Vertebral Dx: thoracic outlet sydrome (anterior scalene) How: Patient in upright position. Passively extend, abduct and externally rotate affected arm while palpating the radial pulse. Ask patient to take a deep breath and hold it in. Ask patient to extend neck and rotate the head towards affected side.

Ortho Exams Flashcards by Fiona Campbell

Adams Sign

Vertebral

Dx: structural scoliosis

How: patient bends forward, scoliosis not improved

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Adson’s Test

Vertebral

Dx: thoracic outlet sydrome (anterior scalene)

How:

Patient in upright position.
Passively extend, abduct and externally rotate affected arm while palpating the radial pulse.
Ask patient to take a deep breath and hold it in.
Ask patient to extend neck and rotate the head towards affected side.

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Braggard’s Test

Vertebral

Dx: sciatica d/t disc herniation

How: during SLR, dorsiflex foot of leg that’s raised

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Bechterew’s Test

Vertebral

Dx: sciatica

How: while seated with flexed neck, pt extends one leg at a time; if no symptoms, pt extends both legs simultaneously

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Burns Bench Test

Vertebral

Dx: malingering

How: pt askted to touch floor while kneeling on a chair/bench. (+) if pt is not able to perform.

-More likely to see as a distractor-

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Cervical Spine Compression Test

Vertebral

Dx: nerve root compression/impingement

How: push down on pt’s head, (+) if sxs reproduced

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Cervical Spine Distraction Test

Vertebral

Dx: nerve root compression/impingement

How: pull up on pt’s head, (+) if sxs relieved

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East’s Test / Roo’s Test

Vertebral

Dx: thoracic outlet syndrome

How: pt hands up, open/close hands for 3 minutes.

(+): weakness of arm, numbness and tingling of the hand, inability to do for 3 min

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Hoover’s Test

Vertebral

Dx: malingering

How: pt supine, doc’s hands under pt’s heels, pt asked to flex one hip

(+): pt does not press down with non-active leg

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Kemp’s Test

Vertebral

Dx: disc herniation vs. facet

How: rotate, extend, flex – push on lumbar SP’s

(+) local pain = facet irritation

(+) radiating pain = nerve root irritation/disc herniation

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Kernig’s Test

Vertebral

Dx: meningitis

How: passively flex knee and hip 90 degrees, then attempt to extend the knee while keeping the hip stable

(+): resistance, pain

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Lasegue’ Test (SLR)

Vertebral

Dx: disc herniation OR sciatica

How: passively raise pt’s leg to 70 degrees

(+): pain between 30 and 70 degrees suggests disk hernia, any radiating pain suggests sciatica

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Lindner Test

Vertebral

Dx: nerve root irritation

How: pt seated or supine, neck passively flexed

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Milgram’s Test

Vertebral

Dx: disc herniation

How: supine, raise extended legs for 30 seconds

(+): inability to hold feet off the table for full 30 sec

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Minor’s Sign

Vertebral

Dx: sciatica

How: patient rises from a sitting position by supporting body weight on the unaffected side, placing one hand on the back

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Shoulder Depression Test

Vertebral

Dx: brachial plexus lesions (nerve root irritation)

How: apply downward pressure to shoulder while flexing patients head to opposite side

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Soto Hall

Vertebral

Dx: cervical disc herniation/cervical nerve root compression

How: patient supine, examiner passively flexes neck & applies pressure on sternum.

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Valsalva

Vertebral

Dx: space occupying lesion

How: bear down

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Vertebral Artery Test

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Vertebral

Dx: vertibral artery insufficiency or compression

How: passively extend head, lat flex, rotate to same side– hold 30 sec (side of compression is restricting blood flow)

(+): dizziness, visual chagnes, nystagmus

(+) means cervical manipulation is CONTRAINDICATED

Wright’s Test

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Vertebral

Dx: thoracic outlet syndrome, brachial artery compression

How: while palpating both radial pulses, life the patients arms slowly into abduction

(+): disappearance of pulse

Apley’s Scratch Test

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Shoulder

Dx: rotator cuff tear, tendonitis

How: touch finger tips at middle of back

(+): pain in shoulder region

Drop Arm Test (Codman’s)

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Shoulder

Dx: rotator cuff tear

How: passively raise patient’s arm above 90 degrees (abduction), then patient lowers arm back to neutral

(+): patient’s arm drops suddenly or experiences pain

Glenohumeral apprehension test

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Shoulder

Dx: shoulder dislocation or glenohumeral instability

How: pt shoulder and elbow at 90 degrees, examiner externally rotates shoulder

(+): pt feels/shows apprehension

Impingement Test (Hawkins-Kennedy)

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Shoulder

Dx: impingemnet (biceps, rotator cuff, supraspinatus)

How: pt. shoulder flexed and horizontally adducted toward midline. Stabilize elbow, and internally rotate shoulder by maneuvering forearm down.

Impingement Test (Neer's)

Shoulder **Dx**: supraspinatus or biceps tendon impingemnet **How**: examiner internally rotates the pt's arm and passively elevated the arm in the scapular plane.

Lippman's Test

Shoulder **Dx**: bicipital tendinosis **How**: pt arm flexed to 90 degress, examiner palpates bicipetal groove (think "Lipps") while passively internally + externally rotating

Speed's Test

Shoulder **Dx**: bicipital tendinosis **How**: resisted shoulder flexion with pt forearm supinated

Yergason’s Test

Shoulder **Dx**: bicipital tendinosis **How**: pt flexes elbow to 90 degress, resisted supination/lat rot

Thoracic possible diagnoses?

* Scoliosis * TOS * Sciatica/impingement * Disc herniation * Meningitis * Vertebral artery compression * Space occupying lesion

Shoulder possible diagnoses?

* Rotator cuff tear * Tendonitis * Dislocation

Wrist/hand/elbow possible diagnoses?

* Tennis elbow * Dequervain’s * Carpal tunnel

Cozen’s Test

Wrist/hand/elbow **Dx**: tennis elbow (lateral epicondylitis/extensor tendonitis) **How**: pt arm out and pronated; resisted wrist extension

Finkelstein's Test

Wrist/hand/elbow **Dx**: DeQuervain’s disease **How**: pt holds thumb in closed fingers and ulnar deviates

Mill's Test

Wrist/hand/elbow **Dx**: tennis elbow (lateral epicondylitis/extensor tendonitis) **How**: palpate patient’s lateral epicondyle while pronating the patient’s forearm, flexing wrist, extending elbow

Phalen's Test

Wrist/hand/elbow **Dx**: carpal tunnel **How**: backwards prayer for 30-60 seconds

Retinacular Test

Wrist/hand/elbow **Dx**: tight retinacular ligaments or capsule **How**: hold PIP, pt flexes DIP. If can't flex DIP, hold PIP in flexed position and have patient try to flex DIP again.

Tinel's Sign

Wrist/hand/elbow **Dx**: carpal tunnel **How**: tap over median nerve in wrist **(+)**: median nerve distrubution pain or tingling (thumb, index, middle, half of the fourth digit)

Valgus/Varus Stress Tests

Wrist/hand/elbow **Dx**: medial (ulnar) or lateral (radial) collatoral lig instability **How**: stabilize elbow, apply medial (valgus) and lateral (varus) force

Ely’s Test

Hip/pelvis **Dx**: muscle tightness, TFL/iliotibial tightness **How**: prone, flex knee to contralateral buttock

Gaenslen Test

Hip/pelvis **Dx**: SI or L4 lesions **How**: supine, one leg off table, bring the other knee to your chest

Hibb Test

Hip/pelvis **Dx**: SI or hip pathology, spondylolisthesis **How**: prone, flex knee, move leg laterally (opposite of Ely's) (+): * pain in hip --\> hip pathology * pain in buttock/pelvic --\> SI pathology or spondylolisthesis

Nachlas Test

Hip/pelvis **Dx**: ddx between SI, lumbar, femoral nerve source (upper lumbar) **How**: pt prone, examiner flexes knee to ipsilater buttock (Ely's is contralateral) **(+)**: location of pain suggests source

Ober Test

Hip/pelvis **Dx**: TFL/iliotibial band contracture **How**: lateral decubitus, affected leg up, flex knee, raise leg, let it fall

Patrick Test (FABER)

**Dx**: SI joint pathology **How**: flex, abduct, externally rotate pt hip (make a 4)

Pelvic Rock Test

**Dx**: SI pathology **How**: compress iliac crests towards midline

Thomas Test

**Dx**: hip flexor tightness **How**: pt supine and brings one knee to chest **(+)**: non-active leg lifts off table

Yeoman's Test

**Dx**: SI joint pathology **How**: pt prone, extend hip with knee extended/flexed to 90

Ortho Exams Flashcards

(47 cards)