Upper Extremity Special Tests Flashcards

1
Q

Acromion types

A
  1. Type I - (flat) least likely to cause impingement
  2. Type II - (curved) more likely to cause impingement
  3. Type III - (beaked) most likes to cause impingement
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2
Q

Functional shoulder articulations

A
  1. Scapulothoracic
  2. Acromioclavicular
  3. Sternoclavicular
  4. Glenohumeral
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3
Q

Neural flexion of shoulder

A

150-170 degrees

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4
Q

Neutral extension of shoulder

A

60 degrees

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5
Q

Neutral external rotation of shoulder

A

60 degrees

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6
Q

Neutral internal rotation of shoulder

A
  1. Stage 1 = 70

2. Stage 2 = -95 (hand behind back)

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7
Q

Adduction of shoulder

A

20-40 w/ arm in front of body

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8
Q

Abduction of shoulder

A

180 along coronal plane

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9
Q

Horizontal flexion of shoulder

A

130-160 from coronal plane

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10
Q

Horizontal extension of shoulder

A

40-50 from coronal plane

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11
Q

Horizontal internal rotation of shoulder

A

70 from coronal plane

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12
Q

Horizontal external rotation of shoulder

A

90 from coronal plane

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13
Q

Boa’s sign

A
  1. Pain in right shoulder/upper back
  2. Referred pain from abdominal organs on right
  3. Indicates possible cholecystitis, pyloric stenosis, duodenal ucler
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14
Q

Kehr’s sign

A
  1. Pain in left shoulder/upper back
  2. Referred pain from abdominal organs on left
  3. Indicates possible plenty injury, gastritis, gastric ulcer, renal stone
  4. Possible cardiac etiology
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15
Q

Elbow flexion

A

145

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16
Q

Elbow extension

A

0

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17
Q

Forearm pronation

A

90 from thumb up (neutral position)

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18
Q

Forearm supination

A

90 from thumb up (neutral position)

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19
Q

Carrying angle

A
Angle abduction from trunk
1. Males: 5-10
2. Females 10-15
3. Abnormal
  A. >15 (cubitus valgus)
  B. <5-10 (cubitus varus)
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20
Q

Wrist flexion

A

80-90

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21
Q

Wrist extension

A

70

22
Q

Adduction (ulnar deviation)

A

30

23
Q

Abduction (radial deviation)

A

20

24
Q

Apley scratch test

A
  1. Test for: shoulder general ROM
  2. Technique:
    A. pt reaches behind head to touch sup medial scapula w/ both arms
    B. Pt reaches behind back to touch inferior angle opposite scapula
    C. Compare both arms
25
Q

AC joint dysfunction test

A
  1. Test for: AC joint dysfunction
  2. Technique: pt crossed arm across chest to put hand on opposite shoulder
    A. Shoulder and elbow flex 90
    B. Pt resist downward force
    *pain = +
26
Q

Drop arm test

A
  1. Test for: supraspinatus (rotator cuff tear)
  2. Technique: pt abducts arms above head, slowly lowers them
    * sudden drop = +
27
Q

Empty can/jobe test

A
  1. Test for: supraspinatus weakness
  2. Technique: pt abduct shoulder 90 w/ 30 horizontal flexion ant, pronate arm
    A. Pt resist downward force
    *pain = +
28
Q

External rotation and lag test

A
  1. Test for: supraspinatus, infraspinatus, teres minor weakness
  2. Technique:
    A. External rotation: elbow flex 90 w/ arm at side, pt ext rotates against dr.
    *pain = +
    B. Lag: same position, dr externally rotates arm and released
    *arm returns to normal = +
29
Q

Subscapularis lift off test

A
  1. Test for: subscapularis weakness
  2. Technique: pt internally rotates arm behind back on lumbar spine
    A. Pt resists dr trying to pull hand away from back
30
Q

Hawkin’s test

A
  1. Test for: impingement between greater tuberosity of humerus against coracoid-humeral ligament
  2. Technique: pronated arm flex 90, internally rotated
    A. Stabilize scapula
    *pain = +
31
Q

Neer’s test

A
  1. Test for: impingement between greater tuberosity humerus and inferior acromion process
  2. Technique: pronated arm passively flexed while stabilizing scapula
    A. Impingement at 90
    *pain = +
32
Q

Apprehension/relocation test

A
  1. Test for: unstable shoulder w/ ligamentous laxity
  2. Technique:
    A. Apprehension: abduct arm 90 w/ elbow flexed 90, slowly externally rotate arm
    *pain/apprehension = +
    B. Relocation: same as apprehension but stabilize glenohumeral joint
    *pt feels improvement = +
33
Q

Yergason’s test

A
  1. Test for: long head biceps/transverse humeral ligament
  2. Technique: pt starts elbow flex 90 and forearm pronated
    A. Pt tries flex arm and supinate against resistance
    B. 3rd time, dr externally rotates arm while resisting
    *pain/tendon popping out of groove = +
34
Q

Speed’s test

A
  1. Test for: long head biceps tendon, bicipital tendonitis
  2. Technique: arm flex 90 and sup
    A. Pt resists downward force at wrist
    *pain ant shoulder = +
35
Q

O’Brian’s test

A
  1. Test for: bicipital-labral complex
  2. Technique: arm flex 90 and adducted to medial line, elbow extended, forearm pronated
    A. Pt resist downward/medial force
    B. Repeated w/ forearm sup
    *pain/clicking = +
36
Q

Roo’s test

A
  1. Test for: thoracic outlet syndrome
  2. Technique: shoulder abd 90 and externally rotated, elbows flex 90
    A. Pt opens and closes hands 3 min
    *parasthesia = +
37
Q

Adson’s test

A
  1. Test for: thoracic outlet syndrome
  2. Technique: shoulder slight extension and abduction, elbow extended, head toward affected side
    A. Dr. Feels radial pulse before put in position and monitors while in position
    *weakened pulse or parasthesia = +
38
Q

Wright’s test

A
  1. Test for: thoracic outlet syndrome
  2. Technique: hyperabduct arm above head, head turned away
    A. Radial pulse felt before put in position and monitored after
    *weakened pulse or parasthesia = +
39
Q

Tinel’s test at elbow

A
  1. Test for: Cubical tunnel syndrome (ulnar nerve)
  2. Technique: hyperflex elbow and extend wrist in forearm pronation
    A. Percuss between olecranon and medial epicondyle
    *numbness/tingling on medial hand = +
40
Q

Resisted supination test

A
  1. Test for: extensor carpi radialis brevis (lateral epicondylitis)
  2. Technique: stablilze elbow, resisted supination
    * pain lateral epicondyle = +
41
Q

Maudley’s test

A
  1. Test for: lateral epicondylitis
  2. Technique: forearm prone, pt resist downward force on middle finger
    * lateral epicondyle pain = +
42
Q

Mill’s test

A
  1. Test for: lateral epicondylitis
  2. Technique: forearm prone, pt resist downward force at wrist
    * pain lateral epicondyle = +
43
Q

Resisted pronation test

A
  1. Test for: flexor carpi radialis origin, medial epicondylitis
  2. Technique: stabilize elbow, forearm sup, pt tries to pronate against resistance
    * pain medial epicondyle = +
44
Q

Resisted wrist flexion test

A
  1. Test for: medial epicondylitis
  2. Technique: stabilize elbow, forearm sup, dr resists wrist flexion
    * medial epicondyle pain = +
45
Q

Tinel’s test

A
  1. Test for: carpal tunnel (median nerve)
  2. Technique: percuss flexor retinaculum
    * numbness/tingling along median nerve distribution = +
46
Q

Phalen’s test

A
  1. Test for: carpal tunnel syndrome
  2. Technique: hyperflexion wrists by pressing dorsum hands together 30-60 sec, arms at 90 abduction and parallel to floor
    * numbness/tingling = +
47
Q

Reverse Phalen’s test

A
  1. Test for: carpal tunnel syndrome
  2. Technique: hyperextension wrists w/ palms together 30-60 sec
    * numbness/tingling = +
48
Q

Finkelstein’s test

A
  1. Test for: De Quervain’s tenosynovitis (extensor pollicis brevis and abductor pollicis longus)
  2. Technique: flex MCP and IP of thumb and place in fist, ulnar deviation at wrist
    * pain of ant snuff box = +
49
Q

Allen’s test

A
  1. Test for: collateral blood supply in hand
  2. Technique: fist held 20-30 sec until blanching, pressure distal ulnar and radial arteries
    A. Fist released, one artery released
    B. Repeat other artery
    *blood flow doesn’t return in blocked side in 5-7 sec = +
50
Q

Supraspinatus

A
  1. Prox: supraspinatus fossa
  2. Distal: sup facet greater tuberacle
  3. Innervation: suprascapular (C4-C6)
  4. Fxn: initiates and assists abduction
51
Q

Subscapularis

A
  1. Prox: anterior scapula
  2. Distal: lesser tuberosity humerus
  3. Innervation: upper (C5) and lower (C6) subscapular n.
  4. Fxn: internal rotation
52
Q

Infraspinatus

A
  1. Prox: infraspinus fossa
  2. Distal: middle facet greater tubercle humerus
  3. Innervation: suprascapular (C5-C6)
  4. Fxn: external rotation