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This particular video is intended as a demonstration of a provocative maneuver (special test) useful to evaluate for Vertebrobasilar insufficiency. This test also may be useful as a pre-manipulation screening tool prior to performing manipulation of the cervical spine involving high velocity, low amplitude methods or requiring cervical spine positioning involving significant extension, side bending, and/or rotation. This test is not intended to be used in isolation, but as part of a comprehensive evaluation, including a thorough history, a detailed physical examination, and additional diagnostic testing as needed based on the entire clinical picture. It is not intended as a complete instructional video and should not be considered a source of complete physical examination instruction. It should be treated as a supplement to independent learning using primary Osteopathic Physical Examination instructional resources. Clinical skills are best learned and developed with support from faculty in the context of a complete Osteopathic Medical School Curriculum. Osteopathic Clinical Skills is a channel dedicated to discussing and exploring Osteopathic Clinical Skills concepts for medical students, residents, and clinicians and presenting them in an easy to understand manner. Attributions: Many thanks to the University of North Texas Health Science Center Texas College of Osteopathic Medicine (UNTHSC - TCOM) for permitting use of the Medical Education Training (MET) facilities and equipment during the production of this video. Additional thanks to the UNTHSC-TCOM learner and faculty volunteers who participated in this production and provided permission for the use of their image in this video.