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Flashcards in LAB MIDTERM MATERIAL Deck (48):
1

Abbott-Saunders Test

( + ) Audible or palpable click

( i ) Subluxation or dislocation of the biceps tendon due to a rupture of transverse ligament or tendon subluxation beneath the subscapularis muscle belly

2

Foraminal Compression

a. ( + ) Exacerbation of localized cervical pain

a. ( i ) Foraminal encroachment or facet pathology without nerve root compression

- - - - - - - - - - - - - -

b. ( + ) Exacerbation of cervical pain with a radicular element

b. ( i ) Foraminal encroachment or facet pathology with nerve root compression

3

Cervical Distraction

a. ( + ) Diminished or absence of local pain

a. ( i ) Foraminal encroachment

- - - - - - - - - - - - - -

b. ( + ) Diminished or absence of radicular pain

b. ( i ) Nerve root compression

- - - - - - - - - - - - - -

c. ( + ) Increase in cervical pain

c. ( i ) Muscular strain, ligamentous sprain, myospasm, facet capsulitis

4

O'Donoghue Maneuver

Wrist and Hand

Wrist Flexion - 80°

Wrist Extension - 70°

Wrist Ulnar Deviation - 30°

Wrist Radial Deviation - 20°

 

( + ) Pain during passive range of motion

( i ) Ligamentous sprain

- - - - - - - - - - - - - -

( + ) Pain during active range of motion

( i ) Muscle or tendon strain

5

Wrist and Hand ROM

Flexion 80°

Extension 70°

Ulnar deviation 30°

Radial deviation 20°

 

Finger Abduction

Finger Adduction

 

Thumb Flexion

Thumb Extension 

 

Finger Flexion

Finger Extension

 

Finger Opposition

 

6

Shoulder Bony Palpation

sternoclavicular articulation

clavicle

acromioclavicular articulation

acromion process 

spine of the scapula

body of the scapula

scapulothroacic articulation

coracoid process

greater tuberosity

bicipital groove

lesser tuberosity

7

O'Donoghue Maneuver

Elbow

Elbow Flexion - 150°

Elbow Extension - 0°

Forearm Supination - 80°

Forearm Pronation - 80°

 

( + ) Pain during passive range of motion

( i ) Ligamentous sprain

- - - - - - - - - - - - - -

( + ) Pain during active range of motion

( i ) Muscle or tendon strain

8

Golfer's Elbow Test

( + ) Pain over the medial epicondyle

( i ) Medial Epicondylitis (Golfer's Elbow)

9

Impingement Sign

( + ) Pain in the shoulder

( i ) Overuse injury to the supraspinatus and possibly biceps tendon

10

Elbow Bony Palpation

medial epicondyle

groove for the ulnar nerve

trochlea

olecranon

olecranon fossa

lateral epicondyle

radial head

lateral supracondylar line of the humerus

medial supracondylar line of the humerus

11

Tinel Elbow Sign

*Introduce patient to reflex hammer, ask permission to proceed

( + ) Pain and/or tenderness at the site being tapped with paresthesia in the ulnar nerve distribution area, digits 4 and 5

( i ) Neuroma of the ulnar nerve

12

Valsalva Maneuver

( + ) radiating pain from the site of lesion, usually recreating the complaint in cervical or lumbar spine

( i )  space occupying lesion, possible disc pathology

13

Cervical Spine ROM

Flexion - 50°

Extension - 60°

Lateral Flexion/Bending (L/R) - 45°

Rotation (L/R) - 80°

14

Finkelstein Test

( + ) Pain distal to the radial styloid process

( i ) Stenosing tenosynovitis of the abductor pollicis longus and extensor pollicis brevis tendons (DeQuervain's Disease)

15

Mills Test

(Mills Maneuver/Evans)

( + ) Pain over the lateral epicondyle

( i ) Lateral epicondylitis (Tennis Elbow)

16

Phalen Sign

Patient would hold this position for 60 seconds or until the point of pain. 58, 59, 60...

( + ) Reproduction of pain, tenderness and/or paresthesia in the median nerve distribution area (thumb, 2nd, 3rd and lateral half of 4th digits)

( i ) Median neuritis, possibly Carpal Tunnel Syndrome

17

Shoulder Depression Test

a. ( + ) Localized pain on the side being tested

a. ( i ) Dural sleeve adhesion, and muscular adhesion or contracture, or spasm, or ligamentous injury

- - - - - - - - - - - - - -

b. ( + ) Radiating pain on side being tested

b. ( i ) Neurovascular bundle compression, dural sleeve adhesions or Thoracic Outlet Syndrome

- - - - - - - - - - - - - -

c. ( + ) Radicular pain on opposite side being tested

c. ( i ) Foraminal encroachment with nerve root compression

18

Tinel Wrist Sign

*Introduce patient to reflex hammer, ask permission to proceed

( + ) Reproduction of pain, tenderness and/or paresthesia in the median nerve distribution area (thumb, 2nd, 3rd and lateral half of 4th digits)

( i ) Median neuritis, possibly Carpal Tunnel Syndrome

19

Lateral Collateral Ligament Test

(Adduction Stress Test)

( + ) Excessive gapping and pain

( i ) Lateral collateral ligament instability

20

Allen Test

Patient would continue for one minute. 58, 59, 60, stop and make a fist....

( + ) A delay of more than 10 seconds (Evans says 5) in returning a reddish color to the hand

( i ) Radial or ulnar artery insufficiency. The occluded artery is not the artery being tested

21

Yergason Test

(Cipriano)

( + ) a. Localized pain or tenderness in the bicipital groove

( i ) a. Bicipital tendonitis

- - - - - - - - - - - - - - - - - -

( + ) b. Audible click or dislocation of biceps tendon

( i ) b. instability of the biceps tendon possibly associated with a torn transverse humeral ligament

22

O'Donoghue Maneuver

(ALL: shoulder, elbow, wrist and hand, cervical spine)

( + ) Pain during passive range of motion

( i ) Ligamentous sprain

- - - - - - - - - - - - - -

( + ) Pain during active range of motion

( i ) Muscle or tendon strain

23

Apley Test

(Apley Scratch Superior/Inferior)

( + ) Exacerbation of pain

( i ) Degenerative tendonitis of rotator cuff tendons, usually supraspinatus

24

O'Donoghue Maneuver

Shoulder

Shoulder Flexion - 180°

Shoulder Extension - 60°

Shoulder ABduction - 180°

Shoulder ADduction - 50°

External Rotation - 90°

Internal Rotation - 70°

 

( + ) Pain during passive range of motion

( i ) Ligamentous sprain

- - - - - - - - - - - - - -

( + ) Pain during active range of motion

( i ) Muscle or tendon strain

25

Wrist Bony Palpation

radial styloid process

scaphoid (navicular)

Lister's tubercle (dorsal tubercle)

lunate

capitate

ulnar styloid process

triquetrium

pisiform

hook of hamate

trapezium

trapezoid

metacarpals

phalanges

26

Kernig Sign

( + ) Inability to fully extend the leg and/or pain (usually in the neck region)

( i ) Meningeal irritation, or meningitis

27

Medial Collateral Ligament Test

(Abduction Stress Test)

( + ) Excessive gapping and pain

( i ) Medial collateral ligament instability

28

Soto-Hall Sign

( + ) Generalized pain in the cervical region, which may extend down to the level of T2

( i ) Non-specific test for structural integrity of cervical region

29

Shoulder ROM

Flexion 180°

Extension 60°

Abduction 180°

Adduction 50°

External rotation 90°

Internal rotation 70°

 

Scapular Retraction

Scapular Protraction

Scapular Elevation

30

Shoulder Soft Tissue Palpation

Prominent Muscles

  • sternocleidomastoid
  • biceps
  • deltoid
    • anterior
    • middle
    • posterior
  • trapezius
  • rhomboid
    • major
    • minor

Rotator Cuff Muscles

  • supraspinatus
  • infraspinatus
  • teres minor
  • subscapularis

Subacromial bursa

Subdeltoid bursa

Axillary borders

  • pectoralis major
  • latissimus dorsi
  • serratus anterior
  • axillary lymph nodes
  • bicipital tendon

31

O'Donoghue Maneuver

Cervical Spine

Cervical Flexion - 50°

Cervical Extension - 60°

Cervical Lateral Flexion (L/R) - 45°

Cervical Rotation (L/R) - 80°

 

( + ) Pain during passive range of motion

( i ) Ligamentous sprain

- - - - - - - - - - - - - -

( + ) Pain during active resisted range of motion

( i ) Muscle or tendon strain

32

Speed Test

( + ) Pain and/or tenderness in the bicipital groove

( i ) Bicipital tendonitis

33

Elbow Soft Tissue Palpation

biceps

triceps

brachial artery

supracondylar lymph nodes

medial collateral ligament

ulnar nerve

olecranon bursa

lateral collateral ligament

wrist flexor muscles:

- pronator teres

- flexor carpi radialis

- palmaris longus

- flexor carpi ulnaris

elbow flexor muscles (mobile wad of three)

-brachioradialis

- extensor carpi radialis longus

- extensor carpi radialis brevis

34

Bunnel-Littler Test

"My patient presents with an inability to flex their proximal interphalangeal joint. I place their metacarpophalangeal joint in extension and attempt to flex their proximal interphalangeal joint, and it does not flex. I then place their metacarpophalangeal joint in slight flexion. One of two things will happen..."

a. ( + ) Flexion of the proximal interphalangeal joint cannot be achieved

a. ( i ) Joint capsule contracture

- - - - - - - - - - -

b. ( + ) Flexion of the proximal interphalangeal joint is achieved

b. ( i ) Tight intrinsic muscles

35

Wrist Soft Tissue Palpation

radial artery

ulnar artery

palmaris longus tendon

thenar eminence

hypothenar eminence

palmar aponeurosis

carpal tunnel region

tissues surrounding proximal interphalangeal joints

tissues surrounding distal interphalangeal joints distal

tufts of fingers

36

Spinal Percussion

a. ( + ) Local pain

a. ( i ) Possible fractured vertebrae, ligamentous involvement if there is spinous pain, and or muscular involvement if there is muscular pain.

- - - - - - - - - - - - - -

b. ( + ) Radiating pain

b. ( i ) Possible disc pathology

37

Cozen

( + ) Pain over the lateral epicondyle

( i ) Lateral epicondylitis (Tennis Elbow)

38

Anterior Apprehension Test

( + ) Patient will have a noticeable look of apprehension or alarm on their face with possible pain

( i ) Chronic anterior dislocation of the glenohumeral joint

39

Elbow ROM

Flexion 150°

Extension 0°

Forearm supination 80°

Forearm pronation 80°

40

Cervical Spine Soft Tissue Palpation

sternocleidomastoid

anterior cervical chain

posterior cervical chain

 

carotid pulse

thyroid gland

 

supraclavicular fossa

trapezius

 

superior nuchal line

greater occipital nerves

41

Cervical Spine Bony Palpation

hyoid bone

thyroid cartilage

first cricoid ring

mandible

mastoid processes

inion (EOP)

occiput

superior nuchal line

spinous processes of cervical vertebrae

facet joints

42

Dawbarn Test

Initial deep palpation elicits well-localized pain by the subacromial bursa

 

( + ) Decrease in pain and/or tenderness

( i ) Subacromial bursitis

43

Retinacular Test

"My patient presents with an inability to flex their distal interphalangeal joint. I place their proximal interphalangeal joint in extension and attempt to flex their distal interphalangeal joint, and it does not flex. I then place their proximal interphalangeal joint in slight flexion. One of two things will happen..."

a. ( + ) Flexion of the distal interphalangeal joint cannot be achieved

a. ( i ) Joint capsule contracture

- - - - - - - - - - -

b. ( + ) Flexion of the distal interphalangeal joint is achieved

b. ( i ) Tight retinacular ligament

44

Drop Arm Test

(Codman's Drop Arm Test)

( + ) Inability to lower the arm slowly or the arm drops suddenly

( i ) Rotator cuff tear, usually supraspinatus

45

Swallowing Test

( + ) Difficulty in swallowing

( i ) Space-occupying lesion at anterior portion of cervical spine.

Possibly esophageal or pharyngeal injury,

anterior disc defect,

muscle spasm

or osteophytes,

etc.

46

Reverse Phalen Sign

(Prayer Sign)

Patient would hold this position for 60 seconds or until the point of pain. 58, 59, 60...

( + ) Reproduction of pain, tenderness and/or paresthesia in the median nerve distribution area (thumb, 2nd, 3rd and lateral half of 4th digits)

( i ) Median neuritis, possibly Carpal Tunnel Syndrome

47

Posterior Apprehension Test

( + ) Patient will have a noticeable look of apprehension or alarm on their face with possible pain

( i ) Chronic posterior disloaction of the glenohumeral joint

48

Dugas Test

( + ) Inability to touch the opposite shoulder and/or inability of the elbow to touch the chest

( i ) Acute dislocation of the glenohumeral joint