A nurse is performing a physical examination on a client who has cervical radiculopathy due to spondylosis. The nurse asks the client to tilt their head toward their affected shoulder and apply slight pressure. The client reports increased pain radiating from their neck to their arm. The nurse recognizes this as a positive result of which of the following tests?
A.
Spurling’s test.
B.
Straight leg raise test.
C.
Tinel’s sign.
D.
Phalen’s test.
The correct answer and Explanation is :
The correct answer is A. Spurling’s test.
Explanation:
Spurling’s test, also known as the Spurling maneuver, is a clinical assessment used to evaluate cervical radiculopathy. In this test, the nurse or clinician typically asks the patient to tilt their head toward the affected shoulder and apply downward pressure on the head. This maneuver aims to reproduce symptoms of radiculopathy, which may include pain, numbness, or tingling radiating down the arm.
In patients with cervical radiculopathy, the compression of nerve roots can occur due to conditions such as spondylosis, herniated discs, or spinal stenosis. When the head is tilted and pressure is applied, the intervertebral foramen, which houses the nerve roots, becomes narrower. If the test is positive, the patient experiences increased pain or radicular symptoms (radiating pain) in the arm, indicating that a nerve root is likely being affected.
This response differentiates Spurling’s test from other assessments. For example, the Straight Leg Raise test is primarily used to assess lumbar radiculopathy by evaluating nerve root irritation in the lower back. Tinel’s sign is used to assess for carpal tunnel syndrome, testing for tingling or electric shock-like sensations when tapping over the median nerve at the wrist. Phalen’s test involves holding the wrists in flexion to elicit symptoms of carpal tunnel syndrome as well.
In summary, the increased pain radiating from the neck to the arm in this scenario confirms a positive Spurling’s test, indicating possible cervical nerve root involvement due to the underlying condition of spondylosis. This test is a valuable tool in diagnosing cervical radiculopathy and guiding further treatment options.