Special Tests Flashcards
(31 cards)
Cervical Distraction Test
Test for nn Compression in Cervical Region
Position: sitting or supine
PT lifts bilaterally from the mastoid processes
Slowly lift pt head maintaining slight neck flex
Positive: cervical/UE pain decreased during distraction
+ could indicate: Pressure on nerve root temporarily relieved; Pain from cervical OA relieved
** Suggests traction may be a viable treatment
Cervical Compression Test
Test for nn Compression in Cervical Region
Position: pt. is sitting; PT applies pressure downward on top of head
Positive: if pain/radiculopathy is evoked
**Usually try decrease symptoms with distraction rather than evoke with compression
Foraminal Compression Test (Spurlings A)
Test for nn Compression in Cervical Region
Position: Pt. is sitting
Pt. laterally flexes to one side and PT applies ~ 10lbs of pressure straight down on head
Positive: if pain radiates into UE toward which head is laterally flexed
Neer’s Sign
Test for Subacromial Impingement
Position:seated or lying; Passive forward flexion with IR with overpressure
Positive: “pt. pain” in subacromion anterior shoulder
Hawkins & Kennedy Test
Test for Subacromial Impingement
Position:seated
passive flexion of arm to 90o, then IR shoulder
Positive: “pt.”pain in subacromion anterior shoulder
GH Apprehension
Test for Anterior GH Instability
Position:pt. supine; passive ABD arm to 90, then ER SLOWLY
Positive: pt. shows sign of apprehension, resistance to further movement
Cozen’s Test
Test for Lateral Epicondylitis
Position: Patient asked to make a fist, pronate forearm, extend and RD wrist
PT resists wrist ext and/or RD
Positive: pain at lateral epicondyle
Mill’s Test
Test for Lateral Epicondylitis
Position: Patient asked to make a fist, pronate forearm flex and UD wrist and extend elbow; Test can be done passively
Positive: pain at lateral epicondyle
3rd Finger Resistance Test
Test for Lateral Epicondylitis
Position: Resist extension of the third digit of the hand distal to the PIP joint
Positive: pain @ lateral epicondyle
Tinel’s Sign at Carpal Canal
Test for Ulnar nn Dysfunction
Position:Tap ulnar nerve as it lies in groove between olecranon process and medial epicondyle 4-6X
Positive: tingling distally in ulnar n distribution
Froment’s Sign
Test for ulnar nerve dysfunction/paralysis
Position: Patient holds a piece of paper between thumb and index finger; PT tries to pull paper away
Positive: terminal phalanx of thumb flexes to compensate for inability of adductor pollicis muscle to work
Tinel’s Sign at the Wrist
Test for Carpal Tunnel Syndrome
Position: pt. sitting, wrist supported on plinth; PT taps over carpal tunnel at the wrist
Positive: tingling or paresthesia into thumb, index, middle and radial side of ring finger
Phalen’s Test
Test for Carpal Tunnel Syndrome
Position: pt. sitting or standing; pt. flexes both wrists maximally, brings dorsal aspect of both hands together, bring elbow down slightly; Hold position for 1 minute
Positive: tingling in thumb, index, middle and radial ½ of ring finger
Can also do the reverse: Reverse Phalen’s (Prayer)
Finklestein Test
Test for Wrist Tendonitis (APL/EPB):DeQuervain’s
Extensor compartment #1
Position: pt. makes fist with thumb inside fingers; Passive or active UD
Positive: pain over APL or EPB tendons at wrist
Look for reproduction of their pain at the wrist
Compare to opposite side ( may be normally uncomfortable!)
Trendelenburg Test
Position: Standing
Method: PT stands behind patient. Observe symmetry of PSIS, pelvis in stance. PT can place hands on iliac crests. Have patient stand on 1 leg
+: during unilateral stance, pelvis drops on the OPPOSITE side; indicates weakness of glut medius on the STANCE side
True Leg Length Test
Position: Supine
Method: Measure from ASIS to medial malleolus
+: greater than 1.5 cm difference between legs
Thomas Test
Position: Supine, Check for excessive lordosis, Bring one knee to chest, Stabilize lumbar spine and pelvis, Relax contralateral hip
NORMAL: hip remains on the table
CONTRACTURE: hip rises from table; Contracture angle can be measured
J SIGN: hip ABDucts indicating tight iliotibial band
Looks at hip flexor LENGTH
Modified Thomas Test
Position: Pt supine, Knee bent over edge of table, Bring one knee to the chest, Stabilize lumbar spine and pelvis, Relax contralateral limb
NORMAL: knee angle 90°
CONTRACTURE: knee angle < 90
Looks at RECTUS FEMORIS LENGTH
90/90 Test
Position:Pt Supine
Method: PASSIVE flexes the hip to 90°with knee bent, Pt extend one knee as much as possible
+: Lacking more than 20 degrees of extension
Looks at length on hamstrings
Ober’s Test
Position: Pt side lying; Lower limb flexed; Stabilize pelvis
Method: Passively abducts and extend upper limb with knee flexed 90° Slowly lower upper limb
+: thigh doesn’t reach midline indicating a contracture of TFL and ITB
Modified Ober’s Test
Position: Pt side lying; Lower limb flexed; Stabilize pelvis Knee is fully extended Greater stretch on IT band Less tension on patella Less tension on rectus
+: if thigh doesn’t reach midline
+: with pain at the greater trochanter even if full ROM is present (trochanteric bursitis)
Patellar Apprehension Test
(+) = pt will look anxious and contract quad with passive lateral displacement of patella
Lachman’s Test
Tests ACL integrity; primarily posterolateral bundle
Checks anterior translation of tibia on femur
Done in 20-30o knee flex; grasp tibia and move anterior on femur
(-)= solid end stop
(+) = mushy or soft end feel
Posterior Drawer
Test for PCL tear
Supine, knee flexed to 90o; hip flexed to 45o
Palpate tibial plateaus as tibia is pushed posteriorly
(-): solid end stop
(+): mushy excessive posterior translation
False negative: tibia sags back on the femur at the starting point of the test (Sag Sign)
Sit on foot to stabilze
Pull slightly forward and then push posterior
