Lab Flashcards
1
Q
Special Test: Relocation - Positive Test
A
Relief of pain or apprehension
1
Q
THRUST Manipulation: GH posterior glide - PT position
A
Stand with back to pt. with thigh in pt. axilla. One hand supports arm while the other is just anterior to the humerus
2
Q
Special Test: Froment’s Sign - Assesment
A
Adductor pollicis weakness from ulnar n. injury
3
Q
Special Test: Lateral collateral stress test - position
A
sitting with arm supinated and flexed 5-30
4
Q
T/F: With shoulder impingement there is equal movement at the GH joint and the scapula.
A
False: less at GH, more at scapula
4
Q
Special Test: Empty Can - Position
A
Sitting, shoulders elevated to 90 in the scapular plane and IR (thumbs pointed down)
4
Q
Q: How do you grade the inferior GH instability?
A
1 cm = G1 laxity 1-2 cm = G2 laxity > 2 cm = G3 laxity
5
Q
MCP THRUST - Indications
A
Restricted MCP joint mobility
6
Q
Special Test: Median nerve test - Positive Test
A
Pain, tingling, reproduction of symtpoms
7
Q
T/F: You should always help someone out of an OP position.
A
True
7
Q
Q: What directions must be lax to be termed multidirection GH instability?
A
anterior, posterior, and inferior
7
Q
Capitate THRUST (volar glide) - Method
A
Apply slight traction to wrist with slight wrist flexion, apply quick thrust while maintain posterior to anterior pressure on the capitate
8
Q
T/F: When you test ligaments/instability you do not need to compare sides.
A
False.
8
Q
Q: What is the technique for the humeroulnar distraction?
A
scoop and distract
9
Q
Special Test: Hawkins-Kennedy - Method
A
Move pt. into 90 shld flexion and 90 elbow flexion, then IR
10
Q
Special Test: Empty Can - Method
A
Apply resistance downward
11
Q
Q: In what direction is distraction performed?
A
Towards the motion barrier
12
Q
Special Test: Mill’s Test - Assessment
A
Lateral epicondylitis
13
Q
Special Test: Sulcus Sign - Method
A
Stabilize scapula, grasp humerus near elbow and distract inferiorly
14
Q
Q: What are the 4 c-spine screens?
A
- Flexion AROM, OP 2. Extension AROM, OP 3. Rotation AROM bilateral, OP 4. Quadrant AROM, No OP
14
Q
T/F: Neer’s test is a PROM test.
A
True
14
Q
Special Test: Sulcus Sign - Assessment
A
GH instability - particularly inferiorly
14
Q
Manipulation: Mill’s test maneuver - Pt. position
A
Sitting, shld abd 60
14
Q
Q: What does a CMC dorsal glide facilitate?
A
ABD
15
THRUST Manipulation: GH inferior glide - Position
Sitting, 90 shld flexion, neutral rotation
17
Special Test: Hawkins-Kennedy - Assessment
Impingement of supraspinatus tendon
19
Defn: Grade 3 Distraction
A distraction force strong enough to stretch the joint capsule
20
Special Test: Neer's - Method
Elevate the pt.'s arm overhead in the scapular plane with arm IR, stabilize behind scapula and press into end range
20
T/F: The inferior glide with ER stretches the joint capsule inferiorly for RCI.
False, superiorly
21
Special test: Inferior glide with ER - Method
On hand cups elbow other stabilizes hand, apply pressure towards feet
22
Manipulation: Pulled elbow reduction - Variation
Pt in supine, elbow 90 flexion, wrist extended, locking thumbs, compress the long axis of the radius while supinating the forearm
23
Special Test: GH Instability Test - Method
Stabilize scapula, gram humeral head/distal humerus, move humerus anterior/posterior
23
Q: What does a CMC volar/ulnar glide facilitate?
flexion
24
Special Test: Clunk - Assessment
Torn glenoid labrum
24
Q: What is RCI?
Contracture of the rotator cuff interval
25
Q: What does a radiocarpal radial glide facilitate?
UD
27
Q: What are the 3 lumbar spine screen?
1. Flexion ROM, OP 2. Extension ROM, OP 3. Quadrant ROM
28
PAM - Humeroradial volar glide - method
grasp the medial aspect to stabilize, move radial head volarly with fingers
29
Q: What does a anterior or volar proximal radioulnar glide facilitate?
supination
30
T/F: With distraction, you want to mobilize out of the pts. pain range.
True, don't want to cause pain
30
Special Test: Medial epicondylitis passive stretch test - Method
passively supinate the pts. forearm with the elbow and wrist in extension while palpating the medial epicondyle
31
Content: Shoulder Exam - AROM (5)
1. Elevation/Flexion 2. ABD (Painful Arc) 3. HBB (Ext/ADD/IR) 4. HAC (ADD) 5. HBH (Scap/ER)
32
Special Test: Tindel's Sign - Assessment
involvement of ulnar nerve
33
Special Test: Cross Over Impingement - Positive Test of Anterior Pain (3)
1. Subscapularis 2. Supraspinatus 3. Long head of biceps
33
Special Test: Medial epicondylitis muscle resisted test - Method
Resist wrist flexion with the elbow straight
34
Special Test: Medial epicondylitis muscle resisted test - Positive Test
Pain, reproduction of symptoms
34
Special Test: Finkelstien's Test - Assesment
Tenosynovitis of the thumb (APL, EPB)
35
Special Test: Median Nerve Tinel's Sign - Assessment
Median n.
36
Special Test: Clunk - Positive Test
Pain, clunk, grinding, pseudolocking
36
Special Test: Phalen's Test/Reverse Phalen's Test - Method
Maintain the position for 60 sec, note the time of onset of symptoms and end the test
37
Special Test: Median nerve test - Method
Grasp pts. hand as if for a hand shake, apply a supination force and have them resist with the elbow flexed. Then straighten the elbow while the resistance is applied
38
Special Test: Median nerve test - Assessment
Pronator teres syndrome, median nerve entrapment
39
Q: What does a CMC volar glide facilitate?
ADD
39
Special Test: Phalen's Test/Reverse Phalen's Test - Pt. Position
Sitting Phalen's: Dorsum of hands together, fingers down ReversE: Palms together, fingers up
41
Special Test: Neer's - Positive Test
Pain
41
Q: What does a radiocarpal volar glide facilitate?
Extension
42
Special Test: Apprehension - Positive Test
Pain or apprehension
43
THRUST Manipulation: GH posterior glide - Position
Supine, arm relaxed at 60 ABD and neutral rotation
44
Special Test: Medial collateral stress test - position
sitting with arm relaxed and 20 elbow flexion
44
Special Test: Allen Test - Method
Compress the radial and ulnar a., have pt. open and close fist rapidly 3-5x, release one artery and observe, repeat with other artery
46
Special Test: Drop Arm - Method
Passively move arm to 90 ABD, ask pt. to hold arm up, remove support
48
Special Test: Empty Can - Assessment
Supraspinatus tendonitis
49
T/F: The Speed's test is a PROM test.
False; AROM
49
Q: What two muscle resisted tests can be performed for lateral epicondylitis?
1. Middle finger (ECRB) extension 2. Wrist extension
50
Q: What does a radiocarpal distraction assess?
Joint mobility of the wrist
51
Capitate THRUST (volar glide) - PT position
Face pt., hold pt. hand with both hands, thumbs overlapped on capitate
52
PAM: Medial humeroulnar glide - Facilitates
Elbow extension
53
Capitate THRUST (volar glide) - Pt. Position
Sittingat EOB with forearm pronated
55
Special Test: Drop Arm - Assessment
RC rupture
55
Q: What does humeroulnar distraction facilitate?
General mobility
57
Special Test: O'Brien's - Positive Test
Pain with IR and no Pain with ER - indicates labral tear (SLAP)
57
Q: What is the position for transvermassage of the extensor tendons?
elbow 90, forearm neutral
57
Special Test: Watson's Sign - Pt. Position
Seated with elbow flexed 90, forearm pronated
58
THRUST Manipulation: GH inferior glide - PT position
Support weight of arm with one hand and other hand distal to acromion (elbow pointing up)
59
Special Test: Cross Over Impingement - Positive Test of Superior Pain
AC joint
60
Special Test: O'Brien's - Assessment
AC adhesion and Labral tears
60
Special Test: Watson's Sign - Method
Stabilize scaphoid and passively move the wrist through UD/RD
61
Q: A GH joint posterior glide facilitates?
IR, flexion, and horz ADD
62
Defn: Grade 1 Distraction
Not enough force to separate the joint surfaces
63
Special Test: Lateral collateral stress test - Method
Apply varus force
65
Special Test: Empty Can - Positive Test
Weakness or pain - indicates partial tear
66
Special Test: Hawkins-Kennedy - Positive Test
Reproduction of symptoms/Pain
66
Q: What is the position for transvermassage of the flexor tendons?
elbow 15-30, forearm supinated
67
Q: What is the position for transvermassage of the triceps tendon?
elbow 90, forearm neutral
68
THRUST Manipulation: GH inferior glide - Method
Ask pt. to lean away slightly, apply pressure to end feel, if no pain then apply HVLA thrust inferiorly
69
Special Test: Mill's Test - Positive Test
Pain at lateral epicondyle
70
Q: What does a CMC dorsal/radial glide facilitate?
extension
72
Defn: Primary impingement
Painful arc is positive
73
Q: What do MCP and IP anterior glides facilitate?
flexion
74
Special Test: Median Nerve Tinel's Sign - Pt. Position
Sitting, arm supinated
76
Special Test: Apprehension and Relocation - Assessment
Anterior GH stability
77
Special Test: Cross Over Impingement - Positive Test of Posterior Pain (3)
1. Infraspinats 2. Teres Minor 3. Posterior Capsule
78
Special Test: Speed's - Position
Sitting with elbow in extension and forearm supinated
79
Capitate THRUST (volar glide) - Indication
Restricted wrist mobility
80
PAM - Humeroradial dorsal glide - position
supine with elbow extended and supinated
82
Special Test: Apprehension and Relocation - Method
Bring arm into 90 ABD, ER shld slowly, if pain is elicited, apply posterior force to reduce the humeral head into place (relocate)
83
Special Test: Cross Over Impingement - Method
Apply OP in ADD
84
Special test: Inferior glide with ER - Assessment
Frozen shoulder or RCI
87
THRUST Manipulation: GH posterior glide - Method
Apply distraction force with distal hand, apply pressure through end feel, if no pain then apply HVLA thrust inferiorly
88
Manipulation: Pulled elbow reduction - Method
Grasp the child's wrist while thumb is placed on radial head, apply elbow flexion + supination high velocity low amplitude thrust
89
Special Test: Finkelstien's Test - Positive Test
Pain over the APL and EPB (compare both sides)
91
Special Test: Clunk - Method
Support under humeral head and apply anterior force while simultaneously applying compression and rotation to the humerus
92
Special Test: Phalen's Test/Reverse Phalen's Test - Positive Test
Increase in symptoms in median n. distribution
93
Q: What does a posterior or dorsal proximal radioulnar glide facilitate?
pronation
94
Special Test: Mill's Test - Method
Passively flex the wrist and pronate the forearm
94
Special Test: Median Nerve Tinel's Sign - Method
tap over median nerve at wrist ~20 sec
95
Special Test: Watson's Sign - Positive Test
Scaphoid shifts dorsally
97
Q: A GH joint inferior glide facilitates?
Elevation
99
Specail Test: Posterolateral instability test - Positive Test
Elbow subluxes with extension and relocated with flexion
100
Special Test: Watson's Sign - Assessment
Volar scaphoid lunate ligament
101
T/F: The Hawkins-Kennedy test is a PROM test.
True
102
Special Test: Allen Test - Pt position
Sitting with forearm free to move, elbow bent, fingers toward ceiling
104
Q: How do you grade anterior/posterior GH Instability?
1 cm = G1 laxity 1.5 cm = G2 laxity \> 1.5 cm = G3 laxity
105
Special Test: Allen Test - Positive Sign
Blanching remains, normal filling \< 5 sec
106
Content: Shoulder Exam - Standing Observations (4)
1. Step Sign - AC separation 2. Scapular location 3. Scapular position/alignment 4. General - swelling, guarding, compensation, skin changes
108
Special Test: Apprehension and Relocation - Position
supine, with glenoid at edge of table
110
T/F: If there is no change in symptoms with the c-spine screen you do not need to apply OP.
False; apply OP to check is symptoms are reproduced
111
Special Test: Lateral collateral stress test - Positive Test
ABnormally gapping of the joint when stress is applied
112
T/F: The cross over impingement test is an AROM test.
False: PROM
114
Q: Describe the quadrant AROM c-spine screen.
Combination of side bend, rotation, and extension - have pt. follow your finger
116
Q: What does a dorsal humeroradial glide facilitate?
extension
117
Q: What does a radiocarpal ulnar glide facilitate?
RD
118
Special Test: Medial collateral stress test - method
Hold elbow laterally and apply valgus force at wrist
119
Special Test: Clunk - Position
Supine, arm overhead in full ABD
121
Special Test: Drop Arm - Positive Test
Inability to hold the arm in test position - indicated complete tear
122
Q: How do you apply OP to the c-spine?
A couple of bounces at end range
124
Q: What does a dorsal distal radioulnar glide facilitate?
supination
125
Special Test: Speed's - Method
Apply resistance to a shoulder in 90 degrees of flexion while palpating the biceps tendon
126
PAM: Lateral humeroulnar glide - facilitate
Elbow flexion
127
Manipulation: Mill's test maneuver - Method
One hand on elbow, thumb on radial head other holding forearm in pronation and wrist flexion; apply thrust increasing shld IR/extension and elbow extension
129
Q: A GH joint lateral glide factilitates?
General pain relief
130
Special Test: Froment's Sign - Method
Place a piece of paper between the thumb and index finger, attempt to remove the paper
131
Capitate THRUST (volar glide) - Alternative method
Can be modified to other carpal bones
132
Special Test: Finkelstien's Test - Method
Pt makes fist with thumb inside, clinician stabilizes forearm and UD wrist
133
Special Test: Froment's Sign - Positive Test
Unable to grasp paper or substitutes with thumb flexors
135
T/F: With a Neer's test the pt.'s elbow should be bent.
False: Straight
136
Q: What does a volar humeroradial glide facilitate?
flexion
137
Defn: Secondary impingement
Painful arc and laxity are positive
138
Special Test: O'Brien's - Method
Apply doward pressure at wrist, to confirm repeat test with ER
139
Q: What does a volar distal radioulnar glide facilitate?
pronation
140
PAM: Humeroradial distraction - Method
Pull radius along long axis while stabilizing the humerus, may apply a slight rotation force
142
Special Test: Cross Over Impingement - Assessment
Impingement
143
Q: What does humeroradial distraction facilitate?
Joint mobility
143
Special Test: Posterolateral instability test - Method
Apply valgus force while moving elbow through extension and flexion
144
Special Test: Median Nerve Tinel's Sign - Positive Test
Pain or paresthesia distal to the wrist
145
Q: What do MCP and IP posterior glides facilitate?
extension
146
Defn: Grade 2 Distraction
Enough force to separate the joint surfaces and eliminate the joint play
148
Special Test: Phalen's Test/Reverse Phalen's Test - Assesment
Median n. compression, carpal tunnel syndrome
149
MCP THRUST - Pt. Position
Sitting with upper arm supported on table or thigh
150
PAM - Humeroradial volar glide - position
supine with elbow extended and supinated
151
Special test: Inferior glide with ER - Position
Supine with arm ABD slightly and elbow bent to 90
152
Special Test: Speed's - Assessment
Biceps Tendinitis
153
Q: What does a radiocarpal dorsal glide factilitate?
Flexion
154
Special Test: Neer's - Assessment
Impingement of supraspinatus tendon
155
Special Test: O'Brien's - Position
Sitting, 90 Shld flexion, 10-15 H-ADD IR
156
Special Test: Speed's - Positive Test
Increased tenderness in the bicipital groove
157
PAM - Humeroradial dorsal glide - method
grasp the medial aspect to stabilize, move radial head dorsally with thenar eminence
158
Q: A GH joint anterior glide factilitates?
ER, extension, horz ABD
159
Special Test: Allen Test - Assesment
Patency of the radial and ulnar a.
160
Special Test: Medial collateral stress test - Positive Test
abnormal gapping of joint
161
T/F: With a Neer's or Hawkin's-Kennedy test you need to test both sides.
False
162
Special Test: Medial epicondylitis passive stretch test - Positive Test
Pain
163
Special Test: Tindel's Sign - Positive Test
Tingling sensation that reproduces the pts. symptoms
164
Special Test: Tindel's Sign - Method
tap along the ulnar nerve in groove between olecranon and medial epicondyle
165
MCP THRUST - PT position
stabilize distal MC with thumb and index finger with one hand and grasp proximal phalanx with the other thumb and index finger
166
MCP THRUST - Method
Bunch up skin at then, distract, then apply thrust in volar direction
