Test
Trail Making Test
Symbol Digit Modalities Test
Stroop Color and Word Test

Chapter 5: Special Tests for Central Nervous System Involvement
Hoffmann's Sign
Babinski's Test
Oppenheim's Test
Chvostek's Sign
Weber Test
Rinne Test
Clonus
Decerebrate Posturing
Decorticate Posturing

Section Two: Cervical Spine
Chapter 6: Dermatome Testing
Sensory Testing: Light Touch
Sensory Testing: Sharp-Dull
Sensory Testing: Temperature
Sensory Testing: Two-Point Discrimination

Chapter 7: Myotome Testing
C1 and C2 Myotome Test
C3 Myotome Test
C4 Myotome Test
C5 Myotome Test
C5/C6 Myotome Test: Elbow Flexion
C6 Myotome Test: Wrist Extension
C7 Myotome Test: Elbow Extension
C7 Myotome Test: Wrist Flexion
C7 Myotome Test: Finger Extension
C8 Myotome Test: Finger Flexion
C8 Myotome Test: Thumb Flexion
C8 Myotome Test: Thumb Extension
T1 Myotome Test: Finger Abduction
T1 Myotome Test: Finger Adduction

Chapter 8: Reflex Testing
Biceps Brachii Reflex (C5 Nerve Root) Testing
Brachioradialis Reflex (C6 Nerve Root) Testing
Triceps Reflex (C7 Nerve Root) Testing

Chapter 9: Special Tests for the Cervical Spine
Brachial Plexus Traction Test
Upper Limb Tension Test (ULTT) 1: Median Nerve Bias
ULTT 2: Median, Musculocutaneous, and Axillary Nerve Bias
ULTT 3: Radial Nerve Bias
ULTT 4: Ulnar Nerve Bias
Shoulder Abduction Test
Cervical Compression Test
Spurling's Test
Cervical Distraction Test
Swallowing Test
Tinel's Sign
Valsalva's Maneuver

Section Three: Thoracic Spine
Chapter 10: Dermatome Testing
Chapter 11: Myotome Testing

Section Four: Lumbar Spine
Chapter 12: Dermatome Testing
Chapter 13: Myotome Testing
L1 and L2 Myotome Test
L3 Myotome Test
L4 Myotome Test: Ankle Dorsiflexion
L4 Myotome Test: Ankle Inversion
L5 Myotome Test
S1 Myotome Test: Ankle Plantarflexion
S1 Myotome Test: Ankle Eversion
S2 Myotome Test

Chapter 14: Reflex Testing
Patellar Tendon Reflex (L4 Nerve Root) Testing
Achilles Tendon Reflex (S1 Nerve Root) Testing

Chapter 15: Special Tests for the Thoracic and Lumbar Spine
Beevor's Sign
Milgram's Test
Brudzinski's Sign
Kernig's Test
Straight Leg Raise Test
Well Straight Leg Raise Test
Quadrant Test
Slump Test
Bowstring Test
Tension Sign
Sitting Root Test
Prone Knee Bending Test
Valsalva's Maneuver

Section Five: Upper Extremity
Chapter 16: Peripheral Nerve Pathology of the Upper Extremity
Axillary Nerve
Long Thoracic Nerve Injury
Cubital Tunnel Syndrome
Cubital Fossa Syndrome
Radial Tunnel Syndrome/Supinator Syndrome
Pronator Teres Syndrome
Carpal Tunnel Syndrome
Tunnel of Guyon Syndrome
Drop Wrist Deformity
Ape Hand Deformity
Bishop's Hand Deformity
Claw Hand Deformity

Chapter 17: Special Tests for the Upper Extremity
Adson's Test
Allen's Test
Military Brace Position
Hyperabduction Syndrome Test
Halstead's Maneuver
Roo's Test
Tinel's Sign at the Elbow
Elbow Flexion Test
Pronator Teres Syndrome Test
Wartenberg's Sign
Phalen's Test
Reverse Phalen's Test
Tinel's Sign at the Wrist
Carpal Compression Test
Pinch Grip Test
Froment's Sign
Egawa's Sign
Wrinkle Test
Ninhydrin Test
Weber's Two-Point Discrimination Test

Section Six: Lower Extremity
Chapter 18: Peripheral Nerve Pathology of the Lower Extremity
Morton's Neuroma
Common Fibular Nerve Injury
Tarsal Tunnel Syndrome
Anterior Compartment Syndrome
Piriformis Syndrome
Meralgia Paresthetica
Ilioinguinal Nerve Entrapment

Chapter 19: Special Tests for the Lower Extremity
Tinel's Sign for Tarsal Tunnel
Pencil Test
Interdigital Neuroma Test
Duchenne Test
Piriformis Test
Yeoman's Test
Femoral Nerve Traction Test

Index

About the Author

James R. Scifers, DScPT, PT, SCS, LAT, ATC is the founding Program Director for the Western Carolina University Athletic Training Education Program. He also serves as an Associate Professor in the School of Health Sciences and the Department of Physical Therapy at Western Carolina University.

Dr. Scifers received his bachelor of science degree in athletic training from East Stroudsburg University, his master of physical therapy degree from Emory University, and his doctor of science in physical therapy degree from the University of Maryland School of Medicine. He is a North Carolina licensed athletic trainer and physical therapist and holds certification as a Board Certified Specialist in Sports Physical Therapy.

Dr. Scifers has more than 18 years of clinical practice in the professional, collegiate, secondary school, and clinical settings. He has served as Program Director for the Athletic Training Education Programs at Salisbury University and Lock Haven University and also as a professor in the University of Kentucky Department of Physical Therapy.