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2b > Special Tests > Flashcards

Special Tests Flashcards

1
Q

Lump special tests

A

Transillumination

Ascultate

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2
Q

Ulcer special tests

A

Peripheral pulses

light touch and pressure sensation

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3
Q

Upper limb neurological special tests

A

Pronator drift

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4
Q

How do you test pronator drift

A

Patients arms outstretched and supinated
Examiner gently taps on one of the outstretched arms
This should be corrected

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5
Q

What is a positive for pronator drift

A

Patient’s arms start to pronate and drift downwards

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6
Q

What does a positive pronator drift test suggest

A

Collateral upper motor neurone lesion

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7
Q

Lower limb neurological special tests

A

Rombergs test

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8
Q

How do you perform Rombergs test

A

Patient stands with feet together, arms outstretched in front of the them, hands suppinated

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9
Q

What is are abnormal Romberg test results

A

Patient cannot perform test with their eyes open. Or when eyes closed the patient rocks and sways

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10
Q

What does inability to perform Romberg test with eyes open suggest

A

Cerebellar lesion

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11
Q

What does rocking and swaying when the eyes are closed suggest in Romberg test

A

Loss of proprioception

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12
Q

Hip special tests

A

Thomas’ test
Assess gait
Trendelenburgs test

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13
Q

How do you perform Thomas’s test

A

Place hand between lumbar spine and bed. Flex the ipsilateral hip and look for correction of lumbar lordosis

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14
Q

What is an abnormal Thomas’s test

A

The contralateral leg (hip you are testing (not touching)) will raise off the bed

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15
Q

What does an abnormal Thomas’s test suggest

A

Fixed flexion deformity

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16
Q

How do you assess gait

A

Watch the patient walking

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17
Q

What is an abnormal gait in a hip examination

A

Waddling gait

Antalgic gait

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18
Q

What does an abnormal gait in a hip examination suggest

A 
Waddling= hip pain or proximal muscle weakness
Antalgic= pain on weight bearing
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19
Q

How do you perform trendelenburgs test

A

Ask the patient to stand on one leg

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20
Q

What is an abnormal trendelenburgs test result

A

The pelvis will dip on the contralateral side (sound side sags)

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21
Q

What does an abnormal trendelenburgs test result suggest

A

Reduced abductor muscle strength

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22
Q

What are the abductors of the hip

A

Gluteus medius, gluteus minimus, tensor fascia latae and sartorius

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23
Q

Cranial nerve examination special tests

A

Rinnes Test

Webers Test

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24
Q

How do you perform Rinnes test

A

Hold 512Hz tuning fork on the mastoid and then immediately move it to the external acoustic meatus.

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25
Q

What is an abnormal Rinnes test result

A

The tuning fork will sound louder when on the mastoid

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26
Q

What does an abnormal Rinnes test result suggest

A

Conductive hearing loss

sensorineural=quitter at both

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27
Q

How do you perform Webers test

A

Hold 512Hx tuning fork on the forehead in the midline

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28
Q

What is an abnormal Webers test

A

Sound is louder in one of the ears

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29
Q

What does an abnormal Webers test suggest

A 
Conductive= louder in affected ear
Sensorineural= louder in normal ear
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30
Q

Knee examination special tests

A

Lachmans test

McMurrays test

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31
Q

What is an abnormal gait, knee examination

A

Abnormal toeing angle or antalgic gait

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32
Q

How do you perform Lachmans test

A

Flex knee to 20 degrees. One hand behind tibia and thumb on tuberosity. Pull thigh anteriorly with other hand.

33
Q

What is an abnormal lachmans test

A

A soft end point of the tibia on the femur

34
Q

What does an abnormal Lachmans test suggest

A

ACL damage

35
Q

How do you perform McMurrays test

A

Flex hip to 90 degrees and maximally flex the knee. Externally rotate the knee whilst grandually extending. Repeat during internal rotation.

36
Q

What is an abnormal McMurrays test

A

Palpable, audible or painful click over the medial joint line

37
Q

What does an abnormal McMurrays test suggest

A

Meniscal tear

38
Q

Spine examination special tests

A

Straight leg raise
Bowstring test
Femoral stretch test

39
Q

How do you perform a straight leg raise

A

Patient lies flat
Passively flex their thigh with their leg extended
Lower the leg gradually and then dorsiflex foot (that makes it worse= Lasegue’s sign)

40
Q

What is an abnormal straight leg raise

A

Back or leg pain

Paraesthesia or pain in a nerve root distribution

41
Q

What does an abnormal straight leg raise suggest

A

Back pain= central disc prolapse
Leg pain= lateral protrusion
Paraesthesia or pain in a nerve root distribution= nerve root irritation

42
Q

How do you perform a Bowstring test

A

Perform straight leg raise
If pain, flex knee slightly
Apply pressure with thumb in the popliteal fossa to stretch tibial nerve

43
Q

What is an abnormal Bowstring test

A

Radiating pain and paraesthesia

44
Q

What does an abnormal Bowstring test suggest

A

Nerve root irritation

45
Q

How do you perform a femoral stretch test

A

With patient prone and anterior thigh fixed to couch

Flex each knee in turn

46
Q

What is an abnormal femoral stretch test

A

Pain in the skin of the anterior compartment of the thigh

47
Q

What does an abnormal femoral stretch test suggest

A

Protrusion of a vertebral disc at L2-4

48
Q

Shoulder examination special tests

A 
Rotator cuff
-resisted active abduction
-resisted active external rotation
-resisted active interal roatation
Acromioclavicular joint pathology
49
Q

How do you test resisted active abduction

A

Abduct the arm.

50
Q

What is an abnormal resisted active abduction

A

Painful between 60 and 120 degrees

51
Q

What does an abnormal resisted active abduction suggest

A

Supaspinatus injury

52
Q

How do you test resisted active external rotation

A

Resist external rotation, with the elbow flexed at 90 degrees

53
Q

What does an abnormal active external rotation suggest

A

Infraspinatus and teres minor injury

54
Q

Which muscle initiates abduction

A

Supraspinatus

55
Q

Which muscle abducts up to 90 degrees

A

Deltoid

56
Q

Which muscle causes abduction beyond 90 degrees

A

Trapezius and serratus anterior

57
Q

How do you test active internal rotation

A

Lift off test. Place hand in small of back push dorsum of hand off the back

58
Q

What is an abnormal test of active internal rotation

A

Inability to move the dorsum of the hand off the back

59
Q

What does an abnormal test of active internal rotation suggest

A

Subscapularis rupture or dysfunction

60
Q

How do you test acromioclavicular joint pathology

A

Scarf test. Place arm in forced adduction across body at 90 degrees of flexion at the shoulder.

61
Q

What is an abnormal test of acromioclavicular joint pathology

A

Pain or tenderness across the ACJ

62
Q

What does abnormal test of acromioclavicular joint pathology suggest

A

Acromioclavicular joint pathology

63
Q

Elbow examination special tests

A

Medial epicondylitis

Lateral epicondylitis

64
Q

How do you test for medial epicondylitis

A

In supinated position ask patient to make a fist and flex their wrist against resistance

65
Q

What is an abnormal test for medial epicondylitis

A

Pain at the medial epicondyle

66
Q

How do you test for lateral epicondylitis

A

In pronated position, ask patient to extend their wrist against resistance.

67
Q

What is an abnormal test for lateral epicondylitis

A

Pain at the lateral epicondyle (extensor muscle origin)

68
Q

Hand examination special tests

A 
Tinels test
Phalens test
Median nerve function
Ulnar nerve function
Radial nerve function
69
Q

How do you perform tinels test

A

Tapping strongly but not too fast over the median nerve as it crosses under the flexor retinaculum via the carpal tunnel

70
Q

What is an abnormal tinels test

A

Pain, numbness or tingling in the cutaneous distribution of the median nerve

71
Q

What does an abnormal tinels test suggest

A

Carpal tunnel syndrome

72
Q

How do you perform phalens test

A

Hold both wrists of the patient;s in palmar flexion for one minute. Compress carpal tunnel with thumbs.

73
Q

What is an abnormal phalens test

A

Pain, numbness or tingling in the cutaneous distribution of the median nerve

74
Q

What does an abnormal phalens test suggest

A

Carpal tunnel syndrome

75
Q

How do you test median nerve function

A

Test palmar abduction of the thumb against resistance

Median nerve distribution sensation

76
Q

What is an abnormal median nerve function test

A

Reduced power and sensation

77
Q

How do you test the ulnar nerve function

A

Ask the patient to cross their index and middle fingers

Test sensation in ulnar nerve distribution

78
Q

What is an abnormal ulnar nerve function

A

Reduced power and sensation

79
Q

How do you test radial nerve function

A

Test wrist dorsiflexion against resistance

Test sensation in the anatomical snuffbox

2b (28 decks)

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