Shoulder depression test

Aka. Brachial plexus distraction test Purpose:  To test for radiculopathy or brachial plexus lesion. Test procedure: • The patient is seated. • The examiner stands behind the patient. • The examiner side-bends the neck and depresses the ipsilateral shoulder. This places a detractive force through the nerve roots of the cervical and brachial plexii. • The examiner observes the … Continue reading Shoulder depression test

Brachial plexus compression test

Purpose:  Test for the presence of brachial plexus irritation. Test procedure: • The patient is seated. • The examiner stands beside the patient supporting them. • The examiner palpates firmly over the brachial plexus and instructs the patient to slowly side-bend their head away from the area being palpated. • The patient may report increase in … Continue reading Brachial plexus compression test

Dix-Hallpike maneuver or test

Definition: The Dix-Hallpike manoeuvre is used to assess for Benign Paroxysmal Positional Vertigo (BPPV) and the integrity of the vestibular apparatus and its associations with the cerebellum Test procedure: Get the patient to sit on the couch lengthwise (with the legs along the long surface). Place them in a position so that when you get … Continue reading Dix-Hallpike maneuver or test

Joint position sense

Definition: The joint position test is a manoeuvre performed to assess the integrity of the position sense, often performed to assess the integrity of the ventral cerebellar tract. Test procedure: The examiner grasps the lateral and medial portion of the toes or else the digits of the hand can be checked. The examiner asks the … Continue reading Joint position sense

Heel-to-shin test

Definition: The heel-to-shin test is a test of lower limb coordination and position sense, often performed to assess the integrity of the cerebellum. Test procedure: 1. With patient lying supine. Instruct the patient to raise one leg and with their heel touch their opposite knee, dragging the heel along the skin, along the shin toward … Continue reading Heel-to-shin test

Finger-to-nose test

Definition: The finger to nose test is an evaluation of upper limb coordination and proprioception, often performed to assess the integrity of the cerebellum. Test procedure: The patient is instructed to touch his/her nose and then without delay touch the examiners extended finger and again touch his/her own nose. This sequence is repeated for a … Continue reading Finger-to-nose test

Testing for ataxia

Definition: Ataxia and ataxic disorders are a group of neurological conditions where by a combination of balance, speech and co-ordination may be affected. Test procedure: These assessments are designed to test for motor control and co-ordination. Rapid alternating movements 1. Patient extends arms. Instruct the patient to swipe one palm alternately with the palm and … Continue reading Testing for ataxia

Testing for tremor

Definition: A tremor is characterised by the involuntary, rhythmic contraction and subsequent relaxation of a muscle, resulting in the movement of certain body parts (most noticeable in the hands and head). Causes include: cerebellar, dystonic, essential, orthostatic, Parkinsonian, physiologic, psychogenic, and rubral. Test procedure: The tests for tremor determine any functional limitations, such as difficulty … Continue reading Testing for tremor

Kernig’s test and Brudzinski’s sign

Definition: Kernig’s test and Brudzinski’s sign are clinical tests used to assess the integrity and inherent tension residing within the spinal cord and it’s meningeses. These tests are often performed to assess a patient suspected to have meningitis and other spino-cerebellar lesions capable of affecting the spinal cord. Test procedure: Kenig’s sign: 1. The patient … Continue reading Kernig’s test and Brudzinski’s sign

Straight leg raise test, Lasegue’s test

Definition: The Straight leg raise is a neurodynamic passive test that aids in assessing the integrity of the spinal cord and its meninges by stressing the sciatic nerve, lumbar region and associated discs/segments using the lower limb as a lever. Test procedure: With the patient lying supine, the examiner passively; 1. Internally rotates and slightly … Continue reading Straight leg raise test, Lasegue’s test

Test for two point discrimination

Definition: The two point discrimination test evaluates the presence of a lesion affecting the peripheral nerve, posterior column, thalamus or sensory cortex. Test procedure: Use a device such as a blunted compass that can create two adjacent points of contact. Vary the application between single or double stimulations, asking the patient to indicate whether they … Continue reading Test for two point discrimination

Test for light touch

Definition: Light touch sensory testing evaluates the presence of a lesion affecting the peripheral nerve, posterior column, thalamus or sensory cortex. Test procedure: Perform the test with the patient either sitting or lying down, using a piece of cotton wool, cloth etc. to dab the skin rather than stroke it. Show the patient what you … Continue reading Test for light touch

Test for pain sensation

Definition: Pain sensory testing evaluates the presence of a lesion affecting the peripheral nerve, lateral spinothalamic tract, thalamus or sensory cortex. Test procedure: Use a hygienic device capable of providing a sharp sensation but not capable of breaking the skin, and something to produce a contrastingly blunt sensation. Demonstrate the two stimuli, then ask the … Continue reading Test for pain sensation

Reflex reinforcement technique

Definition: Also known as the Jendrassik manoeuvre, reinforcement technique is a further method of testing for normal reflex response where it has been found to be absent by conventional reflex testing. Test procedure: Where a reflex appears to be absent in the lower limb ask the patient to interlace the fingers and pull apart, thereby … Continue reading Reflex reinforcement technique

Clonus test at the knee

Definition: Clonus is characterised by a series of involuntary muscular contractions due to a sudden stretch placed upon a muscle. Test procedure: With the patient supine and their leg being tested straight, the examiner rapidly moves the patients patella distally using the web of his/her hand, and holds this position for a few seconds. This … Continue reading Clonus test at the knee

Clonus test at the ankle

Definition: Clonus is characterised by a series of involuntary muscular contractions due to a sudden stretch placed upon a muscle. Test procedure: With the patient supine or in a seated position, the examiner rapidly dorsiflexes the patient’s foot and holds it in that position for a few seconds. This procedure can also be carried out … Continue reading Clonus test at the ankle

Ankle Achilles tendon reflex

Definition: The ankle jerk or ankle tendon reflex, also known as the Achilles reflex, takes place when the Achilles tendon is tapped while the foot is kept by the examiner in a dorsi-flexed position. Test procedure: The ankle reflex can be elicited in the supine, sitting or kneeling positions. With the patient and sitting position … Continue reading Ankle Achilles tendon reflex

Patella tendon knee reflex

Definition: Also known as the knee jerk, this reflex is characterised by the contraction of the quadriceps upon stretching of the patella tendon. Test procedure: With the patient seated or supine, the examine strikes the patella tendon of the patient’s relaxed leg. If the patient is supine, this reflex is easier to elicit with the … Continue reading Patella tendon knee reflex

Brachioradialis tendon reflex

Definition: The Brachioradialis tendon reflex occurs when this tendon is struck by a reflex-hammer, and is characterised by the contraction of this muscle thus flexing the elbow. Test procedure: With the patient seated or supine, the examiner locates the tendon of the Brachioradialis muscle and covers it with their thumb. After which, the examiner strikes … Continue reading Brachioradialis tendon reflex

Triceps tendon reflex

Definition: The triceps tendon reflex can be elicited when the triceps tendon is hit with a reflex hammer, thus inducing a contraction of the triceps brachii muscles. The distal insertion of the triceps is on the olecranon process of the ulna bone. Test procedure: With the patient lying supine or sat on the examining table, … Continue reading Triceps tendon reflex

Biceps tendon reflex

Definition: The Biceps tendon reflex can be elicited when the biceps brachai tendon is hit with a reflex hammer, thus inducing a contraction of the biceps brachii. Test procedure: With the patient lying supine or sat on the examining table, the practitioner holds the patient’s arm at the elbow, and places his/her thumb over the … Continue reading Biceps tendon reflex

Anal reflex

Definition: The superficial anal reflex tests the integrity of a reflex arc involving S4 and S5 spinal segments. Test procedure: Ensure all ethical considerations are met regarding informed consent to examination. Lie the patient on their side with the knees flexed, and gently stroke the anal margin with a suitable implement such as an orange … Continue reading Anal reflex

Cremasteric reflex test

Definition: The cremasteric reflex evaluates the presence of a pyramidal track lesion. Test procedure: The male patient is undressed sufficiently to expose his genitals. The cremasteric reflex can be performed either in the supine or standing positions. Using a pointed but not sharp instrument, like the handle end of a swab stick, a brisk scratch-line … Continue reading Cremasteric reflex test

Plantar reflex / Babinski sign

Definition: The Babinksi response to the plantar reflex is a test which can identify pathological processes affecting the spinal cord and brain, and that also exists as a primitive reflex in neonates. The superficial plantar reflex also evaluates the integrity of a reflex arc involving the L5 and S1 spinal segments. Test procedure: Perform the … Continue reading Plantar reflex / Babinski sign

Tendon reflex

Definition: Tendon and superficial reflex arcs consist of a protective muscular contraction response to a stimulus. In the case of a tendon reflex the stimulus is a stretch to the tendon itself, whereas a superficial reflex is induced by stroking the skin. Test procedure: To induce a tendon reflex, position the muscle so that it … Continue reading Tendon reflex