Sharp Purser Test | Transverse Ligament Integrity

แชร์
ฝัง
  • เผยแพร่เมื่อ 21 ต.ค. 2024
  • Enroll in our online course: bit.ly/PTMSK GET OUR ASSESSMENT BOOK ▶︎▶︎ bit.ly/GETPT ◀︎◀︎
    DOWNLOAD OUR APP: 📱 iPhone/iPad: goo.gl/eUuF7w
    🤖 Android: goo.gl/3NKzJX
    🚨 HELP TRANSLATE THIS VIDEO 🚨
    If you liked this video, help people in other countries enjoy it too by creating subtitles for it. Spread the love and impact. Here is how to do it: • Video
    👉🏼 SUPPORT THIS CHANNEL 😊 : bit.ly/SPPRTPT 👈🏼
    The Sharp Purser test tests the integrity of the transverse ligament which keeps the dens of C2 in place against the neural arch of C1.
    📚 ARTICLES: Hutting et al. (2013): www.ncbi.nlm.n...
    Uitvlugt et al. (1988): www.ncbi.nlm.n...
    Visit our Website: bit.ly/web_PT
    Like us on Facebook: bit.ly/like_PT
    Follow on Instagram: bit.ly/IG_PT
    Follow on Twitter: bit.ly/Tweet_PT
    Snapchat: bit.ly/Snap_PT
    ------
    This is not medical advice! The content is intended to be educational only for health professionals and students. If you are a patient, seek care of a health care professional.

ความคิดเห็น • 45

  • @ateeqamasood6257
    @ateeqamasood6257 6 ปีที่แล้ว +6

    easy to understand , with evidence provided ... great job .. helped alot before my manual therapy exam .. and can you please include spine mobilization techniques ?

    • @Physiotutors
      @Physiotutors  6 ปีที่แล้ว +2

      Glad it helped! We are on it 😉

    • @Dragon-Slay3r
      @Dragon-Slay3r ปีที่แล้ว

      Gangsta got shot he's not a problem anymore 😭

  • @spirituality1700
    @spirituality1700 5 ปีที่แล้ว +7

    I think this test need critical visual imagination of inner structures to comprehend and apply. Thanks a lot

    • @Physiotutors
      @Physiotutors  5 ปีที่แล้ว

      glad you liked the video!

    • @motivationalstudio3193
      @motivationalstudio3193 3 หลายเดือนก่อน

      @@Physiotutors i think atlas anterior glide is recomended not axis anterior glide

  • @joestaszel4668
    @joestaszel4668 4 ปีที่แล้ว +2

    Open mouth lateral flexion radiographs are a good imaging option to further evaluate for craniocervical junction instability.

  • @Dragon-Slay3r
    @Dragon-Slay3r ปีที่แล้ว

    Pincer is sharp from the top and from the bottom it's curve so it's half an egg, which connects to the top egg from blaksley mews

  • @tbanaa
    @tbanaa 10 หลายเดือนก่อน

    Thank you kai

  • @zenzebra2801
    @zenzebra2801 4 ปีที่แล้ว +3

    Interesting. My neck clunks with extension and flexion. Always has. I've never come across someone else whose neck does this. I have recently been diagnosed with hypermobile eds. And I have been referred to a neurologist who has experienced with eds.

    • @Rahul_Arya321
      @Rahul_Arya321 2 ปีที่แล้ว

      How are you now?

    • @zenzebra2801
      @zenzebra2801 2 ปีที่แล้ว

      @@Rahul_Arya321 thanks for asking. I'm managing. My dynamic MRI was only borderline CCI but instability from c2 to c6, and I probably have AAI and I need to get a CT with rotation. I think I have CCI and maybe I was tucking my chin too much during MRI, I don't know. My surgeon doesn't necessarily want to operate though because many people are still sick after surgery. I've never had a doctor in or physical therapist really look at my neck or do a sharp purser test.

    • @Rahul_Arya321
      @Rahul_Arya321 2 ปีที่แล้ว

      @@zenzebra2801 Oh I see.... Do you have what's app? I just want to know that I have any problems in my neck and I'll send a viedo of my mobile neck. 🤦‍♀️😔

  • @RollCorruption
    @RollCorruption 3 ปีที่แล้ว +1

    I have always felt this test is similar to the VBI, if i'm worried about that level of instability or risk, i'd be terrified to do the test.

    • @Physiotutors
      @Physiotutors  3 ปีที่แล้ว +2

      It's a relief test, so the test should actually ease symptoms in case of a high cervical instability.

  • @Galactivation528
    @Galactivation528 5 ปีที่แล้ว +2

    nice illustration

    • @Physiotutors
      @Physiotutors  5 ปีที่แล้ว

      thanks, Adrian happy you like it!

    • @MzyraJ
      @MzyraJ 5 ปีที่แล้ว

      My physio suspects that I have severe upper cervical instability and has referred me to see if we can get an MRI or something, but that image really helps me understand what could be happening to cause all the neurological side of things that I’m experiencing.
      Thanks (though I’m deeply concerned! Only 28, no inciting events, wtf?!)

    • @kylelisowe9316
      @kylelisowe9316 4 ปีที่แล้ว

      @@MzyraJ What were your symptoms if you don't mind me asking

    • @MzyraJ
      @MzyraJ 4 ปีที่แล้ว

      @@kylelisowe9316 oh man, so many things. Seizures for one thing, which can be triggered by bad head positions. Loads of other neurological stuff and weakness and fatigue.
      Unfortunately the MRI was not helpful and my research has shown me there's like a bajillion different neurological conditions with a crazy amount of overlap on symptoms, so all I know is my neurological system is screwed and all I can am given is painkillers :))))

  • @hdenzymes
    @hdenzymes 6 ปีที่แล้ว +2

    HI Guys, great video, I was wondering if I did suspect someone of having cranial vertebral instability would I refer to the doctor right away and wait for their opinion of conservative or non conservative management?

    • @Physiotutors
      @Physiotutors  6 ปีที่แล้ว +1

      In case you suspect it refer out to neurologist

  • @dr.jaredaguilar1537
    @dr.jaredaguilar1537 5 ปีที่แล้ว +1

    Thanks Guys!!!

  • @crypticchess3712
    @crypticchess3712 5 ปีที่แล้ว +3

    Looks like a very aggressive mulligan concept headache snag, lol

  • @kristyhawes
    @kristyhawes 4 หลายเดือนก่อน

    I have mild spondylitis straightening of cervical spine lordosis misalignments in c1cc2 c3 c4

  • @RichR4
    @RichR4 4 ปีที่แล้ว +6

    you describe the mechanism by which this stresses the transverse ligament being due to an anterior to posterior movement of C1 on C2 but if you are securing the forehead and pushing the spinous process of C2 posterior to anterior then as far as I can see all this woud do is push the anterior aspect of the dens of C2 into the posterior aspect of the anterior arch of C1 which would place no anatomical stress on the transverse ligament at all. The mechanism you propose can surely only be correct if you were contacting the transverse processes of C1 and challenging them in a posterior to anterior direction whilst stabilising the skull. - can you explain?

    • @badruddinhasansaky5881
      @badruddinhasansaky5881 8 หลายเดือนก่อน

      Yes I also agree with you

    • @ironchad5656
      @ironchad5656 2 หลายเดือนก่อน

      I agree, but it’s been 4 years

  • @Swarrenii
    @Swarrenii 2 ปีที่แล้ว +1

    Would you still perform this test if the patient does not complain of sx in flexion? Could this be a method of ruling it out or should we go to the provocative test?

  • @TherapeuticTactics
    @TherapeuticTactics 3 ปีที่แล้ว

    thank you!

  • @spuerbechs11
    @spuerbechs11 6 ปีที่แล้ว +1

    Thanks for the video :) I have a question you could might help me with...what is the difference between the Sharp Purser and the Modified Sharp Purser test? Thank you :)

    • @Physiotutors
      @Physiotutors  6 ปีที่แล้ว +2

      The original description by Sharp was just active upper cervical flexion by the patient which elicits symptoms, possibly with gentle overpressure into flexion by the examiner. So it's a symptom provocation test instead of a reduction test. It's basically the first part of the modified sharp-purser test that we are showing.
      We didn't call it "modified" because the original test is not really performed as stand-alone test anymore.

  • @lazlo5954
    @lazlo5954 2 ปีที่แล้ว

    at minute 2:25 you say that the posterior translation of the occiput and atlas will increase the symptoms and create a positive test. But wouldn't the symptoms actually decrease by the posterior translation if the transverse ligament is "damaged"? So a decrease of the symptoms would create a positive test? Would be very thankful for an answer :) Great videos by the way!

    • @lazlo5954
      @lazlo5954 2 ปีที่แล้ว

      nevermind, you said decrease not increase haha

  • @lucasvar8
    @lucasvar8 4 ปีที่แล้ว

    Baja prevalencia 🤔, aplicar reglas canadienses para eliminar posible fx cervical.

  • @mjclaudianava5397
    @mjclaudianava5397 3 ปีที่แล้ว +1

    What's the difference between sharp Purser test and transverse ligament stress test?

    • @Physiotutors
      @Physiotutors  3 ปีที่แล้ว +1

      The Sharp Purser Test is a relief test as the atlas and the dens are approximated thus reducing provocation.
      The Transverse ligament stress test does exactly the opposite. It moves the atlas anteriorly, so the dens is moved towards the dura which can lead to symptoms if the transverse ligament is ruptured.

    • @mjclaudianava5397
      @mjclaudianava5397 3 ปีที่แล้ว

      @@Physiotutors Thank you!

  • @teymur85
    @teymur85 5 ปีที่แล้ว +1

    Question: Since this is a provocative test the therapists hand behind the head should be placed on the spinous process of the atlas to translate the atlas anteriorly and thereby stress the transverse ligament, or am I incorrect?

    • @Physiotutors
      @Physiotutors  5 ปีที่แล้ว +2

      It's not a provocation but a reduction test. That's why you reduce the distance between the atlas and the dens by pushing C2 anteriorly.

    • @teymur85
      @teymur85 5 ปีที่แล้ว +1

      @@Physiotutors Got it, thank you

  • @joranwa430
    @joranwa430 6 ปีที่แล้ว +4

    big thumb up