Flashcards in Orthopedic Tests Deck (82)
Procedure for Rust's Sign
If the patient spontaneously grasps the head with both hands when laying down or when rising from a recumbent position, then this is a positive sign.
A positive Rust's Sign indicates what possible issues?
severe sprain, rheumatoid arthritis, fracture, severe cervical subluxation
Reporting statement for Rust's Sign
Rust's sign is present; this result suggests severe upper cervical (atlanto-axial) instability
Clinical indication for Rust's Sign
Suggests, ligament, muscle damage or possible fracture. Note: X-ray patient before preforming any other tests
Procedure for Libman's Sign
The examiner applies thumb pressure to the mastoid process and gradually increases the pressure until the patient states that it is becoming noticeably uncomfortable.
Reporting statement for Libman's Sign
Libman's sign demonstrates an unusually low, high, or normal threshold for pain in the patient.
Clinical indication for Libman's Sign
Is useful for interpretation of palpation findings in later exams
Procedure for Bakody Sign
The patient will be in a seated position and will place the hand of the affected extremity on the top of their head, raising the elbow to the level of the ear.
Purpose/function of Bakody Sign
This is a position that the patient will assume if they have severe radicular symptoms. This decreases the traction of the lower part of the brachial plexus, and thus pain diminishes. This is a positive Bakody sign/test.
Findings for Bakody Sign
This is a sign that the patient has symptoms of a nerve root irritation. This is as effective as the compression tests and causes the patient a lot less pain. Note location of pain-it will help to identify the etiology
Findings for Reverse Bakody Sign
The pain of the patient's chief complaint is exacerbated. This indicates a thoracic outlet syndrome from interscalene compression. This is a positive Reverse Bakody sign/test
Findings for Negative Bakody Sign
The patient experiences no change in the pain or there is no pain complaint in the neck and/or arm. This is a negative Bakody sign/test. Clinical indication: Differentiate a nerve root (IVF) encroachment from a thoracic outlet syndrome (TOS)
Procedure for Bikele's Sign
The patient is asked to abduct the shoulder to 90 degrees, and then the elbow is put into full extension
Purpose/function of Bikele's Sign
The patient is being placed in a position that will traction the brachial plexus and its nerve roots. Function: stressing the brachial plexus
Findings for Bikele's Sign
The pain is radicular in nature and goes into the arm. Note the location of the pain; it will help to identify the etiology
Procedure for Brachial Plexus Tension Test
The patient is asked to abduct both shoulders to 90 degrees and place the hands behind the head. The doctor then pulls the elbows back.
Purpose/function of Brachial Plexus Tension Test
The patient is being placed in a position that tractions the brachial plexus and its nerve roots. Function: Stressing the brachial plexus
Findings for the Brachial Plexus Tension Test
The pain is radicular in nature and goes into the arm. Note the location of the pain-it helps identify etiology
Procedure for Dejerine's Sign (aka Dejerine's Triad, Triad of Dejerine)
Coughing, sneezing and straining during defecation may cause aggravation of radiculitis symptoms. This aggravation is due to the mechanical obstruction (space occupying lesion) such as a herniated or protruding intervertebral disc, spinal cord tumor, or spinal compression fracture.
Reporting statement for Dejerine's Sign
Dejerine's sign is present and suggests a space occupying mass at the C(?) level. The course of radiculitis helps identify the location of the lesion.
Cause of Dejerine's Sign.
herniated or protuding intervertebral disc
spinal cord tumor
spinal compression fracture
Clinical indications of Dejerine's Sign
Any sudden increase in intra-thoracic and intra-abdominal pressure blocks the venous flow from the epidural space through the intervertebral veins or a retrograde flow of blood because these veins do not comtain valves. The pressure increase causes a distention of the veins in the epidural space, which in turn forces the dura towards the spinal cord causing stretching of the nerve roots, which may result in pain. note location of pain
Procedure for Valsalva's Maneuver
The doctor stands in front of the seated patient and the patient is asked to take in a breath and bear down as if they were laboring during a strenuous defecation. Patients may become dizzy due to a decreased cerebral blood supply.
Purpose/function of Valsalva's Maneuver
To test for the presence of a space occupying lesion within the spinal column that is communicating with the spinal cord meninges; (eg. spinal cord tumor, IVD lesion, hemangiomas). Function: the patient is placing exhalation force against a closed glottis. This increases intra-thecal presure within the spinal cord.
Findings for Valsalva's Maneuver
A sharp accentuation of pain at the level of the lesion usually indicates a space occupying lesion (eg. herniated disc, tumor, or osteophyte). Note the location of pain
Procedure for the Swallowing Test
While seated, the patient is instructed to swallow
Presence of pain or difficulty swallowing during the Swallowing Test indicates:
space occupying lesion
osteophyte at the anterior portion of the cervical spine
Reporting statement for the Swallowing Test
This result suggests esophageal irritation due to direct trauma or a retro esophageal space occupying lesion
Procedure for Naffziger's Test
The doctor stands behind a seated patient and occludes the external jugular veins at the level of the clavicles for 10-15 seconds. The doctor then asks the patient to couch