Boards 4 orthos Flashcards
Naffzinger’s
Seated, digitally compress both internal jugular veins for 30 secs, finish with coughing (Doc is post) - positive = pain in peripheral distribution
Milgram’s
Double SLR - Supine, raise & hold legs (30 secs) 3 inches off the table. - positive = LBP (disk herniation/strain) or inability to maintain = hip flexor issues / deconditioned
Swallowing test
seated instruct patient to swallow - pain with swallowing = SOL, Cx fx, tumor, sprain/strain
Jackson’s test
Seated, rotation and compress = (IVF encrouchment)
Spurlings test
Seated, fist strike after “maximal position” = Disc and IVF encrouchment
O’Donoghue’s
Varies, active with resistance then passive rotation of neck - positive = pain (strain/sprain)
Sternal Compression
Supine, pressure on sternum (doc pushes down on patient sternum) -> lateral rib pain = rib fracture, midline pain = costochondritis
Libman’s
Seated, pressure on mastoid - assessment of patient pain threshold
George’s (Maigne’s)
Seated, cervical rotation & extension for 45 seconds - positive = nausea, dizziness, nystagmus
DeKleyn’s
Supine George’s test
Hallpike’s (Nylan Barrany)
Supine, extend head off table, add rotation & lateral flexion then unsupported extension
Reverse Bakody’s
Seated hand on head = positive for TOS when increase in pain
Allen’s Maneuver
Seated, flex elbow 90, ext arm horizontal, ext, rotated arm, patient rotates head away (check pulse) = positive for TOS if decreased pulse
Mazion shoulder rock
Seated touch opposite shoulder & bring elbow up and down (reverse Dugas) = Pain is significant shoulder pathology
Calloway’s
Seated, measure vertical shoulder circumferences (increased girth) = dislocation
Dawbarn’s
Seated Press on bursa while abducting arm (decreased pain after 90 degrees) = subacromial bursitis
Supraspinatus arc
Standing, resist patient arm abduction throughout entire 180 degrees - positive for pain at 10-20 and 90-110 for supraspinatus issues
Supraspinatus press
Seated, 1) With patient at arm 90 degrees abducted, resist abduction 2) angle arms forward 30 degrees and internally rotate, resist abduction (weakness in 1 = deltoid, weakness in 2 = supraspinatus)
Wrinkel shrivel
Seated, place hand in tepid water for 5 minutes - positive = no pad wrinkle (denervation)
Bunnel - Littler’s
Seated 1) with MCP extended, flex (test) PIP 2) With MCP flexed, flex (test PIP (decreased motion in 2 = PIP joint problem, increased motion in 2 = intrinsic muscle problem)
Retinaculum test
Same as bunnel-littler’s except using the PIP to test DIP flexion
Finsterer’s
Seated, strike base of 3rd metacarpal = Kienboch’s Disease
Adam’s positions
Adam’s test in 3 positions: Standing, kneeling, sitting = scoliosis
Forestier’s Bowstring
Standing, feel paraspinals, as patient laterally flexes = ipsilateral contraction = AS
Chest expansion
Seated erect or standing, tap measure at T4 level (or rib 6), patient expires, then inspires = positive less than 2 inches male or 1.5 inches in females = AS
Lewin Supine
Supine stabilize legs as patient attempts a sit up = positive when unable = AS
Amoss’ sign
Supine or side-lying, patient rises to a sitting position (positive if action causes a localized thoracic pain) = AS
SLR (Laseque’s)
SLR
Laseque differential sign
Supine, SLR until sciatic pain elicited , dr. then flexes knee (relieves pain - rules out hip involvement)
Sicard’s
Supine, SLR, drop 5 degress, extend big toe = positive (sciatica)
Turyn’s
Supine, extend big toe (sciatica)
Fajerstajn’s
Supine, Well Leg Raise, decreased 5 degree, dorsiflex foot (sciatica on affected side = medial disc)
Lindner’s
Supine, holding head, flex body into a “C” (positive sciatica) (lateral disc)
Tripod sign
Seated, observed during bechterew’s - increased trunk extension (tight hamstring)
Beery’s sign
Sitting relieves hamstring discomfort
Neri bowings
Standing, trunk flexion without/with knee flexion (curtsy)
Lewin standing
Standing, pull each knee into extension then both while stabilizing pelvis - if pain with extension followed by one or 2 legs snap back to flex
Mazion’s pelvic maneuver (advancement)
Standing, advance uninvolved leg & flex trunk (touch toes)- bend forward till heel of back leg come off floor or with pain on affected side
Lewin-Gaenslen’s
Side lying Gaenslen’s stabilize pelvis and extend hip - pain in SI joint
Double leg raiser
Supine, SLR one side, then the other - note what angle pain occurs then raise both legs, also noting when pain occurs - SI or lumbosacral joint
Piedallu
Seated, palpate PSIS, patient flexes forward, low PSIS becomes high (affected side usually starts out low)
Ely’s sign
Bring heel to buttock (no stabilization) + if heel doesn’t touch butt, hip rises off table or pain and tingling
Ludloff’s
Seated, raise involed thigh off table (lift knee upwards) = lesser trochanter fracture if unable
Gauvain’s
Side-lying, extend and continually rotate hip, feeling abdominals and hip for pain and tightness (TB of the hip)
Fouchet’s (Grind)
Supine, compress patella, if no pain, rub sideways (perkin’s sign) = Chodromalacia patellae
Patellar tap
Supine, milk down to superior pole & press patella (+ = feel a tap) (Minor effusion)
Leg length functional
Supine, compare measurement from umbilicus to each medial malleolus
Actual structural leg length
Supine, compare measurement from ASIS to each ipsilateral medial malleolus
Hoover’s test
Supine place hands under heels & patient attempts to raise paralyzed leg (+ no downward pressure on uninvolved side) (malingering)
Burn’s bench
Kneeling on table, bend forward (+ = refusal) (Low back pain malingering)
Magnuson’s
Ask patient to locate pain, distract, ask again (+ when change location) (malingering)
Perthes’ (Tourniquet)
Standing with tourniquet around thigh, exercise (+ = varicosities) ie: kickout for 1 min
Claudication
Walk for 1 min at 120 steps/min check for color change/cramp (+ claudication) (arterial competency)
Bicycle/Stoop
Bicycling upright until claudication then stoop forward (relief of pain = neurgenic claudication, no relief = intermittent claudication)
Barre-Lieou’s
Seated maximally rotate head side to side several times (VBI)
Mittlemeyer’s
Standing, march in place eyes opened & then closed (positive rotation towards side of vestibular lesion)
Gonda’s
Flick 4th or 5th toe (positive “baby” babinski response
Rossolimo’s
Tap ball of foot (+ = curling toes) pathological response UMNL
Tromner’s
Tap end of fingers (+ flexion of thumb and fingers) UMNL
Gordon’s finger sign
Press pisiform (+ for extension of fingers) UMNL
Chaddock’s wrist
Stroke medial forearm, near wrist (+ = flexion of wrist, extension and flaring of fingers) UMNL
Babinski pronation
Tap dorsum of hands that are supinated (+ pronation of hand) UMNL
Mannkopf’s
Monitor pulse & press into painful site
