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5 Ortho > Practical > Flashcards

Practical Flashcards

1
Q

Neer’s Positioning

A

Stabilize scapula
IR humerus
passively flex arm to max range in scapular plane

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2
Q

Neer’s Positive

A

Pain at sub-acromial or anterior edge of acromion, often visible pain

test is sensitive but not specific. Negative gives us more information

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3
Q

Meaning of Positive Neers

A

supraspinatus impingement

jams greater tuberosity against acromion, pinching supraspinatus or biceps tendon

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4
Q

Empty Can positioning

A

abduct arm to 90°
move to 30° in scapular plane
IR arm, with hand pointing down
provide resistance down

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5
Q

Empty Can positive

A

pain or weakness in the position w/resistance at subacromial space

not a great test b/c it decreases the joint space
High specificity, can rule in a positive

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6
Q

Empty can positive meaning

A

supraspinatus is pinched in subacromial space, contractile tissue weakness

supraspinatus impingement

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7
Q

Full can positioning

A

abduct arm to 90°
move to 30° in scapular plane
provide resistance down

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8
Q

Full can Positive

A

pain or weakness in the position w/resistance at subacromial space

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9
Q

Meaning of Full Can positive

A

supraspinatus is weak or has pain in normal position w/normal action

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10
Q

Hawkins-Kennedy Positioning

A

passively raise arm to 90° of flexion
Flex elbow to 90°
Support distal humerus
Move arm into IR at wrist

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11
Q

Hawkins-Kennedy Positive

A

Provocation test, pain
Most likely at subacromial

sensitive, not highly specific

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12
Q

Meaning of positive hawkins-kennedy

A

supraspinatus tendon is pushed against coracoids process

impingement

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13
Q

Cross Adduction Positioning

A

passively flex arm to 90°
max adduct arm

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14
Q

Cross Arm Positive

A

localized pain over acromioclavicular

more specific than sensitive

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15
Q

Cross Arm Positive Meaning

A

RC tendons and biceps tendons are pinched
impingement

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16
Q

Yocum positioning

A

pt places involved side hand on opposite shoulder
pt actively raises elbow

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17
Q

Yocum positive

A

painful at anterior shoulder

sensitive, not specific

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18
Q

Yocum positive meaning

A

RC tendons and biceps tendon are pinched
impingement

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19
Q

Drop Arm Positioning

A

passively abduct arm to 90°
pt slowly lowers arm

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20
Q

Drop Arm Positive

A

weakness or pain causes patient to drop arm to their side

high specificity, good at ruling in

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21
Q

Drop Arm Positive Meaning

A

function and integrity of supraspinatus
positive would indicate a tear

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22
Q

ER Lag Positioning

A

20° elevation in scapular plane
passively flex the elbow to 90°
ER shoulder maximally, then back 5°
ask pt to hold in that position

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23
Q

ER Lag Positive

A

arm starts to drift into IR
increased specificity, good at ruling in

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24
Q

ER Lag Positive Meaning

A

tests for infraspinatus pathology, possible tear

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25
Hornblower Positioning
bring shoulder to 90° of abduction, 90° ER ask pt to hold this
26
Hornblower Positive
arm falls into internal rotation high specificity and sensitivity
27
Hornblower Positive Meaning
Indicates a massive teres minor tear
28
Gerber Positioning
hand goes behind back, with back of hand resting at mid lumbar lift hand off back with IR apply resistance
29
Gerber Positive
hand can't be lifted off the back compensation w/shoulder or elbow extension
30
Gerber Positive Meaning
subscapularis pathology possible tear
31
Belly Press Positioning
alternative to gerber elbow 90° and hand on stomach apply force to ER to forearm
32
Belly Press Positive
weak compared to non-affected compensation w/shoulder extension or wrist flexion high specificity, ruling in
33
Belly Press Positive Meaning
subscapular pathology possible tear
34
Obrien's Positioning
pt flexes to 90° while keeping elbow extended, adducted 10°, supinated. Apply force down. pt IRs, with thumb down, Apply force down.
35
Obrien's Positive
pain in GHJ in pronation but NOT in supination high sensitivity, better at ruling out
36
Obrien's Positive Meaning
possible labral tear, or SLAP tear
37
Compression Rotation Test Positioning
pt supine, abduct arm to 90°, elbow in 90° of flexion provide axial compression, then humerus is circumducted and rotated
38
Compression Rotation Positive
pain or clicking high specificity, can rule in
39
Compression Rotation Positive Meaning
indicates SLAP or labral tear
40
Crank Positioning
supine, elevate arm to 160° in scapular plane apply axial force and rotate into IR and ER
41
Crank Positive
clicking or pain in GHJ high specificity, can rule in
42
Crank Positive Meaning
indicates labral pathology
43
Apley's Scratch Positioning
pt brings 1 arm into extension, IR, adduction pt brings other arm into flexion, ER, abd pt tries to touch fingers
44
Apley's Scratch Positive
unable to touch fingers together or overcompensates with one arm
45
Apley's Scratch Positive Meaning
pt has decreased ROM in GHJ
46
Sulcus Sign Positioning
pt sits or stands with arms relaxed by side hold at proximal elbow and pull down
47
Sulcus Sign Positive
sulcus forms at superior humeral head
48
Sulcus Sign Positive Meaning
may indicate multidirectional or inferior stability
49
Apprehension Positioning
supine, PT abducts arm to 90°, slowly ER if no symptoms, apply force anteriorly
50
Apprehension Positive
pt experiences instability, apprehension, pain at front high spin, can rule in
51
Apprehension Positive Meaning
pain at front = anterior instability pain at back = impingement
52
Relocation Positioning
supine, PT abducts arm to 90°, slowly ER no symptoms, apply force posteriorly
53
Relocation Positive
pain or apprehension decreases high spin, can rule in
54
Relocation Positive Meaning
anterior instability
55
Anteromedial + Posterior Lateral Joint Play Placement
0-30° abd = superior GHL 30-60° abd = middle GHL 90° abd = inferior GHL
56
Force of AM Joint Play
hand is on greater tubercle, and head of humerus force is up other hand is on distal humerus, distract and push down
57
Force of PL joint play
hand is on greater tubercle and head of humerus force is down other hand is on distal humerus, distract and pull up
58
Indication of AM or PL Joint Play
determining the integrity of the ligaments, hypermobility (gd 2), capsule integrity, ROM, end feel
59
GH distraction placement
-use hand closest to pt, place in axilla -thumb goes distal to jt margin, fingers 90° posteriorly -other hand supports lateral humerus
60
GH Distraction Force
hand in axilla moves humerus laterally
61
GH Distraction Indications
testing initial tx = gd 2 pain = gd1/2 mobility = gd 3
62
GH Inferior Glide Placement
one hand in pts axilla web space of other hand goes distal to acromion process
63
GH Inferior Glide Force
w/superior hand, glide humerus in inferior direction gd 1 distraction on axilla
64
GH Inferior Glide Indications
increase abduction = gd 3 reposition the humeral head gd 1 distraction and inferior glide for progression, when there's 90° of abduction
65
GH Posterior Glide Positioning
patient: 45° abduction, and 30° flexion PT: back to pt, arm goes against trunk, grab distal humerus. Other hand goes distal to ant jt line, fingers are superiorly faced
66
GH Posterior Glide Force
grade 1 distraction on elbow glide posterior-lateral with other hand
67
GH Posterior Glide Indication
increase flexion increase IR
68
GH Anterior Glide Positioning
pt: prone with padding in acromion PT: pt arm goes on thigh, outside hand goes on distal humerus. Other hand goes distal to acromion, fingers are superiorly faced
69
GH Anterior Glide Force
gd 1 distraction to distal humerus anterior and slight medial force
70
GH Anterior GLide Indications
increase extension increase ER

5 Ortho (14 decks)

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