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

“By providing students with a clear, concise, and well-illustrated text on neurologic examination techniques, Dr. Scifers has filled an obvious void in the athletic training, physical therapy, and allied health literature. Special Tests for Neurologic Examination is much more than a collection of special tests and examination techniques. The descriptions and figures have been carefully selected and the inclusion of alternate (regional) names for selected techniques minimizes the confusion experienced by students who are often required to master a large number of tests. The publication of this text is both timely and appropriate.”

— John M. Hauth, EdD, ATC, East Stroudsburg University of Pennsylvania

"Special Tests for Neurologic Examination by Dr. James R. Scifers is a great text that compiles information about various neurologic examination and evaluation techniques into an easy-to-use guide for students, clinicians, and educators. I highly recommend, Special Tests for Neurologic Examination. This text would be a valuable addition to any athletic training or physical therapy curriculum, as a supplement to larger evaluation texts."

-Jessica Walter, MSEd, ATC, LAT, Cumberland University, Athletic Training & Sports Health Care

 "It is a valuable resource for experienced clinicians who need a quick guide to cranial nerve testing, concussion testing and grading, and other neurological tests. The overall organization is easy to follow. This is a valuable resource for athletic training students and experienced athletic trainers who see athletes post-concussion. It may serve as a quick reference in the training room or clinic, or as a teaching tool."   

— Barbara Jean Billek-Sawhney, PT, EdD, GCS, Slippery Rock University, Doody Enterprise, Inc.

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.