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UE testing Flashcards

1
Q

sharp-purser test

A
  • pt neck flexed - causes symptoms
  • PT palm on forehead, thumb and forefinger on axis SP, posteriorly translate head
  • assesses transverse ligament - stabilizer of dens on atlas
  • (+) reduction in symptoms, click/clunk felt
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2
Q

alar ligament stress test

A
  • pt head in PT hand, other hand pincer grasp C2 SP
  • sidebend pt head to right and feel for left TP to come into fingers
  • (+) significant side bending with empty end feel, TP does not come into fingers
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3
Q

cervical radiculopathy

A
  • < 60 degrees rotation to involved side
  • (+) spurling’s - pressure through C spin
  • (+) distraction test
  • (+) median nerve
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4
Q

cervical flexion rotation test

A
  • pt flexes C spine to end range
  • PT stabilizes head and uses hands to rotate to end range
  • for upper C spine ROM
  • (+) is symptom reproduction or difference of 10 degrees in one direction
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5
Q

UE dermatomes and myotomes

A
  • dermatomes
  • C4: posterior lower neck, clavicle
  • C5: deltoid
  • C6: thumb
  • C7: middle finger
  • C8: pinky
  • T1: medial forearm
  • myotomes
  • C1/2: neck flexion
  • C3: neck side bending
  • C4: shoulder elevation
  • C5: shoulder abduction
  • C6: elbow flexion, wrist extension
  • C7: elbow extension, wrist flexion
  • C8: thumbs up (APB/EPL)
  • T1: finger abd.add
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6
Q

special tests for TOS

A
  • cervical rotation lateral flexion - 1st rib
  • ROOS (east) test
  • cyriax release test/passive scapular elevation
  • hyperabduction test
  • costoclavicular test
  • adson’s test
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7
Q

Roos test

A
  • pt abducts shoulders to 90, elbows flexed to 90, ER shoulders 90 - field goal arms
  • open and close fists through full range as quickly as possible for 3 (?) minutes
  • positive is increase in symptoms, sensation of heaviness or tingling
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8
Q

passive scapular elevation
cyriax release test

A
  • grab under pt forearms and support wrists
  • fully elevate pt shoulders and have them lean back 15 degrees
  • hold 1 minute
  • (+) reproduction of symptoms by unloading vascular bundle, causing numbness, tingling, cold, hot, fatigue
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9
Q

hyperabduction test

A
  • TOS
  • find pt radial pulse and passively abduct shoulder through complete range and ER arm
  • hold 1 minute
  • (+) is abolishment or decreased radial pulse or increase in symptoms
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10
Q

costoclavicular test

A
  • for TOS between clavicle and first rib
  • palpate radial pulse
  • pt retracts and depresses scapula as much as possible while arm into extension and slight abduction
  • hold 1 minute
  • (+) decrease in radial pulse or increase in symptoms
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11
Q

adson’s test

A
  • for TOS scalene entrapment
  • palpate radial pulse and passively abduct, extend, ER arm
  • pt takes deep breath and rotates head ipsilaterally
  • (+) abolishment or decreased radial pulse
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12
Q

brachial plexus test

A
  • TOS vs BP parasthesias
  • palpate upper trapezius and inferior portion of anterior scalene with thumb
  • squeeze 30 seconds and assess for symptoms
  • assess opposite side
  • (+) reproduction of parasthesias
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13
Q

shoulder arc of pain

A
  • usually 75-120 - can be flexion, abduction, or scaption/elevation
  • subacromial pain syndrome
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14
Q

neer test

A
  • subacromial pain syndrome
  • start with least aggressive version enecessary to reproduce pain
  • PASSIVE: block scapula, neutral rotation, full scaption
  • (+) if reproduces familiar pain
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15
Q

hawkins-kennedy

A
  • hawkins impingment test - subacromial pain syndrome
  • scaption/elevation position for subacromial impingement - bursa, supraspinatus
  • flexed and horizontally adducted for coracoid impingement - biceps against coracoid
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16
Q

empty can/full can

A
  • rotator cuff
  • suprapsinatus
  • 90 degrees elevation and full IR for empty can
  • 90 degrees elevation and neutral rotation for empty can
  • if EC is painful but full can is not, likely subacromial or bursa
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17
Q

champagne toast test

A
  • rotator cuff - supraspinatus
  • less deltoid and no impingement like EC/FC
  • 30-40 degrees of flexion and abd, slight ER, elbow 80-90 degrees flexion
  • PT attempt to push humerus back to neutral (Adduction and extension)
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18
Q

resisted ER at side

A
  • can be subacromial
  • at 45 degrees abduction - infraspinatus
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19
Q

speed’s test

A
  • biceps tendinopathy
  • pt shoulder felxed to 90, palm up (ER), slight bend in elbow
  • resistance to distal forearm while palpating biceps tendon - reproduction of symptoms at biceps tendon
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20
Q

yergason’s test

A
  • LHB pain
  • elbow by side, flexed to 90
  • pt supinates arm against PT resistance
  • (+) reproduction of symptoms
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21
Q

drop arm

A
  • supraspinatus
  • test: straight arm in abduction
  • sign: bent elbow in scaption
  • pt arm passively to 90 degrees
  • (+) unable to hold position or slowly lowers involved arm with control
  • straight down - supraspinatus
  • hand in/horn blower - infraspinatus
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22
Q

external rotation lag sign

A
  • infraspinatus, teres minor
  • passively flex pt elbow to 90, abduct shoulder 20 degrees, max ER
  • pt asked to maintain position
  • (+) if fall into IR
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23
Q

belly press test

A
  • subscapularis
  • pt involved hand on belly, tries to push palm into belly
  • (+) if pt flexes at wrist, uses shoulder ext/add to push into belly
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24
Q

internal lag sign

A
  • subscapularis - also need good shoulder IR
  • pt hand behind back like functional IR
  • pt asked to lift/hold arm off back
  • (+) pt unable to maintain arm off back
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25
load and shift
- MDI - stabilize clavicle and scapula - gently load humerus - push into glenoid - glide humeral head ant and post - note amount of translation and end feel - (+) is movement (not pain)
26
sulcus sign
- MDI - stabilize scapula by holding acromion - pull downward on distal humerus to produce inferior traction force on GH joint - (+) is depression between acromion and humeral head - 1+ is < 1 cm - 2+ is 1-2 cm - 3+ is > 2 cm
27
hyperabduction
- MDI - stabilize scapula, pt arm passively abducted - elbow flexed to 90, forearm parallel to floor - > 110 degrees is lengthening/laxity of IGHL and positive in 85% with instability
28
load and shift in supine
- for return to sport with labral tear or repair - pt supine, arm 90/90 - grasp proimal humerus with inside hand and distal humerus with outside hand - stabilize distal humerus and shift proximal ant/post in plane of scapula/glenoid - the crazy david james one
29
apprehension test
- anterior GH, bankart lesion - pt supine, arm 90/90 - shoulder progressively ER - passively - (+) pt reports pain or apprehension - relocation - same test but posterior pressure applied at proximal humerus
30
jerk test
- posterior, 7-11 tears - axial force applied to arm in 90 degrees abduction and IR - pt arm horizontally adducted (scaption to midline) - maintain axial load - (+) sharp pain with click/clunk - can also be infraspinatus if other infrapsinatus involvement
31
kim test
- posterior, 6-9 - axial force applied to arm in 90 degrees abduction - arm elevated 45 degrees diagonally upward with backward force applied at proximal humerus - (+) posterior shoulder pain with click
32
o'briens
- activate compression test - SLAP tear - pt shoulder flex to 90, elbows extended - first full IR, adduction - backs of hands together and resist downward force on arms - then full supination - resist downward force again - deep pain - biceps labral complex - over AC joint - AC joint pathology - posterior shoulder pain - SLAP - anterior shoulder pain - LHB - (+) if pain eleicited with first and eliminated with second - if both painful, subacromial
33
modified dynamic sheer test
- SLAP - pt seated - pt shoulder put into 120 abd and max ER w/ elbow at 90 - palpate post joint line and lower 120 -> 60 - max ER, 30-60 abd, axial load - (+) painful click
34
biceps load II
- SLAP - abduct pt (supine or seated) shoulder to 120, flex elbow to 90 - resist patient elbow flexion - (+) deep shoulder pain
35
resisted supination with ER
- SLAP - pt supine - passively abduct arm to 90 degrees - pt tries to supinate against resisted force - fires biceps - passively ER shoulder - (+) reproduction of symptoms, clicking, popping
36
LHB intra-articular tendon pathology
- throwers/overhead sports - presents like SLAP - active compression/o'briens - thrower's test - palpation within proximal groove
37
crossbody adduction test
- pt shoulder passively flexed to 90 and adducted across pt body - (+) pn at AC joint
38
resisted extension/horizontal abduction
- pt horizontally abducts arm against resistance - (+) pn in AC joint
39
cozen's test
- for lateratal epicondylalgia - pt elbow in full extension - PT thumb over lateral epicondyle - wrist into extension with hand in fist - slight pronation with radial deviation - try to move pt out of position - (+) reproduction of symptoms
40
mill's test
- lateral epicondylalgia - shoulder in 70 degrees abd, 90 degrees flexion - thumb inside fist - flex and ulnarly deviate hand - extend elbow slowly
41
third finger test
- lateral epicondylalgia - PT resists extension of middle finger
42
elbow flexion test
- cubital tunnel syndrome - pt fully flexes elbow with neutral wrist - maintain position 1-3 minutes or until reproduction of symptoms
43
shoulder IR test
- cubital tunnel syndrome - pt UES 90/90, max IR - (+) if any symptoms within 10 seconds
44
froment's sign
- cubital tunnel syndrome - patients grips piece of paper using lateral key grip, PT tugs paper - normal: pt maintains lateral key grip - adductor pollicis in tact - (+) change of thumb and forrefinger to "O" - indicates use of flexor pollicis longus
45
wartenburg's sign
- cubital tunnel syndrome - examiner passively spreads pt fingers apart on table - patient adducts fingers - (+) inability to adduct pinky finger
46
tinnel's sign
- cubital tunnel syndrome - pt supine, field goal arms - tap ipsilateral cubital tunnel - (+) reproduction of familiar symptoms
47
PTS test
- median nerve - pronator teres syndome - pt seated - flex elbow to 90 and passively pronate forearm at wrist - apply resistance into supination to activate pronator muscle - pt resists as PT extends elbow
48
pinch grip ok sign
- median nerve - anterior interosseous syndrome - pt asked to pinch tips of index finger and thumb together to make "Ok" sign - (+) not tip-to-tip but pad-to-pad, indicates anterior interosseous nerve (branch of median nerve) pathology or compromised AIN
49
elbow valgus stress test
- at 0 and 30 degrees of flexion - apply valgus force - for UCL
50
moving valgus stress test | elbow
- pt seated w/ shoulder 90 degrees abd - passively apply valgus from extension to flexion
51
varus stress test | elbow
- at 0 and 30 degrees - for radial collateral ligament injury
52
pivot shift apprehension test | elbow
- posterolateral instability - pt supine with arm overhead and palm supinated - PT standing at head of table - apply axial load, flex elbow, apply valgus stress - (+) radius/ulna sublux off humerus, sudden clunk of joint at 40-70 degrees flexion
53
biceps squeeze test
- bicep rupture - pt seated w/ arm in lap, elbow flexed 60-80 degrees, slight pronation - squeeze bicep with both hands - (+) lack of supination - indicates rupture of biceps brachii tendon
54
biceps hook test
- biceps rupture - pt seated, elbow at 90 - insert tip of index finger under medial or lateral edge of biceps tendon in antecubital fossa
55
motions of the thumb
56
thumb ulnar collateral ligament stress test
- for tear of UCL - seated, arm on table, thumb up - take pt thumb to full extension - apply valgus stress to UCL - (+) more than 30-35 degrees movement
57
first CMC grind test
- for OA - seated, arm on table, thumb up - follow MC down to CMC joint line and grind joint - (+) reproduction of symptoms
58
watson's scaphoid shift
- scapholunate instability - seated arm on table - place pt hand in extension and ulnar deviation - palpate scaphoid - passively move hand into radial deviation and release scaphoid - (+) palpable/audible clunk or pain
59
carpal bones
- scaphoid, lunate, triquetrum, pisiform - trapezium, trapezoid, capitate, hamate - "um odd"
60
finklestein test (eichoff's)
- dequervain's tenosynovitis - seated, hands in fist w/ thumb inside fingers - stabilize forearm and deviate wrist in ulnar direction - (+) reproduction of pain of APL and EPB
61
WHAT test
- dequervain's tenosynovitis - seated, arm on table, wrist flexed, fingers to floor - stabilize hand - pt thumb into radial adduction against PT pressure - resist adductuction - (+) reproduction of pain | APL and EPB
62
tinel's | carpal tunnel syndrome
- CTS - median nerve - pt seated, arm on table, palm up - support pt hand in neutral wrist - tap carpal tunnel up to 30 seconds - (+) reproduction of symptoms
63
phalen's
- CTS - median nerve - pt seated - ask pt to fully flex both wrists, backs of hands together for up to 60s - (+) reproduction of numbness or paresthesias in median nerve distribution
64
carpal compression test
- CTS - median nerve - pt seated, arm on table, palm up - apply even, constant pressure over CT to compress median nerve - hold up to 30s - (+) reproduction of median nerve symptoms

npte - msk (7 decks)

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