Orthopedic Exam / Special Tests for Physical Therapy: HEAD & NECK
VERTEBRAL ARTERY TEST: (Procedure Below)
The Vertebral Arteries:
Both vertebral arteries, the one on the left and the other on the right, rise up from the subclavian arteries on a path parallel to the carotid artery. Inside the skull, the two vertebral arteries merge to form the basilar artery, which is among the arteries supplying blood to the brain. and merge to form the single midline basilar artery in a complex called the vertebrobasilar system, which supplies blood to the posterior part of the circle of Willis and thus significant portions of the brain. The vertebral arteries are responsible for supplying blood to the brain stem portion of the brain, which helps control basic functions such as breathing, heart rate, and sleeping.
The vertebral arteries branch from the subclavian arteries, entering deep to the transverse foramens of each cervical vertebrae (C6 through C1). Once they have passed through the transverse foramen of C1, the vertebral arteries travel across the posterior arch of C1 and through the suboccipital triangle before entering the foramen magnum. The two vertebral arteries then join to form the basilar artery at the base of the Pons.
The vertebral artery can be divided into four parts. The first part runs between the internal jugular vein and C7 vertebrae. The second part is situated in front of the trunks of the cervical nerves and runs vertically as far as the transverse process of the axis of C2. The third part originates from the C2 foramen transversarium (a hole in the vertebra near the transverse process). The fourth part pierces the dura mater (a layer of membrane that protects the brain) and runs down to the medulla oblongata (a portion of the brain stem that is the primary control center for heart rate and breathing).
VERTEBRAL ARTERY TEST:
- To test for: Ischemia or Circulation deficiency of the vertebral artery at the transverse foramen.
Video Demo Instructions, Procedure, Positive Test:
Special Test: VERTEBRAL ARTERY TEST:Video Demo
Special Test: Vertebral Artery Test: PROCEDURE
• Patient is seated or supine
• Patient actively or passively rotates the head fully to one side, then extends the neck
• Hold for 30 seconds
• Do the same on the other side
Special Test: Vertebral Artery Test: POSITIVE SIGN:
- Patient complains of dizziness, nystagmus, or both. (Further testing is contraindicated and patient must be referred to a doctor).