Special Tests Flashcards

Question

Allen Test Assesses For

Answer 1

* Circulation to Hands

Answer 2

* Circulation to Fingers

Answer 3

* Femoral Anteversion

Answer 4

* Hip Joint Pathology

Answer 5

* Hip Joint Pathology

Answer 6

* Labral Lesion

Answer 7

* Rectus Femoris Length

Answer 8

* Hamstrings Legnth

Answer 9

* TFL & IT band contracture

Answer 10

* Hip flexor contracture

Answer 11

* Valgus instability (MCL)

Answer 12

* Varus instability (LCL)

Answer 13

* Meniscus or Collateral Ligament

Answer 14

* Meniscus

Answer 15

* Joint Effusion

Answer 16

* Patella dislocation/instbaility

Answer 17

* Patellofemoral Dysfunction

Answer 18

* ITB pain (friction) syndrome

Answer 19

* ATF Ligament

Answer 20

* ATF Ligament

Answer 21

* High Ankle Sprain

Answer 22

* Deltoid Ligament

Answer 23

* Calcaneal Tendon Rupture

Answer 24

* Planatar Fasciitis

Answer 25

Body: Seated Examiner: Stands behind body Procedure: 1. Arm by side, passive lateral rotation of the GH 2. Move arm to 45d abduction; passive lateral rotation of the GH 3. Move arm to 90d abduction; passive lateral rotation of the GH 4. Move arm to 120d abduction; passive lateral rotation of the GH

Answer 26

Body: Supine Examiner: Facing head Procedure: 1. Holds patient wrist; passive abduction to 90d; passive flexion to 30d 2. Place other hand over the proximal humerus close to the humeral head 3. Gradually and slowly and carefully apply levering pressure - push down on the humeral head while pulling up at the wrist

Answer 27

Body: Seated Examiner: Stands beside body Procedure: 1. Passively abduct the arm to 90d with an extended elbow 2. Support the arm under the elbow or by placing the wrist on your shoulder 3. Place one hand over the proximal humerus between the middle and upper third (close to humeral head) 4. Apply pressure to push the humeral head down and forward (diagonal)

Answer 28

Body: Seated or standing Examiner: Stands beside body Procedure: 1. Passive forward flexion of arm to 90d 2. Passive maximum medial rotation of arm

Answer 29

Body: Seated or standing Examiner: Stands beside body Procedure: 1. Position tested arm in passive medial rotation 2. Passive maximum elevation of the medially rotated arm in the scapular plane

Answer 30

Body: Standing Examiner: Stands beside body Procedure: 1. Arm forward flexed to 90d with elbow fully extended. Arm then horizontally adducted to 10-15d and medially rotated so the thumb faces downard. In this position, apply an eccentric load, pushing the test arm down towards the hip. 2. Return to the start position and repeat the test, this time with the arm in lateral rotation so that the thumb faces up.

Answer 31

Body: Seated or standing Examiner: Stands beside body Procedure: 1. Tested arm is brought to 90d forward flexion 2. Either active or passive maximum horizontal adduction is then applied

Answer 32

Body: Seated Examiner: Stands beside body Procedure: 1. Patient is fully passive 2. Examiner places one hand on the spine of the scapula and the other hand on the clavicle, then squeezes their hands together providing a shearing force

Answer 33

Body: Standing Examiner: Stands behind body Procedure: 1. Arm is passively abducted to 90d 2. Patient is asked to slowly lower the arm back to the side in a controlled motion as the examiner removes support of the arm.

Answer 34

Body: Standing Examiner: Stands behind body to observe Procedure: 1. Body stands with hand on lumbar spine as shown below 2. Body is instructed to lift the hand away from the back 3. If able to lift the hand from the back, the examiner applies gentle load to the hand to assess the strength of the subscapularis as well as to observe what the scapula does under dynamic load.

Answer 35

Body: Seated or standing Examiner: Stands beside or in front of body Procedure: 1. Test arm is brought to 90d of forward flexion with the elbow fully extended and the forearm supinated. 2. Isometric resistance is placed on the distal forearm in the direction of extension.

Answer 36

Body: Standing Examiner: Stands beside or behind body Procedure: 1. Arm is actively abducted in the frontal plane to 90d abduction. Isometric resistance is applied. 2. Arm is then actively brought forward about 30d to be in the scapular plane and medially rotated so that the thumb points down (empty can). Isometric resistance is applied.

Answer 37

Body: Standing Examiner: Should observe posteriorly as well as anteriorly Procedure: 1. Body is shown the plane of the scapula and the movement of scaption, which is full elevation in the plane of the scapula (about 30d forward of frontal plane (diagonal)) 2. Body actively goes through 8-12 reps of the movement of scaption.

Answer 38

Body: Standing Examiner: Standing Procedure: 1. Tested arm positioned with shoulder laterally rotated and slight elbow flexion (about 30d) 2. Examiner stabilises at the elbow with a gentle palpating finger over the UCL 3. Examiner gently grasps wrist/distal forearm and applies a valgus force by abducting the forearm.

Answer 39

How to perform Body: Standing Examiner: Standing Procedure: 1. Tested arm positioned with slight elbow flexion (about 30d) 2. Examiner stabilises at the elbow with a gentle palpating finger over the RCL 3. Examiner gently grasps wrist/distal forearm and applies a varus force by adducting the forearm.

Answer 40

Body: Seated or standing Examiner: Seated or standing Procedure: 1. Gently grasp elbow to stabilise with a palpating thumb over the lateral epicondyle 2. The patient is then asked to actively make a fist, pronate the forearm, and radially deviate and extend the wrist and is instructed ‘don’t let me move you’. 3. Examiner then applies isometric resistance away from this position (in direction of wrist flexion and ulnar deviation)

Answer 41

Body: Seated or standing Examiner: Seated or standing Procedure: 1. Gently grasp elbow to stabilise with a palpating thumb over the lateral epicondyle 2. The examiner then lengthens the irritated tendon by applying passive full pronation of the patient’s forearm, full wrist flexion and full elbow extension

Answer 42

Body: Seated or standing Examiner: Seated or standing Procedure: 1. Body’s forearm rests on the table in a pronated position with the dorsum of the hand facing up 2. The examiner resists extension of the third digit of the hand distal to the proximal interphalangeal joint, stressing the extensor digitorum muscle and tendon

Answer 43

Body: Seated or standing Examiner: Seated or standing Procedure: 1. Gently grasp elbow to stabilise with a palpating thumb over the medial epicondyle 2. The examiner then lengthens the irritated tendon by applying passive full supination of the patient’s forearm, full wrist extension and full elbow extension

Answer 44

Body: Seated or standing Examiner: Seated or standing Procedure: 1. Person’s elbow flexed to 90d 2. Ask them to maximally pronate 3. Provide resistance so the pronation is isometric 4. Ask the person to maintain the contraction while they let you straighten the arm 5. Passively extend their arm while they continue to resist pronation

Answer 45

Body: Seated Examiner: Seated Procedure: 1. The patient sits with the test elbow at 90d with a neutral forearm rotation and maximum ulnar deviation of the wrist. 2. The examiner applies an axial load while passively supinating and pronating the ulnarly deviated wrist

Answer 46

Body: Seated Examiner: Seated Procedure: 1. The patient is seated with the elbow flexed to 90° and the wrist in ulnar deviation 2. The examiner holds the patient’s forearm with one hand and then applies an axial compression force through the fourth and fifth metacarpals.

Answer 47

Body: Seated or standing Examiner: Seated or standing Procedure: 1. The clinician holds the patient’s hand and creates a valgus (testing the UCL) or varus (testing the RCL) stress to the MCP joint of the thumb

Answer 48

Body: Seated Examiner: Stands behind body Procedure: 1. The patient makes a fist with the thumb inside the fingers 2. Examiner then performs POP of ulnar deviation

Answer 49

Body: Seated Examiner: Seated Procedure: 1. The patient is asked to open and close the hand several times as quickly as possible and then squeeze the hand tightly. 2. The examiner then occludes both the radial and ulnar arteries while the hand remains closed. 3. The patient then opens the hand while pressure is maintained over the arteries. 4. One artery is tested by releasing the pressure over that artery to see if the hand flushes. 5. Repeat on the other artery.

Answer 50

Body: Seated Examiner: Seated Procedure: 1. To test distal blood flow, the examiner compresses the nail bed and notes the time taken for color to return to the nail.

Answer 51

Body: Prone Examiner: Standing Procedure: 1. The body lies prone with the knee flexed to 90°. 2. The examiner palpates the posterior aspect of the greater trochanter. 3. The hip is then passively rotated medially and laterally until the greater trochanter is parallel with the examining table or reaches its most lateral position. (see final note below) 4.The degree of anteversion can then be estimated based on the angle of the lower leg with the vertical.

Answer 52

Body: Supine Examiner: Stands beside body Procedure: 1. Bring the hip to a flexed and adducted position (knee to opposite shoulder) (see notes below) 2. Apply axial load (see notes below) and scour the hip throughout an arc of movement in abduction while flexion is maintained

Answer 53

Body: Supine Examiner: Stands beside body Procedure: 1. Body lies supine 2. Examiner places the foot of the patient’s test leg on top of the knee of the opposite leg (the figure-4 position). 3. Examiner then slowly lowers the knee of the test leg toward the examining table

Answer 54

Body: Supine Examiner: Stands beside body Procedure: 1. Examiner flexes the body’s hip and knee to 90d each 2. Examiner slowly and carefully applies passive internal rotation and adduction to hip

Answer 55

Body: Prone Examiner: Stands beside body Procedure: 1. The examiner takes the test leg into end range and over pressure of knee flexion

Answer 56

Body: Supine Examiner: Stands beside body Procedure: 1. The supine body flexes both hips to 90° while the knees are bent. 2. The body grasps behind the knees with both hands to stabilize the hips at 90° of flexion. 3. The body then actively extends each knee in turn as much as possible.

Answer 57

Body: Side lying, with bottom leg flexed to 90d for stability Examiner: Stands behind body and maintains a stabilising hand on the pelvis to prevent it from rolling back Procedure: 1. Take test leg (upper leg) and passively abduct and extend with the knee straight while the hip remains in slight extension. Gently remove support from the leg, allowing it to fall into an adducted position towards the table. The test leg should be able to fall below neutral (adduction). 2. You may repeat the above exactly except with a flexed knee. (see notes)

Answer 58

Body: Supine on very edge of the table with legs overhanging the table. One leg is left to overhang while the body supports the other leg by hugging it to the chest. Examiner: Stands side on to observe Procedure: 1. Body hugs one knee to the chest, allowing the test leg to hang from the edge of the table.

Answer 59

Body: Supine Examiner: Stands beside body Procedure: 1. Examiner takes the test leg and stabilises at the ankle 2. Examiner applies a valgus stress to the knee when fully extended 3. Examiner introduces slight flexion (30d) and applies a valgus stress

Answer 60

Body: Supine Examiner: Stands beside body Procedure: 1. Examiner takes the test leg and stabilises at the ankle 2. Examiner applies a varus stress to the knee when fully extended 3. Examiner introduces slight flexion (30d) and applies a varus stress

Answer 61

Body: Supine or seated Examiner: Stands beside body Procedure: 1. position the knee at 20-30d of flexion, stabilise femur, apply an anterior stress to the tibia.

Answer 62

Body: Seated on edge of table Examiner: Sits in front of body, rests their ankle on the thigh to keep the knee at 30d flexion Procedure: 1. position the knee at 20-30d of flexion, stabilise femur, apply an anterior stress to the tibia.

Answer 63

Body: Supine Examiner: Stands beside body with thigh under the body’s distal thigh to stabilise in 30d flexion Procedure: 1. position the knee at 20-30d of flexion, stabilise femur, apply an anterior stress to the tibia.

Answer 64

Body: Supine with hip bent to 45d and knee bent to 90d (feet resting on table) Examiner: Places pillow on top of foot and then sits on pillow to stabilise Procedure: 1. Gentle but firm grasp with both hands around the tibia 2. Gently and progressively lean back to apply an anterior stress to the tibia

Answer 65

Body: Supine with hip bent to 45d and knee bent to 90d (feet resting on table) Examiner: Places pillow on top of foot and then sits on pillow to stabilise Procedure: 1. Gentle but firm grasp with both hands around the tibia 2. Gently and progressively push forward to apply an posterior stress to the tibia

Answer 66

Body: Supine with hip bent to 45d and knee bent to 90d (feet resting on table) Examiner: Observes from side on Procedure: 1. Observe for posterior sag of the tibia relative to the femur. This is seen when the tibial plateau does not protrude out, as can be seen comparing the bottom two images below.

Answer 67

Body: Prone Examiner: Stands beside body Procedure: 1. Examiner may choose to stabilise the posterior thigh into the table with one hand, and apply force with the other hand. Or, examiner may choose to use their leg and a pillow to stabilise the posterior thigh into the table and then use both hands to apply force to the tibia. 2. The thigh is stabilised won into the table 3. The examiner applies a distraction force and then rotations (medial and lateral) to the tibia to stress the MCL and LCL. 4. The examiner applies a compression force and then rotations (medial and lateral) to the tibia to stress the medial meniscus and lateral meniscus.

Answer 68

Body: Supine Examiner: Stands beside body Procedure: 1. Patient is supine with hip and knee both completely flexed 2. Examiner applies medial rotation to tibia in this position and then extends the knee fully while maintaining the internal rotation 3. Examiner returns to the start position, changes the degree of knee flexion, and repeats the test 4. The examiner chooses 3-5 different angles of knee flexion and repeats. 5. By having the tibia medially rotated, the lateral meniscus is stressed. 6. The examiner repeats all preceding steps except with lateral rotation of the tibia, which stresses the medial meniscus.

Answer 69

Body: Supine Examiner: Stands beside body Procedure: 1. Examiner starts at the inferomedial edge of the patella and gently brushes or strokes the skin in a clockwise direction (if a clockface: from 7 to 12) a few times 2. Examiner then uses the other hands to stroke from superolateral downwards in a clockwise direction (if a clockface: from 1 to 7).

Answer 70

Body: Supine, quadriceps relaxed, knee bent to about 30d Examiner: Stands beside body Procedure: 1. Body is relaxed and passive while the examiner carefully and slowly pushes the patella laterally in a gentle, slow, progressive way.

Answer 71

Body: Seated with leg hanging off table and the femur laterally rotated Examiner: Beside body Procedure: 1. Provides isometric resistance for each of the following: The patient performs 10s isometric quadriceps contractions at 120°, 90°, 60°, 30°, and 0° flexion. 2. If there are no symptoms recreated in any of the positions above, the test is negative. 3. If symptoms are recreated in any of the positions, the patient’s leg is passively returned to full extension by the examiner. The patient’s leg is then fully supported on the examiner’s knee, and the examiner pushes the patella medially. 4. The medial glide is maintained while the knee is returned to the painful angle, and the patient performs an isometric contraction, again with the patella held medially.

Answer 72

Body: Supine Examiner: Stands beside body Procedure: 1. Test leg brought to 90d hip and knee flexion 2. Firm but tolerable (it cannot be intolerable to start) pressure is applied to the site of friction which is usually 1-2 cm proximal to the lateral joint line of the knee 3. Examiner maintains pressure while body extends knee to fully straight

Answer 73

Body: Supine Examiner: Stands in front of body Procedure: 1. Supine with foot hanging off edge of table 2. Stabilise tibia and fibula down into the table, allowing the foot to rest in 20d plantar flexion 3. Grasp foot and draw it anteriorly to stress the ATFL 1. Supine with knee flexed to 90 and hip flexed to 45 so foot rests on table 2. Stabilise foot into the table 3. Push the tibia and fibula posteriorly to stress the ATFL

Answer 74

Body: Side lying with ankle in neutral (no dorsiflexion or plantar flexion) Examiner: Stands at feet Procedure: 1. Stabilise the lower leg 2. Grasp the calcaneus and talus and rotate them into inversion while applying force downwards

Answer 75

Body: Seated with the leg hanging over the examining table with the knee at 90°. Examiner: In front of body, with one hand stabilising the leg proximally Procedure: 1. With the other hand, the examiner holds the foot in plantigrade (90°) and applies a passive lateral rotation stress to the foot and ankle.

Answer 76

Body: Side lying with ankle in neutral (no dorsiflexion or plantar flexion) Examiner: Stands at feet Procedure: 1. With the patient side-lying on the side to be tested, place the ankle in neutral dorsiflexion. 2. The clinician stabilizes the lower leg and then everts the ankle.

Answer 77

Body: Prone Examiner: Stands beside body Procedure: 1. With the patient prone and ankle off the edge of the table, the clinician squeezes the muscle belly of the gastrocnemius.

Answer 78

Body: Standing, ideally on a step or similar with the toes overhanging Examiner: At the feet Procedure: 1. With patient standing, the clinician passively extends the MTP joint to wind the plantar fascia around the MTP joint

Special Tests Flashcards

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