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Flashcards in Special Tests Deck (24)
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1
Q

Spurling’s/Reverse Spurling’s Test

A

To diagnose cervical disc herniations or spondylosis

Rotate and laterally flex head to the unaffected side. Lightly compress the head down to axial load the spine

Spurlings is ipsilateral

Reverse Spurlings is contralateral

2
Q

L’Hermitte’s Sign

A

Passive or Active neck flexion

pain/electrical sensation shooting down back or into legs - indicates myelopathy or multiple sclerosis

3
Q

Adson Test

A

To test for thoracic outlet syndrome

Palpate radial pulse on affected side w/ fully extended elbow. Have pt rotate head to side of testing and extend the neck. Then abduct, extend, and laterally rotate the shoulder. Have the patient take and hold a deep breath, then assess for decrease in pulse response

4
Q

Hoffmann’s Test

A

Used to determine upper motor neuron lesion above T1

Have patient relax hand, flick the nail of the middle finger

Positive sign occurs if the muscles of the hand and thumb flex. This indicates a lesion originating in the CNS that is not a radiculopathy or peripheral nerve lesion

5
Q

Shoulder Impingement and Tendonitis Test

A

Neer’s Test: fully extended arm resistance against thumb up and thumb down

Hawkin’s Test: Arm and shoulder flexed 90 degrees with thumb down - pain suggests subacromial impingement

6
Q

Shoulder Internal Rotation Tests

A

Test subscapularis

Bear Hug: Have pt put palm on opposite shoulder and resist provider trying to push arm upwards

Belly Press: Have pt push against resistance towards their belly

Lift Off: Have patient place hand behind the back, palm facing away from body, and lift it away from back against resistance

7
Q

Supraspinatus Shoulder Test

A

Drop Sign: Have the pt slowly raise arm in scapular plane and then slowly lower - positive if arm suddenly drops

Empty Can: Pt extends arm out with thumb down, and resists applied pressure downward

8
Q

Shoulder Instability/Dislocation Tests

A

Apprehension: pt supine, abduct and elbow flexed 90 degrees with gentle external rotation - pt gets apprehensive

Sulcus: Pts arm relaxed at side - gentle traction in inferior direction to try to cause subluxation w/ visible dimple

Jobe’s Relocation: Apprehension with pressure on humeral head to relieve apprehension

Load and Shift: One hand holds scapular spine and coracoid process while other slides humeral head back and forth

9
Q

Shoulder Labral Lesion Tests (SLAP)

A

Speed’s: Extended and supinated arm flexed superiorly against resistance - also for long head tendonitis

Yergason’s: elbow flexed with arm at side - resist supination and external rotation @ same time

Obrien Test: arm extended and internally rotated 15 D across chest- resist downward movement with both thumb down and palm up

10
Q

AC Joint Separation Tests

A

Cross Arm Test: arm extended with elbow 90 degrees across the chest - have patient cross arm over to sweep by opposite shoulder

11
Q

Infraspinatus and Teres Minor Tests

A

External rotation: arm adducted with elbow flexed 90 degrees, resist internal rotation

Hornblower’s Test: abduct arm to 90 degrees with elbow flexed in front, have pt rotate arm externally against resistance

12
Q

Elbow Tests

A

Varus (inward deformity)

Valgus (outward deformity)

Hook test (distal biceps tear)

Ulnar nerve compression with bent elbow

13
Q

Wrist Tests - Ulnar Palsy

A

Wartenbergs sign: 5th finger abduction at rest

Froments sign: flexion of thumb with decreased grip - cant hold paper between thumb and curled fingers

14
Q

Wrist Tests - Median nerve palsy

A

Tinel’s sign: carpal tunnel or ulnar palsy

Phalen’s/Modified Phalen’s: bent wrist causing tingling in the thumb, index, and pointer finger

15
Q

De Quervain’s Tenosynovitis

A

Swelling/stenosis around sheath surrounding abductor pollicis longus and extensor pollicis brevis

Pain, swelling, and triggering phenomena with thumb pinching

Finkelstein’s Test: pt makes a fist w/ thumb inside the fingers - push fist into ulnar deviation = pain @ dorsoradial aspect indicates de Quervain’s

16
Q

Mallet Finger Test

A

Isolate extensor tendon by holding involved finger at the middle phalanx - instruct patient to actively extend distal interphalangeal joint

Inability to actively extend distal joint suggests extensor tendon avulsion at the base of the distal phalanx

17
Q

Back Tests

A

Psoas sign: appendicitis or irritation to iliopsoas hip flexors

Straight leg raise: Underlying herniated disk (L5)

18
Q

Hip Tests

A

Trendelenberg: used to determine hip abductor strength - one-legged pelvis tilt

FABER (figure-of-4): flexion-abduction-external rotation test to detect sacroiliac and hip pathology; place

Piriformis: hip and knee flexed to 90 D; stabilize pelvis and use hand to apply flexion, adduction, and internal rotation at the knee

19
Q

Knee ACL Tests

A

Anterior drawer: sit on foot and slide the tibia anteriorly

Lachman’s: thigh supported and leg relaxed - flex knee 30 D and lift/pull on tibia while stabilizing the femur

Pivot Shift: fully extend knee and slowly flex while applying valgus stress and internal rotation

Lelli’s: Fist under calf while applying pressure to the top of the femur

20
Q

Knee PCL Tests

A

Sag sign: tibia sags compared to femur position with hip and knee flexion

Posterior drawer: sit on pts foot and push the tibia posteriorly

21
Q

Knee Meniscus Tests

A

McMurray’s: flex knee to max pain-free position then gradually extend while maintaining tibia internal/external rotation - wait for click

Pain with full flexion

Apley’s Test: McMurray’s test but pt is lying prone - using gravity

22
Q

LCL/MCL Knee tests

A

Varus: assesses lateral collateral - push to lateral side

Valgus: assesses medial collateral - push to medial side

23
Q

Patella

A

Grind for chondromalacia

Apprehension for dislocation

24
Q

Foot/Ankle Tests

Thompson

Homan’s

Interdigital Neuroma

Ankle clonus

A

Thompson: squeezing calf for plantar flexion

Homan’s: Check for DVT

Interdigital Neuroma: Upward pressure between metatarsal heads - commonly 3rd and 4th heads

Ankle clonus: upper motor neuron lesions - rhythmic contractions; lower motor lesions - fasciculations