Flashcards in Signs/ Tests Deck (22):
Referred rebound tenderness
Press deeply on the LLQ then quickly withdraw your fingers
Place your hand just above the patient's R knee and ask patient to raise that thigh to your hand
Flex the patient's R thigh at the hip with the knee bent and rotate the leg internally at the hip
Hook your left thumb under the costal margin at the point where the lateral border of the rectus muscle intersects with the costal margin.
Apley scratch test
Ask the patient to touch the opposite scapula
Difficulty suggests rotator cuff disorder or adhesive capsulitis
Press on scapula with one hand and raise the patient's arm with the other.
Pain indicates possible inflammation or rotator cuff tear
Flex the patient's shoulder and elbow to 90 degrees with palm facing down. Then with one hand on the forearm and one on the arm rotate the arm internally.
Pain indicates possible rotator cuff tear or inflammation
Supraspinatus strength (empty can test)
Elevate arms to 90 degrees and internally rotate the arms with thumbs pointing down. Ask patient to resist you as you place downward pressure on the arms.
Weakness indicates possible rotator cuff tear
Ask the patient to place arms at side and flex elbows to 90 degrees with thumbs up. Provide resistance as teh patient presses the forearms outward.
Weakness indicates possible rotator cuff tear or bicipital tendinitis
Flex patient's forearm to 9 degrees at elbow and pronate the patient's wrist. Provide resistance when the patient supinates the forearm.
Pain indicates inflammation of long head of biceps tendon and possible rotator cuff tear
Drop arm sign
Ask patient to fully abduct the arm to shoulder level (or 90 degrees) and lower it slowly. If the arm drops quickly indicates a rotator cuff tear.
Hand Grip Strength
Ask patient to grasp your second and third fingers. Decreased strength is a positive test for weakness of the finger flexors and/or intrinsic muscles of the hand.
Ask patient to grasp the thumb against the palm and then move the wrist toward the midline in ulnar deviation
Pain during this maneuver identifies de Quervain's tenosynovitis from inflammation of the abductor pollicis longus and extensor pollicis brevis tendons. Can also be CTS
Meidan nerve compression
Tap lightly over the course of the median nerve
Median nerve compression
Ask patient to hold the wrists in flexion for 60 seconds (have patient press backs of both hands together at right angles)
Bulge sign (knee)
With the knee extended place the left hand above the knee and apply pressure on the suprapatellar pouch, milking the fluid downward. Stroke downward on the medial aspect of the knee and apply pressure to force fluid into the lateral area. Tap the knee just behind the lateral margin of teh patella with the R hand
Balloon sign (Major effusions)
Place thumb and index finger of right hand on each side of the patella. With the left hand, compress the suprapatellar pouch against the femur. Feel for fluid entering into the spaces next to the patella under your right thumb and index finger.
Ballotting the patella
To asses large effusion
Compress the suprapatellar pouch and push the patella sharply against the femur. Watch for fluid return to the suprapatellar pouch
Integrity of Achilles tendon
Place patient prone with knee and ankle flexed at 90 degrees and squeezes the calf
Watch for plantar flexion
Grasp the heel and flex the knee
Cup your other hand over the knee joint with fingers and thumb along the medial joint line
From the heel, externally rotate the lower, then push on the lateral side to apply a valgus stress on the medial side of the joint. At the same time slowly extend the lower leg in external rotation
If click if felt or heard- meniscal tear possible
Abduction (or Valgus) Stress test (MCL)
Move the thigh 30 degrees laterally to the side of the table. Place one hand against the lateral knee to stabilize the femur and the other hand around the medial ankle. Push medially against the knee and pull laterally at the ankle