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NPLEX II - Lynda > Physical Medicine Part 2 > Flashcards

Physical Medicine Part 2 Flashcards

(101 cards)

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1
Q

What is the indication for Glenohumeral Apprehension Test?

A

ANT shoulder dislocation (differentiate btwn instability and impingement)

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2
Q

What is the contraindication/caution regarding Glenohumeral Apprehension Test?

A

Test should be done slowly to avoid dislocating the humerus

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3
Q

What is the technique for Glenohumeral Apprehension Test?

A

W/ pt supine, hold affected arm out w/shoulder abducted 90 degrees and elbow flexed 90 degrees. Then laterally rotate shoulder (using arm as a crank to pull it back) slowly.

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4
Q

What is the positive for Glenohumeral Apprehension Test?

A

Pain in shoulder, apprehension on pt’s face, and/or pt resists further posterior motion.

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5
Q

What is the interpretation of a positive Glenohumeral Apprehension Test?

A

Anteriorly dislocated shoulder

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6
Q

What is the indication for Impingement Test?

A

Rotator cuff pathology, bicipital tendinitis/paratendonitis, scapular or humeral instability, labral pathology

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7
Q

What is the technique for Impingement Test set-up?

A

Pt’s arm is abducted 90 degrees by examiner and fully rotated laterally

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8
Q

What is the technique for Hawkins-Kennedy Test?

A

Pt’s arm is flexed to 90 degrees and the shoulder is forcibly rotated medially

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9
Q

What is the technique for Neer Test?

A

Pt’s arm passively elevated in scapular plane while arm is medially rotated.

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10
Q

What is a positive Hawkins-Kennedy Test?

A

Symptoms w/ ANT and/or POST shoulder pain

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11
Q

What is a positive Neer Test?

A

Pt’s face shows pain

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12
Q

What is the interpretation of positive Impingement Test?

A

Impingement of intervening structures btwn greater tuberosity of the humerus and the coracohumeral ligament (poor sensitivity and specificity)

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13
Q

What is the indication for Lippmann’s Test?

A

Bicipital paratononitis/tendinosis

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14
Q

What is the technique for Lippmann’s Test?

A

Examiner holds pt’s arm flexed to 90 degrees and palpates biceps tendon 2.5-3 inches below the shoulder; biceps tendon is moved in the bicipital groove

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15
Q

What is a positive Lippmann’s Test? What is the interpretation of a positive Lippmann’s Test?

A

Sharp pain; bicipital paratenonitis or tendinosis

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16
Q

What is the indication for Speed’s Test (Biceps or Straight-arm Test)?

A

Biceps muscle or tendon pathology

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17
Q

What is the technique for Speed’s Test (Biceps or Straight-arm Test)?

A

Pt. flexes shoulder forward while examiner resists; the forearm is first supinated, then pronated, and the elbow extended completely

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18
Q

What is a positive Speed’s Test (Biceps or Straight-arm Test)?

A

Increased tenderness in the bicipital groove, particularly when arm is supinated

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19
Q

What is the interpretation of a positive Speed’s Test (Biceps or Straight-arm Test)?

A

Bicipital paratenonitis or tendinosis

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20
Q

What is the indication for Yergason’s Test?

A

Biceps muscle or tendon pathology

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21
Q

What is the technique for Yergason’s Test?

A

With elbow flexed 90 degrees and forearm pronated, pt supinates and laterally rotates against resistance

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22
Q

What is a positive Yergason’s Test?

A

Pain in biceps tendon or biceps tendon slips out of the groove

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23
Q

What is the interpretation of a positive Yergason’s Test?

A

Biceps tendinitis, displaced biceps tendon, bicipital groove instability

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24
Q

What is the indication for Cozen’s Test (Lateral Epicondylitis or Tennis Elbow)?

A

Overuse injury to extensors at elbow

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25
What is the technique for Cozen's Test (Lateral Epicondylitis or Tennis Elbow)?
Extend elbow, flex wrist, pronate, then examiner resists wrist extension while stabilizing the elbow
26
What is a positive Cozen's Test (Lateral Epicondylitis or Tennis Elbow)?
Pain w/over lateral epicondyle and/or in extensor tendon
27
What is the interpretation of a positive Cozen's Test (Lateral Epicondylitis or Tennis Elbow)?
Tennis elbow or extensor tendonitis
28
What is the indication for Mill's Test (Lateral Epicondylitis or Tennis Elbow)?
Injury to extensor at elbow
29
What is the technique for Mill's Test (Lateral Epicondylitis or Tennis Elbow)?
Pronate forearm, flex wrist and extend elbow while palpating lateral epicondyle
30
What is a positive Mill's Test (Lateral Epicondylitis or Tennis Elbow)?
Pain over lateral epicondyle
31
What is the interpretation of a positive Mill's Test (Lateral Epicondylitis or Tennis Elbow)?
Tennis elbow or lateral epicondylitis
32
What is the indication for Valgus/Varus Stress Test (Ligamentous stability tests at the elbow)?
Pain in the medial or lateral collateral ligaments at elbow
33
What is the technique for Valgus/Varus Stress Test (Ligamentous stability tests at the elbow)?
Pt sitting w/arm in slight flexion to "unlock" olecranon; stabilize elbow w/one hand and hold wrist w/ the other
34
What is the technique for testing the Medial Collateral Ligament?
Press medially w/ hand at elbow on the lateral epicondyle (Valgus stress), w/ other hand holding the medial wrist
35
What is the technique for testing the Lateral Collateral Ligament?
Press laterally w/ hand at elbow on the medial epicondyle (Varus stress), w/ other hand holding the lateral wrist
36
What is a positive Valgus/Varus Stress Test (Ligamentous stability tests at the elbow)? What is the interpretation of this positive test?
Pain in ligament tested; ligamentous instability
37
What is the indication for Finkelstein's Test?
Pain in thumb
38
What is the technique for Finkelstein's Test?
Pt first makes a fist by placing thumb inside closed fingers and actively ulnar deviates. Alternatively (and less painfully), Pt places ulnar surface of arm on table w/hand hanging off edge and examiner gently ulnar deviates the hand then pulls thumb toward palm.
39
What is a positive for Finkelstein's Test?
Pain occurring at the wrist over the abductor pollicis longs and extensor pollicis brevis tendons
40
What is the interpretation of a positive Finkelstein's Test?
deQuervain's or Hofmann's disease (paratendonitis in the thumb)
41
What is the indication for Phalen's Test?
Neurological dysfunction
42
What is the technique for Phalen's Test?
Have pt place the dorsals of the hands together and press both wrists into significant flexion, hold 30-60 sec.
43
What is the positive for Phalen's Test?
Pain during test or upon releasing
44
What is the interpretation of positive Phalen's Test?
Carpal tunnel syndrome
45
What is the indication for Retinacular Test?
Instability of proximal interphalangeal joint
46
What is the technique for Retinacular Test?
Hold PIP still, have pt flex DIP. If pt can't flex DIP, hold PIP in flexed position and have pt try to flex DIP again.
47
What is the interpretation of a positive Retinacular Test?
Can't flex DIP regardless of PIP's position = tight retinacular ligaments or capsule Can flex DIP only if PIP is flexed = tight retinacular ligaments, normal capsule and/or flexor digitorum profundus tight
48
What is the indication for Tinel's Sign?
Neurological dysfunction of median nerve
49
What is the technique for Tinel's Sign?
Tap over median (ulnar) nerve root distribution in the wrist
50
What is a positive Tinel's Sign?
Tingling or shooting pain in distribution of median nerve in the hand; pain in distribution of ulnar nerve
51
What is the interpretation of a positive Tinel's Sign?
Carpal Tunnel Syndrome; ulnar nerve palsy
52
What is the indication for Ely's Test?
Muscle tightness
53
What is the technique for Ely's Test?
Pt prone, w/ toes hanging over the edge of the table, legs relaxed; flex pt's knee, bringing heel to contralateral buttock
54
What is a positive Ely's Test?
Hip flexion on ipsilateral side w/ passive knee flexion
55
What is the interpretation of a positive Ely's Test?
Tight rectus femoris muscle, lumbar lesion, contracture of the tensor fascia late, or an osseous hip lesion
56
What is the indication for Ober's Test?
Contracture of iliotibial band
57
What is the technique for Ober's Test?
Pt's legs are flexed at knee to the point that normal lumbar lordosis disappears. Place one hand on the trochanter of the upper (affected) leg and grasp the ankle w/ your other hand. Flex knee to 90 degrees and passively abduct and raise leg as high as possible. Keep thigh in neutral position to relax iliotibial tract. Lower leg in a supported fall, or completely remove hand and allow leg to fall.
58
What is a positive Ober's Test?
Leg remains abducted and doesn't fall to table
59
What is the interpretation of a positive Ober's Test?
Contraction of the fascia late or iliotibial tract (severe). Possible poliomyelitis or meningomyelocele
60
What is the indication for Ortolani's (Click) Test?
Dislocated, lax hips during the first few weeks after birth
61
What is the contraindication to Ortolani's (Click) Test?
Dislocations that are difficult to reduce; avoid repeating often because it can damage articular cartilage of femoral head
62
What is the technique for Ortolani's (Click) Test?
Place infant on their back and flex the hips and knee to 90 degrees. The examiner's thumbs are against the inside of the knees and the fingers along the outside of the thigh. Abduct and externally rotate hips.
63
What is a positive Ortolani's (Click) Test?
An audible, palpable click at the hip joint due to femoral head sliding over acetabular rim
64
How is a positive Ortolani's (Click) Test interpreted?
Congential hip dislocation
65
What is the indication for Patrick's Test (F-ab-er or F-Patrick test)?
Limitation of motion in the hip
66
What is the technique for Patrick's Test (F-ab-er or F-Patrick test)?
Flex (F), abduct (AB), and externally rotate (ER) and extend the patient's hip (place the pt's foot on opposite knee)
67
What is a positive for Patrick's Test (F-ab-er or F-Patrick test)?
Pain in hip joint
68
What is the interpretation of a positive Patrick's Test (F-ab-er or F-Patrick test)?
Arthritis, bursitis, ligament strain/sprain, or tight capsule in the hip
69
What is the indication for the Telescoping Test?
Femoral head displaced out of acetabular cavity; femur anteverted and hip joint capsule lax
70
What is the technique for Telescoping Test?
Push anteriorly then posteriorly on each hip alternately (the knee and hip of the leg worked on are both flexed)
71
What is a positive for Telescoping Test?
Excessive movement
72
What is the interpretation of a positive Telescoping Test?
Congenital hip dislocation
73
What is the indication for Thomas Test?
Soft tissue stiffness that restricts joint motion
74
What is the technique for Thomas Test?
Leg not at chest comes up off table
75
What is the interpretation of a positive Thomas Test?
Tight hip flexor muscle (iliopsoas or rectus femoris)
76
What is the indication for Trendelenberg Test?
Weakness of hip abductor muscles
77
What is the contraindication for Trendelenberg Test?
Inability to balance on one leg
78
What is the technique for Trendelenberg Test?
Observe patient as they stand on one leg
79
What is a positive Trendelenberg Test?
Hip/iliac crest rises on side with leg down, and drops on side of leg which is lifted. Torso laterally flexes toward side with leg down as compensation
80
What is the interpretation of a positive Trendelenberg Test?
Gluteus medius weakness on side with the leg down
81
What is the indication for Anterior Drawer Test?
One-plane instabilities
82
What is the contraindication for Anterior Drawer Test?
Torn ligaments that allow posterior sag
83
What is the technique for Anterior Drawer Test?
Pt supine; flex knee and hip to 90 degrees, examiner then sits on the foot and pulls the tibia toward self
84
What is a positive Anterior Drawer Test?
Tibia moves anteriorly
85
What is the interpretation of a positive Anterior Drawer Test?
Anterior Cruciate ligament torn
86
What is the indication for Posterior Drawer Test?
One-plane instabilities
87
What is the contraindication for Posterior Drawer Test?
Torn ligaments that allow posterior sag
88
What is the technique for Posterior Drawer Test?
As Ant. Drawer but push tibia away from examiner
89
What is a positive Posterior Drawer Test?
Tibia moves posteriorly
90
What is the interpretation of a positive Posterior Drawer Test?
Posterior Cruciate ligament torn
91
What is the indication for Apley's Compression Test?
A tear or loss of the menisci, hindering function
92
What is the technique for Apley's Compression Test?
Pt prone w/ examiner's knee on pt's posterior thigh; flex knee 90 degrees, lat. rotate and push down. Repeat w/ medial rotation.
93
What is the positive for Aply's Compression Test? How is that interpreted?
Damage to/problem w/ lat and/or med. meniscus; not a ligamentous problem (Note: this is not a very sensitive test)
94
What is the indication for Apley's Distraction Test?
A tear in the collateral ligament lesion, hindering function
95
What is the technique for Apley's Distraction Test?
Pt prone; flex knee, pull up after stabilizing femur w/ knee, rotate internally and externally
96
What is a positive for Apley's Distraction Test?
Pain in collateral ligaments, excessive motion
97
What is the interpretation of a positive Apley's Distraction Test?
Collateral ligament sprain or rupture; NOT a meniscus problem
98
What is the indication for Apprehension Test?
Patellar instability
99
What is the technique for Apprehension Test?
Pt supine; quads relaxed, knee flexed 30 degrees; press patella laterally
100
What is the positive for Apprehension Test?
Pain; pt grimaces, shows apprehension
101
What is the interpretation for a positive Apprehension Test?
Chronic patellar dislocation

NPLEX II - Lynda (29 decks)

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