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special tests Flashcards

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1
Q

yergason’s test

A

Purpose: test the integrity of the transverse ligament/biceps tendinopathy. Exam:patient sitting with shoulder neutral and elbow at 90 with forearm pronated. Resist forearm supination and shoulder ER. Positive if: you feel biceps pop out, or pain in LHB

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2
Q

Speed’s Test

A

Purpose: Biceps tendinopathy. Exam: Upper limb either in full extension and supination resisting flexion or at 90 and resist extension for eccentric contraction. Positive if: reproduces pain in biceps

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3
Q

Neer’s Impingement Test

A

Purpose: impingement of LHB / supraspinatus. Exam: sitting; shoulder is passively IR and then brought into full ABD. Positive if pain in the shoulder region

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4
Q

Supraspinatus (empty can) test

A

Purpose: identifies tear and/or impingement of supraspinatus tendon or possible supra scapular nerve neuropathy. Exam: patient seated and bring to 90 and resist ABD; then bring to IR and 30 degrees horizon. ADD and resist ABD. Positive if there is pain or weakness in the empty can position

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5
Q

Drop Arm Test

A

Purpose: Identifies a tear or full rupture of the rotator cuff. Exam: seated with shoulder passively ABD to 120. Patient instructed to lower arm to their side. Positive if patient is unable to perform the task

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6
Q

Posterior internal impingement test

A

Purpose: identify an impingement between the rotator cuff and the greater tuberosity or the posterior glenoid and labrum. Exam: Supine: passive ABD to 90, fully ER and horizon. ADD 15-20 degrees. Positive if reproduces pain in posterior shoulder

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7
Q

Clunk Test

A

Purpose: identifies a labral tear. Exam:supine with shoulder in full ABD, push the humeral head anterior while rotating the humerus into ER. Positive if there is an audible clunk.

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8
Q

Anterior Apprehension Sign

A

Purpose: hx of anterior shoulder dislocation. Exam: patient is supine and move into 90 ABD. Slowly move into ER. Positive: pt is apprehensive to the movement

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9
Q

Posterior Apprehension Sign

A

Purpose: hx of a posterior dislocation. Exam: pt is supine and you move the shoulder to 90 ABD, put a posterior force through the shoulder by pushing on elbow and then move the shoulder into IR and horizon. ADD. Positive if: patient is apprehensive

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10
Q

Acromioclavicular Shear Test

A

Purpose: identify dysfunction of the AC joint. Exam: patient is seated. examiner places heel of one hand on the spine of scapula and the other heel of hand on the clavicle: push them together. Positive if there is pain to the AC joint.

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11
Q

Adson’s Test

A

Purpose: identify pathology of structures in the thoracic inlet. Exam: Patient seated. palpate the radial pulse. Then patient rotates head toward the testing side, extend and ER the shoulder and extend the head and again assess radial pulse. Positive if: neurological, vascular symptoms, disappearance of pulse

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12
Q

Costoclavicular Syndrome (military brace) test

A

Purpose: thoracic outlet. Exam: patient seated. find the radial pulse and move the shoulder down and back and reassess pulse. Positive if: neurological or vascular symptoms

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13
Q

Wright (hyperabduction test)

A

Purpose: Thoracic Outlet. Exam: patient is seated, find the radial pulse and move the shoulder into max ABD and ER. Patient rotates their head opposite this arm and takes deep breaths. Positive if: reproduction of neurological/vascular symptoms

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14
Q

Roos Elevated Arm Test

A

Purpose: thoracic outlet. Exam: Shoulder ABD to 90, full ER and slight horizontal ADD. elbow to 90 and open and closes hands for 3 minutes. Positive if: reproduction of neuro/vascular symptoms

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15
Q

ULTT1 biases

A

Median Nerve, Anterior interosseous nerve

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16
Q

ULTT1 arm positions

A

Shoulder: Depression and ABD to 110. Elbow: extended. Forearm: supinated. Wrist: Extended. Fingers and thumb: extended Cervical: contralateral side bend

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17
Q

ULTT2 biases

A

Median, axillary, and musculocutaneous nerves

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18
Q

ULTT2 arm positions

A

Shoulder: depression and ABD to 10. Elbow: extended. Forearm: supinated. Wrist: extended, Shoulder: ER, Cervical: contralateral side flexion

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19
Q

ULTT3 Radial nerve arm positions

A

Shoulder: depression and ABD 10. Elbow: extension. Forearm: pronation. Wrist: Flexion and ulnar deviation. Fingers and thumb: flexion. Shoulder: IR Cervical: opposite side bend

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20
Q

ULTT4 Ulnar nerve positions

A

Shoulder: depression and ABD 10-90. Elbow:flexion, Forearm: supination. Wrist: extension and Radial deviation. Fingers: Extension. Shoulder: ER. Cervical: opposite side bend

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21
Q

Elbow ligament stability testing

A

Elbow placed in 0-20 of flexion and place values force to assess ulnar collateral ligament and varus force to assess radial collateral ligament.

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22
Q

Lateral epicondylitis or tennis elbow test

A

place elbow at 90, and pronated and radially deviated. resist wrist extension. Positive if there is pain at lateral epicondyle

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23
Q

Medial epicondylitis or golfer’s elbow test

A

seated with elbow at 90. Passively supinate, extend elbow and extend wrist. Positive if pain over medial epicondyle

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24
Q

Pronator Teres syndrome test

A

Purpose: to identify a median Nerve entrapment. Exam: resist forearm pronation and elbow extension at the same time. Positive if there is tingling or paresthesia in median nerve distribution.

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25
Finkelstein's Test
Purpose: identify de Quervian's tenosynovitis (ABD pollicis longus and Extensor pollicis Brevis). Make a fist with thumb tucked, move the wrist into ulnar deviation. Positive in pain in the wrist - must compare to other side
26
Bunnel-Littler Test
Purpose: identify tightness in the structures surrounding the MCP joints.Exam: Start with MCP stabilized in slight EXT. Then PIP is flexed. Then MCP is flexed with PIP flexed. If the two are equal this is capsular tightness. If flexion is increased with the MCP in flexion then there is intrinsic muscular tightness
27
Tight retinacular test (fingers)
Purpose: identify tightness around the PIPs. Exam: PIP stabilized in neutral and DIP is flexed. The PIP flexion with DIP is performed. IF they are equally tight, it is scapular tightness. IF there is more DIP flexion with PIP flexion then the retinaculum is tight.
28
Froment's Sign
Purpose: identify ulnar nerve dysfunction. Exam: Patient grasps a piece of paper between the first and second finger. Pull paper out and look for IP flexion of the thumb: this indicates weakness of ADD pollicis muscle that is innervated by ulnar nerve.
29
Phalen's Test
Purpose: identify carpal tunnel. Exam: upside down prayer position for 1 minute. Positive if there is tingling/paresthesia into median nerve distribution.
30
Two point discrimination test for the hand is normally
generally less than 6mm
31
Allen's Test
Purpose: identify vascular compromise of ulnar/radial arteries. Exam: identify both arteries, have patient open and close fingers several times then close fist. Occlude ulnar after and have patient open hand: observe palm of hand, then release and assess vascular filling. Positive is abnormal filling: normal is white color to normal color
32
FABER test
Identifies: hip mobility dysfunction. Exam: figure 4 position and lower the leg down towards the table. Positive if patient is unable to assume relaxed position or reproduction of pain.
33
Grind/Scour Test
Purpose: Hip DJD. Exam: supine, hip to 90 flexion and knee maximally flexed. Apply compressive force through the femur. Positive if there is pain in hip or referred pain
34
Trendelenburg sign
Purpose: assess glut med. Exam:Standing on one leg observe the pelvis. Positive if ipsilateral pelvis drops
35
Thomas Test
Purpose: identify tightness of hip flexors. Exam: one knee held to chest and opposite is relaxed. Positive if patient is unable to remain flat on table
36
Ober's test
Purpose: IT band, TFL. Exam: patient is sidelying, with lower limb flexed at hip and knee. Passively Extend and ABD hip with knee in 90 flexion and lower to table. modified obers's keeps the knee extended. Positive if does not touch the table
37
Ely's test
Purpose: tightness of Rec Fem. Exam:Prone and flex the knee. If hip flexes it is positive
38
90-90 hamstring test
Purpose: identify tight hamstrings. Exam: supine, begin in 90 90. Then passively extend the knee until resistance. Positive if knee is unable to reach 10 degrees from full extension.
39
Piriformis Test
supine with foot of test leg passively placed lateral to opposite knee. test hip is ADD. Positive if test knee is unable to pass over the resting knee or there is pain in buttock/sciatic nerve distribution.
40
Craig's Test
Purpose: identify abnormal femoral antetorsion angle. Exam: patient prone and identify the point where greater troch is most lateral and measure. Normal angle is 8 to 15 degrees hip IR. Less than 8 indicates a retroverted hip and greater than 15 indicates an anteverted hip
41
Knee collateral ligament testing
knee placed in 20-30 degrees of flexion and apply values and varus force.
42
lachman's stress test
purpose: ACL laxity. Exam: patient is supine with the knee flexed 20-30 degrees, pull tibia anterior
43
Pivot shift (anterolateral rotary stability)
Purpose: integrity of ACL. Exam: supine, test knee is in extension, hip flexed and ADD 30, with slight IR. Place values force through the knee while flexing the knee. Positive if tibia relocates during the test. As the knee is flexed, the tibia clunks backward at approximately 30-40. The tibia at beginning of test was subluxed and then was reduced by pull of IT band.
44
Posterior sag test
Purpose: integrity of PCL. supine, hip flexed to 45 and knee flexed to 90, observe to see if tibia sags in this position.
45
Posterior drawer test
Purpose: integrity of PCL. supine, hip flexed 45, knee to 90 and passively glide tibia posterior
46
Reverse Lachman's
Purpose: PCL integrity. Exam: prone knees flexed to 30, passively glide tibia posterior
47
McMurray's
Purpose: mensical tears. Exam: supine. Test knee starts in max flexion. IR and Extend the knee to test the Lateral Meniscus. ER and Extend the knee to test the medial meniscus. Positive is click or pain
48
Apley test
purpose: differentiate between meniscal vs ligamentous. Prone, knee to 90 and distract the knee joint and apply IR and ER. Then apply load to knee joint and ER IR. Pain or decreased motion with compression=meniscus. distraction=ligamentous
49
Hughston's plica test
supine and test knee flexed with tibia IR. Passively glide patella medially and palpate the medial femoral condyle. Feel for popping as you passively flex and extend the knee
50
Patellar apprehension test
supine, glide the patella laterally. positive if apprehensive
51
Clarke's sign
Purpose: patellofemoral dysfunction. supine, knee in extension push posterior on superior aspect of patella and have patient perform quad set. Positive is pain
52
Ballotable patella (patellar tap test)
Purpose: infrapatellar effusion. Exam: supine knee in etension and apply a tap over the patella. Positive is perception of the patella floating.
53
Flunctuation test
Purpose: knee joint effusion. supine, knee in extension. place one hand over supra patellar pitch and other over anterior aspect of knee. alternate pushing down with one hand at a time. Positive is movement of fluid
54
Q angle
normal is 13 for men and 18 for women
55
Noble compression
purpose: IT band. supine, hip flexed to 45 and knee flexed to 90. apply pressure to lateral femoral condyle. Positive is pain around 30 degrees of knee flexion.
56
Neutral subtalar
prone, palpate dorsal aspect of talus. DF foot until resistance is felt then move foot through arc of supination and pronation. Neutral is the point at which you feel foot fall off easier to one side or other.
57
Anterior drawer test
Purpose: identify ligament instability (ATFL). Position: supine with heel off table in 20* of PF. Stabilize the lower leg and grasp foot pulling talus anterior. Positive if talus has excessive anterior glide and or pain is noted
58
Talar tilt test
Purpose: identify ligament instability (calcaneofibular ligament) Position: side lying with knee slightly flexed and ankle neutral. Move foot into adduction testing calcaneofibular ligament and into abduction testing deltoid ligament. Positive: excessive ADD or ABD occurs and or pain
59
Thompson Test
Purpose: evaluate integrity of the achilles tendon. Position: prone, foot off edge and squeeze the calf. Positive:no movement of foot
60
Morton's test
Purpose: identify neuroma or stress fracture in foot. Position: supine with foot supported on table. Grasp the metatarsal heads and squeeze. Positive: pain in forefoot
61
Vertebral Artery Test
First start with head NOT off edge of table: Hold head and neck in extension for 30 seconds. IF no change add rotation left 30 seconds then right 30 seconds. If no change repeat the same thing with head off the table. Positive: dizziness, visual disturbances, disorientation, blurred speech, nausea/vomiting
62
Hautant's Test
Purpose:determine if cause of dizziness/vertigo is vascular or vestibular. Procedure: patient sitting with shoulders at 90 and palms up. Patient closes their eyes for 30 seconds in this position. If arms lose the position it is positive for vestibular. If not, have them perform neck extension, the right then left 30 seconds each, if arms lose their position it would be vascular.
63
Transverse ligament stress test
Purpose: determine integrity of transverse ligament. Procedure: patient supine, glide C1 anterior. If not a firm end feel or there is dizziness, nystagmus, lump sensation in throat or nausea it is positive
64
Anterior shear test
Purpose: assess integrity of upper cervical spine ligaments. Procedure: glide c2-7 anterior, if not firm end feel it's positive or dizziness, nystagmus, lump in through, nausea
65
Spurling Test
Purpose: Identify dysfunction of cervical nerve root. Procedure: patient sitting with head side bent toward the uninvolved side, apply pressure downward. Repeated on involved side. Positive if pain or paresthesia in dermatomal pattern for involved nerve root
66
Maximum cervical compression test
Purpose: identify compression of neural structures at intervertebral foramen and or facet dysfunction. Procedure: sitting do the vertebral artery procedures. Positive if pain or paresthesia in dermatomal pattern for involved nerve root or localized pain in neck if facet joint dysfunction
67
distraction test - spine
Purpose: indicated compression of neural structures at intervertebral foramen/facet joint dysfunction. Positive is decreased symptoms
68
Shoulder Abduction Test
Purpose: identify compression of neural structures within intervertebral foramen. Place one hand on top of head. Repeat on opposite side. Positive if there is a decrease in symptoms
69
Lhermitte's sign
Purpose: identify dysfunction of spinal cord or UMN lesion. Patient is long sitting. passively flex their neck and hip with extended knee, repeat on opposite. positive if pain down the spine and into the limbs
70
Romberg test
Purpose: identify UMN lesion. Procedure: stand and close eyes for 30 seconds, excessive swaying can indicate lesion
71
Rib Springing Test
Purpose: evaluate rib mobility. Procedure: prone begin at upper ribs applying a posterior/anterior force through each rib progressively working through entire rib cage. Then sidling repeat. Positive if pain, excess motion or restricted motion
72
Slump Test
Purpose: identify dysfunction of neuro structures supplying the lower limb. Seated, slump sit, passively flex the head and neck. if no increase then extend on the knee, if no change then dorsiflex the ankle. Positive if reproduction of neuro symptoms
73
Lasegue's Test
Purpose: identify dysfunction of neuro structures to the lower limbs. In supine, passively flex a straight leg until there is shooting pain, then lower until the pain subsides and dorsiflex the ankle. Positive if reproductin of pain
74
Femoral nerve traction test
Purpose: identify compression of femoral nerve. Lie on non painful side, with neck flexion, and hip and knee flexion. Passively extend the hip with knee extended, if no change flex the knee during extension. Positive if neuro pain on anterior thigh
75
Babinski
Positive if extension of the big toe and splaying of the other toes
76
Quadrant Test
for intervertebral foramen: side bend left, rotate left and extend maximally to close the intervertebral foramen on that side. positive if pain or paresthesia. Facet: side bend left, rotate away and extend maximally.
77
Stork Standing Test
Identifies a spondylolisthesis. Stand on one leg, then have them move into trunk extension. Positive if there is low back pain on the same side of the leg that is on the ground
78
McKenzie Side glide test
differentiates between scoliotic curvature vs near dysfunction causing the abnormal curve - only do if a patient presents with a trunk lateral shift. Shift the shoulder and pelvis in standing - positive if there are neuro symptoms
79
Bicycle test
spinal stenosis vs claudication
80
Gillet's test
Purpose: assess posterior movement of the ilium in relation to the sacrum. Standing place thumb under one PSIS, other thumb over center of sacrum at the same level. Have them flex the hip. Normal PSIS motion is inferior. If it doesn't move it is dysfunctional.
81
Ipsilateral anterior rotation test
Same as Gillet's but PSIS should move superior with extension.
82
Gaenslen's Test
Sidelying on non painful side. Move their leg into hip extension. Positive if pain.
83
Goldthwait's test
differentiates spine vs SIJ. supine, fingers in between lumbar vertebrae. Passively perform SLR, if pain is present prior to movement in the lumbar spine then it is from SIJ
84
TMJ compression test
push up on mandible, pain in TMJ is positive

Therapy Ed (7 decks)

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