Ortho Dx Flashcards
(44 cards)
Maximal Cervical Compression
pt seated, dr standing behind.
The examiner instructs the pt to rotate the head and hyperextend the neck over the shoulder on the
side of rotation.
Perform bilaterally.
( + ) Pain on the concave side
( i ) Foraminal encroachment with or without nerve root compression
(based on presence or absence of radicular component)
Shoulder Depressor
pt seated, dr stabilizes pt’s laterally flexed head while pushing down on shoulder. (3 positives/indicators)
( + ) Localized pain on the side being tested
( i ) Dural sleeve adhesion, muscular adhesion, contracture, or spasm, or ligamentous injury
( + ) Radiating pain on the side being tested
( i ) Neurovascular bundle compression, dural sleeve adhesions, or
Thoracic Outlet Syndrome
( + ) Radicular pain on the side opposite
( i ) Foraminal encroachment with nerve root compression.
Mill’s Test/Maneuver
AKA Evan’s
( + ) pain over lateral epicondyle
i ) lateral epicondylitis (Tennis Elbow
Anterior Apprehension, bilaterally
( + ) pt will have a noticeable look of apprehension or alarm on their face with possible pain
( i ) Chronic anterior dislocation of the shoulder (glenohumeral joint)
Tinel Wrist
( + ) Reproduction of pain, tenderness and/or paresthesia in the median nerve distribution area (thumb, 2nd, 3rd, and the lateral ½ of the 4th digit).
( i ) Median neuritis, possibly Carpal Tunnel Syndrome
McMurray’s Test
( + ) Clicking sound or pain by knee joint.
( i ) Tear of medial meniscus if positive on external rotation
Tear of lateral meniscus if positive on internal rotation
The greater the angle the knee is flexed when the positive is elicited, the more posterior the meniscal injury.
Drawer Sign of the ankle
( + ) Translation with the talus moving away from or toward the tibia.
( i ) With tibia pushed/ foot pulled; a tear/instability of the anterior talofibular ligament.
With tibia pulled/foot pushed; a tear/instability of posterior talofibular ligament.
Lasegue’s Test
( + ) Reproduction of sciatic pain before 60 degrees
( i ) Sciatica
Bechterew’s
( + ) Reproduction of radicular pain or inability to perform correctly due to tripod sign.
( i ) Sciatic radiculopathy
Cozen
( + ) Pain over the lateral epicondyle.
i ) Lateral epicondylitis (Tennis Elbow
Posterior Apprehension
( + ) Patient will have a noticeable look of apprehension or alarm on their face with possible pain
( i ) Chronic posterior dislocation of the glenohumeral joint.
ROM: Cervical Spine
Active and Passive:
Flexion 50° Extension 60° L lateral flexion 45° R lateral flexion 45° L rotation 80° R rotation 80°
Ulnar Abduction stress test of elbow
/Medial Collateral Ligament Test
/Abduction Stress Test
( + ) Excessive gapping & pain.
( i ) Medial collateral ligament tear and/or instability
Drawer Sign of the knee
( + ) Gapping > 6mm (tibia moves posterior) when the leg is pushed.
( i ) Torn posterior cruciate ligament.
( + ) Gapping > 6mm (tibia moves anterior) when the leg is pulled.
( i ) Torn anterior cruciate ligament.
Laguerre
pt is supine, dr grasps the affected leg, flexes and externally rotates the hip and abducts the thigh (this test is similar to Patrick except the ankle of the affected leg
is not resting on the contralateral knee).
Examiner applies pressure to the end range of motion while stabilizing the contralateral ASIS (rest ankle on forearm and with other hand reach under arm to stabilize)
( + ) Pain in the hip joint
( i ) Hip joint pathology
( + ) Pain in the sacroiliac joint
( i ) mechanical probem of the sacroiliac joint
Bonnet Sign
pt supine, dr strongly INTernally rotates and ADducts the affected
leg across the midline and then performs a SLR
( + ) Pain in posterior thigh or leg.
( i ) Immediate pain is sciatic neuropathy from piriformis syndrome.
Femoral Stretch/Nerve Traction Test
pt lies on the unaffected leg side, hip and knee slightly flexed, pt straightens back and flexes neck.
The affected leg is extended by the dr at the hip approx. 15º
The affected knee is flexed (stretching femoral nerve)
( + ) Pain on the anterior portion of the thigh.
( i ) Traction on the femoral nerve indicating involvement of the 2nd, 3rd and 4th lumbar nerve roots.
Nachlas Test, State positive Ely’s (?)
pt prone, dr takes the heel of the affected leg and approximates it to the ipsilateral buttock while stabilizing the pelvis to prevent hip flexion.
( + ) Pain in the buttock and/or pain in the lumbar region
( i ) Sacroiliac joint lesion, or Lumbar pathology
Ely’s Sign (Ely Test – Cipriano)
pt prone, examiner passively flexes the patient’s knee toward the ipsilateral buttock.
( + ) Hip on side being tested will flex causing the buttock to raise off the table.
( i ) Rectus femoris or hip flexor contracture
Hyperabduction Maneuver a.k.a. Wright Test
pt seated, examiner finds radial pulse in a neutral position and hyperabducts the patient’s arm slowly to full abduction while monitoring the pulse.
( + ) Pain and/or paresthesia, decreased or absent pulse, amplitude, pallor.
( i ) Compression of the axillary artery by pectoralis minor or coracoid process. Thoracic outlet syndrome.
Golfer’s Elbow Test
( + ) Pain over the medial epicondyle.
( i ) Medial Epicondylitis
Cervical Distraction
( + ) Diminished or absence of local cervical pain.
( i ) Foraminal encroachment without NR compression
( + ) Diminished or absence or radiating pain.
( i ) Foraminal encroachment with NR compression
( + ) Increase of cervical pain.
( i ) muscular strain, ligamentous sprain, myospasm or facet capsulitis
Morton’s
( + ) Sharp pain in the forefoot.
i ) Metatarsalgia or neuroma (usually at the 3rd and 4th metatarsal interspace
Brudzinski Sign
Patient supine, examiner flexes patient’s head to the chest.
+ ) Involuntary knee flexion.
( i ) Meningeal irritation or nerve root lesion (classic test for meningitis
Kernig Sign
( + ) Inability to fully extend the leg and/or pain (usually in the neck region)
( i ) Meningeal irritation/ meningitis.
