NMS 2

Question 1

Trendelenburg test

Answer 1

patient stands and raises one foot and then the other while the doctor observes the butt

positive: butt on foot that is elevated drops
indicates: hip abductor weakness on stance leg side

Question 2

ely’s sign

Answer 2

patient side lying, involved side up. doctor places one hand on plevis. thigh is abducted and extended. the doctor then alows the leg to drop into adduction

positive: knee stays elevated
indicates: TFL contracture

Question 3

barlow’s

Answer 3

bone with baby’s hip in adduction, in which gentle posterior pressure is placed on each hip, one at a time
positive: deep sounding “thunk” as ball subluxates out of socket

Question 4

ortolani’s

Answer 4

infant supine. legs are abducted and externally rotated

positive: palpable or audible click
indicates: congenital hip dislocation

Question 5

allis

Answer 5

patient supine. patient flexes both knees to 90 degrees with feet placed flat on table and both maleoli are approximated. doctor compares height of knees
positive: significant difference
indicates; posterior displaced femoral head or femur shortening

Question 6

thomas test

Answer 6

while the patient is supine the thigh is flexed with knee bent upon the abdomen
positive: oppostive thigh/knee rises off table
indicates hip flexion contracture (psoas)

Question 7

laguerre’s test (patrick fabre in air)

Answer 7

patient supine, doctor flexes, abducts and laterally rotates hip. doctor then aplies pressure over oppositve ASIS with one hand and with other hand presses down knee

positive: pain inhip
indicates: hip joint lesion, SI lesion

Question 8

patrick’s test (fabre’s)

Answer 8

patient supine. thigh is flexed, abducted, externally rotated and extended while downward pressure is placed on opposite ASIS and same knee

positive: pain inhip
indicates: hip lesion

Question 9

yeoman’s

Answer 9

doctor stabilizes SI joint esting with other hand. doctor flexes leg of affected side and hyperextends the thigh by lifting knee off table

Question 10

nachlas test

Answer 10

leg flexed to 90. heel approxiated to same butt. doctor stabilzes side they are testing

positive: pain in SIjoint
indicates: SI lesion or if pain is on anterior thigh: femoral nerve stretch

Question 11

hibb’s

Answer 11

doctor stabilizes pelvis on side they are standing. with other and, doctor grasps the ankle of the opposite leg and flexes kee to 90 degrees. doctor slowly pushes leg laterally away producing internal rotation of the hip
pain in femur- hip pathology

Question 12

iliac compression

Answer 12

patient is in side-lying position with involved side up. doctor’s hands are placed over the upper part of the iliac crest. doctor exerts donward pressure

Question 13

lewin-gaenslen’s

Answer 13

patient lies on unafffected side and pulls lower knee to chest. doctor stands behind patient stabilizes pelvis and hyperextends the top thigh

Question 14

hip abduction stress test

Answer 14

patient is lying on non affected side. patient actively abducts leg, then doctor exerts downward pressure proximal to knee

positive: pain at PSIS
indicates: SI joint problems, glute medius weaknesss

Question 15

minor’s sign

Answer 15

ask patient to rise from seated position

positive: patient will support body with uninvolved side balancing on good side
indicates: sciatica

Question 16

becterew’s sitting test

Answer 16

patient seated. patient attempts to extend each leg one at a time. doctor places one hand on the side being tested to resist hip flexion by the patient. patient then attempts to extend both legs together with both thighs stabilized by the doctor

positive: pain or leaning back
indicates: disc, posteromedial disc if pain when good leg raised

Question 17

neri’s bowing

Answer 17

when bending forward from waist the knee flexes on side of involvement

positive: knee bucking
indicates: tight hamstring (disc problem, SI sprain/strain, lumbosacral lesions)

Question 18

kemp’s

Answer 18

patient seated/standing and supported by doc. doctor rotates patient’s trunk from the original position and circumducts the trunk otward the affected side and then away from the affected side

positive: sciatic pain down involved side
indicates: posteromedial disc(kemp’s away from pain), posterolateral disc(kemp’s into pain, localized pain(facet)

Question 19

belt test AKA supported adam’s test

Answer 19

patient bends forward and the examiner notes when the pain occurs. then while doctor is behind the patient the doctor grasps the ASIS and braces their hip into the sacrum. the patient then flexes again and ROM is noted.
if lesion is in pelvis, patient will have no pain while pelvis is stabilized
lesion is in the spine, pain will present in both situations

Question 20

bonnet’s sign

Answer 20

when the patient supine the doctor stands on side being tested. doctor internally rotates leg, adducts leg, then performs SLR

positive: radicular pain into limb
indicates: piriformis syndrome

Question 21

bowstring sign

Answer 21

doctor performs an SLR to the point of pain. knee is flexed slightly and placed on doctor’s shoulder. digital pressure is placed above the popliteal fossa and then in the popliteal fossa

positive: apin in lumbar region or radiculopathy
indicates: sciatica

Question 22

lindner’s sign

Answer 22

patient’s head is pasivley flexed to chest

positive: pain in lumbar region radiating to sciatic nerve
indicates: root sciatica

Question 23

goldthwait’s

Answer 23

patient supine with affected leg raised slowly while hand is under lumbosacral portion of spine. repeat on other side

positive: pain
indicates: 0-30:SI, 30-60:lumbosacral, 60-90: lumbar spine or contralateral SI

Question 24

milgram’s

Answer 24

patient is supine with limbs extended. patient is aske dto elevate legs until 6 inches off table and hold for as long as possible
positive: pain
indicates SOL

Question 25

WLR (fajerstazn's)

Answer 25

SLR with dorsiflexion of foot is performed on asymptomatic side of sciatic patient positive: pain down symptomatic side indicates: medial disc lesion

Question 26

turyn's sign

Answer 26

while the patient is in the supine position, doctor dorsiflexes big toe psotivie: pain in affected leg indicates; sciatica

Question 27

sicard's sign

Answer 27

perform SLR, drop 5 degrees and dorsiflex big toe postive: pain in affected leg indicates: sciatica

Question 28

braggard's sign

Answer 28

after pain is elicited with SLR, the leg is lowered below the point of discomfort and the foot is sharply dorsiflexed positive: pain in affected leg indicates: sciatica

Question 29

SLR

Answer 29

patient is supine with legs extended. doctor places one hand under heel and other over knee and slowly raises leg postive: pain down affected side indicates: sciatica, disc, lumbar lesion

Question 30

finkelstein's test

Answer 30

patietn is asked to make a fist with thumb tucked inside. fist is then ulnar deviated evaluates: extensor pollicis brevis and abductor pollicis longus positive: pain over anatomical snuff box indicates: dequervain's dx AKA stenosing tenosynovitis

Question 31

froment's

Answer 31

doctor places a piece of paper etween the patient's thumb and index fingers and attempts to pull paper out positive: unable to keep paper between fingers indicates: ulnar nerve palsy

Question 32

phalen's sign

Answer 32

patient flexes the wrists maximally and hold position for up to 60 seconds by pushing both wrists together positive: tingling into first 3 digits of hand indicates: CTS

Question 33

tinel sign at wrist

Answer 33

percuss over flexor retinaculum of wrist of the tunnel of guyon positive: tingling into lateral 3 fingers or medial 2 fingers indicates: CTS, ulnar nerve impingement

Question 34

mill's test

Answer 34

patient is instructed to extend the forearm, make a fist, flex the wrist and then maximally pronate forearm. this test can be performed pasively by doc positive: pain lateral elbow indicates: carpal tunnel syndrome or ulnar nerve impingement

Question 35

reverse cozen

Answer 35

patient seated with arm close to body. patient makes a fist and flexes wrist with supination. doc resists flexion of wrist while supporting elbow positive: pain in medial elbow indicates: medial epicondylitis

Question 36

cozen's

Answer 36

patient's elbow is flexed to 90 degrees with forearm pronated and fist dorsiflexed. doc stabilizes elbow and resists the patient's dorsiflexion positive: pain in lateral elbow indicates: lateral epicondylitis

Question 37

medial epicondylitis

Answer 37

AKA little leaguer's elbow, golfer's elbow affects flexor carpi ulnaris pain with flexion of wrist at medial position of elbow

Question 38

lateral epicondylitis

Answer 38

AKA radiohumeral bursitis, tennis elbow affects the extensor carpi radialis brevis pain with extension of wrist and pronation of the elbow

Question 39

yergason's test

Answer 39

patient flexes elbow to 90 degrees while seated. doctor palpated bicipetal tendon and resists patient attempt to actively supinate the hand and flex elbow positive: audible click or snap in the bicipital groove indicates: bicipital tendon instability

Question 40

dawbarn's

Answer 40

deep palpation by doctor over the subaracromial bursa elicits pain. without moving fingers the arm is passively abducted positive: reduction of pain indicates: subacromial bursitis

Question 41

dugas

Answer 41

patient places hand of affected shoulder on opposite shoulder and attempts to touch chest with elbow positive: unable to perform indicates: acute shoulder dislocation

Question 42

apprehension

Answer 42

doctor abducts slowly externally rotates affected shoulder positive: patient shows signs of apprehension of alarm indicates: chronic shoulder dislocation

Question 43

codman's drop arm

Answer 43

examiner passively abducts arm to aboe 90 then suddenly removes support. makes deltoid suddenly contract causing increased pain positive: inability to maintain arm position indicates: supraspinatus tear

Question 44

elevation of scapula is done by?

Answer 44

traps | levator scapulae

Question 45

retraction of scapula is done by?

Answer 45

rhomboid major and minor

Question 46

protraction of scapula is done by?

Answer 46

serratus anterior

Question 47

rotator cuf muscles of shoulder

Answer 47

supraspinatus infraspinatus teres minor subscapularis

Question 48

supraspinatus

Answer 48

abduction suprascapular nerve inserts at greater tubercle

Question 49

infraspinatus

Answer 49

external rotation suprascapular nerve inserts at greater tubercle

Question 50

teres minor

Answer 50

external rotation; axillary nerve | inserts at greater tubercle

Question 51

subscapularis

Answer 51

internal rotation subscapular nerve inserts at lesser tubercle

Question 52

roo's

Answer 52

patient seated. both arms at 90 degrees then patent abducts and externally rotates them. patient then repeatedly opens and closes the fists for 3-5 minutes positive: reproduction of symptoms or unusual discomfort indicates: TOS

Question 53

bikele's

Answer 53

patient actively abducts shhould to 90 degrees with elbow flexed to 90 degrees and then extends the shoulder. now patient extends elbow positive: resistance and increased radicular pain indicates: TOS, brachial plexus neuritis, meningeal irritation

Question 54

halstead's

Answer 54

patient extends the head back. examiner slightly abducts arm then applies downward traction on arm while taking pulse positive: alteration of amplitude of radial pulse indicates: cervical rib

Question 55

reverse bakody

Answer 55

while seated, patient actively places palm on top of head | positive: increase pain

Question 56

wright's | hyperabduction maneuver

Answer 56

patient seated while doctor palpates radial pulse. each arm is invididually abducted to 180 degrees. doctor notes angle at which radial pulse diminishes or disappears positive: if pulses are los with more than 10 degree difference indicates: pec minor syndrome, axillary artery

Question 57

costoclavisular manuver | eden's test

Answer 57

doc palpates radial pulse while drawing patient's shoulder down and back. patient flexes chin to chest positive: alteration in amplitude of radial pulse indicates: subclavian atery, scalenus medius syndrome

Question 58

modified adson test (scalenus medius test)

Answer 58

with patient seated, doctor slightly abducts, extends and externally rotates arm while taking a radial pulse. patient rotates head away from tested side and extends head. patient takes a deep breath positive: alteration in amplitude of radial pulse indicates: cervical rib

Question 59

adson's test (scalenus anticus test)

Answer 59

with patient seated, doctor slightly abducts, extends and externally rotates arm while taking a radial pulse. patient rotates head toward tested side and extends head. patient takes a deep breath positive: alteration in amplitude of radial pulse indicates: subclavian artery, scalenus medius syndrome

Question 60

allen's test

Answer 60

patient is eated with elbow flexed and forearm supinated, ask the patient to pump hand, keep closed while examiner occludes radial and ulnar arteries until hand is blanched. the patient slowly opsn the hand while doc opens one artery and records filling time. repeat with other artery positive: delay of more than 10 second for blood to return incidactes: occlusion of rcorresponding artery

Question 61

naffziger's

Answer 61

have patient sit erect while doctor holds digital pressure bilaterally over jugular veins or puts a BP cuff around patient's neck and pumps to 40mmgh, holds for 30 second. if no pain patient is instructed to cough. contraindicated with vascular compromise positive: pain indicates: SOL

Question 62

valsalva

Answer 62

doc asks aptient to take a deep breath and hold while bearing down postivie: radicular pain indication: SOL

Question 63

spurling's

Answer 63

patient actively maximally rotates and alterall flexes head to affect side. doc delivers a vertical blow to the top of patient's head positive: pain in neck,shoulder or arm indication: SOL

Question 64

soto hall

Answer 64

with patient supine,doctor places one hand on sternum while passively flexing patient's head toward chest postive: localized pain indicates: fracture (anterior pain), ligament damage (posterior pain)