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NPLEX II - Lynda > Physical Medicine Part 2 > Flashcards

Physical Medicine Part 2 Flashcards

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
Q

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

A

Extend elbow, flex wrist, pronate, then examiner resists wrist extension while stabilizing the elbow

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26
Q

What is a positive Cozen’s Test (Lateral Epicondylitis or Tennis Elbow)?

A

Pain w/over lateral epicondyle and/or in extensor tendon

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27
Q

What is the interpretation of a positive Cozen’s Test (Lateral Epicondylitis or Tennis Elbow)?

A

Tennis elbow or extensor tendonitis

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28
Q

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

A

Injury to extensor at elbow

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29
Q

What is the technique for Mill’s Test (Lateral Epicondylitis or Tennis Elbow)?

A

Pronate forearm, flex wrist and extend elbow while palpating lateral epicondyle

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30
Q

What is a positive Mill’s Test (Lateral Epicondylitis or Tennis Elbow)?

A

Pain over lateral epicondyle

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31
Q

What is the interpretation of a positive Mill’s Test (Lateral Epicondylitis or Tennis Elbow)?

A

Tennis elbow or lateral epicondylitis

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32
Q

What is the indication for Valgus/Varus Stress Test (Ligamentous stability tests at the elbow)?

A

Pain in the medial or lateral collateral ligaments at elbow

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33
Q

What is the technique for Valgus/Varus Stress Test (Ligamentous stability tests at the elbow)?

A

Pt sitting w/arm in slight flexion to “unlock” olecranon; stabilize elbow w/one hand and hold wrist w/ the other

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34
Q

What is the technique for testing the Medial Collateral Ligament?

A

Press medially w/ hand at elbow on the lateral epicondyle (Valgus stress), w/ other hand holding the medial wrist

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35
Q

What is the technique for testing the Lateral Collateral Ligament?

A

Press laterally w/ hand at elbow on the medial epicondyle (Varus stress), w/ other hand holding the lateral wrist

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36
Q

What is a positive Valgus/Varus Stress Test (Ligamentous stability tests at the elbow)? What is the interpretation of this positive test?

A

Pain in ligament tested; ligamentous instability

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37
Q

What is the indication for Finkelstein’s Test?

A

Pain in thumb

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38
Q

What is the technique for Finkelstein’s Test?

A

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.

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39
Q

What is a positive for Finkelstein’s Test?

A

Pain occurring at the wrist over the abductor pollicis longs and extensor pollicis brevis tendons

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40
Q

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

A

deQuervain’s or Hofmann’s disease (paratendonitis in the thumb)

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41
Q

What is the indication for Phalen’s Test?

A

Neurological dysfunction

42
Q

What is the technique for Phalen’s Test?

A

Have pt place the dorsals of the hands together and press both wrists into significant flexion, hold 30-60 sec.

43
Q

What is the positive for Phalen’s Test?

A

Pain during test or upon releasing

44
Q

What is the interpretation of positive Phalen’s Test?

A

Carpal tunnel syndrome

45
Q

What is the indication for Retinacular Test?

A

Instability of proximal interphalangeal joint

46
Q

What is the technique for Retinacular Test?

A

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
Q

What is the interpretation of a positive Retinacular Test?

A

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
Q

What is the indication for Tinel’s Sign?

A

Neurological dysfunction of median nerve

49
Q

What is the technique for Tinel’s Sign?

A

Tap over median (ulnar) nerve root distribution in the wrist

50
Q

What is a positive Tinel’s Sign?

A

Tingling or shooting pain in distribution of median nerve in the hand; pain in distribution of ulnar nerve

51
Q

What is the interpretation of a positive Tinel’s Sign?

A

Carpal Tunnel Syndrome; ulnar nerve palsy

52
Q

What is the indication for Ely’s Test?

A

Muscle tightness

53
Q

What is the technique for Ely’s Test?

A

Pt prone, w/ toes hanging over the edge of the table, legs relaxed; flex pt’s knee, bringing heel to contralateral buttock

54
Q

What is a positive Ely’s Test?

A

Hip flexion on ipsilateral side w/ passive knee flexion

55
Q

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

A

Tight rectus femoris muscle, lumbar lesion, contracture of the tensor fascia late, or an osseous hip lesion

56
Q

What is the indication for Ober’s Test?

A

Contracture of iliotibial band

57
Q

What is the technique for Ober’s Test?

A

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
Q

What is a positive Ober’s Test?

A

Leg remains abducted and doesn’t fall to table

59
Q

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

A

Contraction of the fascia late or iliotibial tract (severe). Possible poliomyelitis or meningomyelocele

60
Q

What is the indication for Ortolani’s (Click) Test?

A

Dislocated, lax hips during the first few weeks after birth

61
Q

What is the contraindication to Ortolani’s (Click) Test?

A

Dislocations that are difficult to reduce; avoid repeating often because it can damage articular cartilage of femoral head

62
Q

What is the technique for Ortolani’s (Click) Test?

A

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
Q

What is a positive Ortolani’s (Click) Test?

A

An audible, palpable click at the hip joint due to femoral head sliding over acetabular rim

64
Q

How is a positive Ortolani’s (Click) Test interpreted?

A

Congential hip dislocation

65
Q

What is the indication for Patrick’s Test (F-ab-er or F-Patrick test)?

A

Limitation of motion in the hip

66
Q

What is the technique for Patrick’s Test (F-ab-er or F-Patrick test)?

A

Flex (F), abduct (AB), and externally rotate (ER) and extend the patient’s hip (place the pt’s foot on opposite knee)

67
Q

What is a positive for Patrick’s Test (F-ab-er or F-Patrick test)?

A

Pain in hip joint

68
Q

What is the interpretation of a positive Patrick’s Test (F-ab-er or F-Patrick test)?

A

Arthritis, bursitis, ligament strain/sprain, or tight capsule in the hip

69
Q

What is the indication for the Telescoping Test?

A

Femoral head displaced out of acetabular cavity; femur anteverted and hip joint capsule lax

70
Q

What is the technique for Telescoping Test?

A

Push anteriorly then posteriorly on each hip alternately (the knee and hip of the leg worked on are both flexed)

71
Q

What is a positive for Telescoping Test?

A

Excessive movement

72
Q

What is the interpretation of a positive Telescoping Test?

A

Congenital hip dislocation

73
Q

What is the indication for Thomas Test?

A

Soft tissue stiffness that restricts joint motion

74
Q

What is the technique for Thomas Test?

A

Leg not at chest comes up off table

75
Q

What is the interpretation of a positive Thomas Test?

A

Tight hip flexor muscle (iliopsoas or rectus femoris)

76
Q

What is the indication for Trendelenberg Test?

A

Weakness of hip abductor muscles

77
Q

What is the contraindication for Trendelenberg Test?

A

Inability to balance on one leg

78
Q

What is the technique for Trendelenberg Test?

A

Observe patient as they stand on one leg

79
Q

What is a positive Trendelenberg Test?

A

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
Q

What is the interpretation of a positive Trendelenberg Test?

A

Gluteus medius weakness on side with the leg down

81
Q

What is the indication for Anterior Drawer Test?

A

One-plane instabilities

82
Q

What is the contraindication for Anterior Drawer Test?

A

Torn ligaments that allow posterior sag

83
Q

What is the technique for Anterior Drawer Test?

A

Pt supine; flex knee and hip to 90 degrees, examiner then sits on the foot and pulls the tibia toward self

84
Q

What is a positive Anterior Drawer Test?

A

Tibia moves anteriorly

85
Q

What is the interpretation of a positive Anterior Drawer Test?

A

Anterior Cruciate ligament torn

86
Q

What is the indication for Posterior Drawer Test?

A

One-plane instabilities

87
Q

What is the contraindication for Posterior Drawer Test?

A

Torn ligaments that allow posterior sag

88
Q

What is the technique for Posterior Drawer Test?

A

As Ant. Drawer but push tibia away from examiner

89
Q

What is a positive Posterior Drawer Test?

A

Tibia moves posteriorly

90
Q

What is the interpretation of a positive Posterior Drawer Test?

A

Posterior Cruciate ligament torn

91
Q

What is the indication for Apley’s Compression Test?

A

A tear or loss of the menisci, hindering function

92
Q

What is the technique for Apley’s Compression Test?

A

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
Q

What is the positive for Aply’s Compression Test? How is that interpreted?

A

Damage to/problem w/ lat and/or med. meniscus; not a ligamentous problem (Note: this is not a very sensitive test)

94
Q

What is the indication for Apley’s Distraction Test?

A

A tear in the collateral ligament lesion, hindering function

95
Q

What is the technique for Apley’s Distraction Test?

A

Pt prone; flex knee, pull up after stabilizing femur w/ knee, rotate internally and externally

96
Q

What is a positive for Apley’s Distraction Test?

A

Pain in collateral ligaments, excessive motion

97
Q

What is the interpretation of a positive Apley’s Distraction Test?

A

Collateral ligament sprain or rupture; NOT a meniscus problem

98
Q

What is the indication for Apprehension Test?

A

Patellar instability

99
Q

What is the technique for Apprehension Test?

A

Pt supine; quads relaxed, knee flexed 30 degrees; press patella laterally

100
Q

What is the positive for Apprehension Test?

A

Pain; pt grimaces, shows apprehension

101
Q

What is the interpretation for a positive Apprehension Test?

A

Chronic patellar dislocation

NPLEX II - Lynda (29 decks)

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