Class 2 (1/14/21)

Question 1

Yergason Test

Answer 1

1. The patient should be seated or standing, with the humerus in the neutral position and the elbow in the 90° of flexion.
2. The patient is asked to externally rotate and supinate their arm against the manual resistance of the therapist.
   Positive (+): The pain is reproduced in the bicipital groove during the test.
   -> For bicipital tendonitis

Question 2

Pronation/Supination of the forearm

Answer 2

Pronation and supination: a pair of unique movements possible only in the forearms and hands, allowing the human body to flip the palm either face up or face down.
Hold elbow at 90-degree angle for both tests.
Pronation: palm faces down.
Supination: palm faces up.

Question 3

Finkelstein test

Answer 3

1. Patient must sit comfortable and relaxed on the examination table.
2. Examine the patient’s hand in the air, while the other hand rests just beside the body.
3. The therapist then asks the patient to make a fist around a thumb and to perform a ulnar deviation.
   Positive (+): the patient complains of pain over the 1st extensor compartment of the wrist.
   - It indicates stenosing tenosynovitis (DeQuervain’s disease) = “Mommy thumb”
   aka trigger finger

Question 4

Tenosynovitis

Answer 4

Inflammation of the fluid-filled sheath (called the synovium) that surrounds a tendon, typically leading to joint pain, swelling, and stiffness.

Question 5

Carpal tunnel syndrome

Answer 5

1. Carpal tunnel syndrome is a common condition that causes pain, numbness, and tingling in the hand (the palm and radial side).
2. The condition occurs when one of the major nerves to the hand — the median nerve — is compressed as it travels through the wrist.
   Symptoms: numbness of the thumb, index finger, middle finger, and the half of the ring finger.

Question 6

Phalen’s test

Answer 6

1. The patient is asked to push the dorsal surface of the hands together and hold this position for 30-60 seconds.
2. This position will increase the pressure in the carpal tunnel, in effect compressing the median nerve between the transverse carpal ligament and the anterior border of the distal end of the radius.
   Positive (+): when the patient’s symptoms are reproduced, test gives the same symptoms as that experienced with carpal tunnel syndrome, namely paresthesia (burning, tingling, numbness) in the distribution of the median nerve.

Question 7

Tinel’s test

Answer 7

1. It is performed by lightly tapping over the nerve to elicit a sensation of tingling or “pins and needles” in the distribution of the nerve.
2. Positive (+): when there is pressure neuropathy of the nerve in the hand. When the nerve is not trapped behind a structure there will be a negative test and the patient will feel no pain. On the opposite when the nerve is trapped the patient will feel tingling’s in the distal area.

Question 8

Brudzinski sign

Answer 8

1. In a quiet environment with the client resting in a supine position, gently grasp the patient’s head from behind.
2. Gently flex the neck, bringing chin to chest.
   Positive (+): Involuntary flexing of hips and knees (an involuntary reaction to lessen the stretch on the inflamed meninges).
   -> Meningitis

Question 9

Kernig test

Answer 9

1. The patient is positioned in supine with hip and knee flexed to 90 degrees.
2. The knee is then slowly extended by the examiner (Repeat on both legs).
3. Positive (+): Resistance or pain and the inability to extend the patient’s knee beyond 135 degrees, because of pain, bilaterally indicates positive.
   - > Meningitis

Question 10

Herniated disk

Answer 10

1. Herniated intervertebral disks are more common in the lumbar spine.
2. Herniated disk press on spinal nerve which results in pain, numbness and weakness.
3. This pain can worsen with movement, coughing, sneezing, straining.

Question 11

Sciatica

Answer 11

1. The pain that radiates along the sciatic nerve, which branches through the lower back, buttocks, and down to the back of leg (it typically affects one side of the body).
2. Sciatica most commonly occurs when a herniated disk, bone spur on the spine or narrowing of the spine (spinal stenosis) compresses on part of the nerve. This causes inflammation, pain and often some numbness in the affected leg.
   “shooting pain”

Question 12

Straight leg test

Answer 12

1. It is a passive test. Each leg is tested individually with the normal leg being tested first. When performing the SLR test, the patient is positioned in supine, the hip medially rotated and adducted, and the knee extended.
2. The clinician lifts the patient’s leg by the posterior ankle while keeping the knee in a fully extended position.
3. The clinician continues to lift the patient’s leg by flexing at the hip until the patient complains of pain or tightness in the back or back of the leg.
   Positive (+): if there is a tension in sciatic roots over intervertebral disks (radicular symptoms) from 35 to 70 degrees of hip flexion.
   70° = joint pain

Question 13

Braggard’s test

Answer 13

1. Perform straight leg test. Then after the patient has straightened their legs, passively dorsiflex the ankle by pushing up the feet (lower the leg to the level without any pain!).
2. Positive (+): if it produces pain in the spine. Positive test indicates nerve root lesion, disk herniation or sciatica.

Question 14

Patrick/Faber test

Answer 14

1. The patient is positioned in supine. The leg is placed in a specific position (hip flexed and abducted with the lateral ankle resting on the contralateral thigh proximal to the knee).
2. While stabilizing the opposite side of the pelvis at the anterior superior iliac spine, an external rotation, abduction and posterior force is then lightly applied to the ipsilateral knee until the end range of motion is achieved.
   Positive (+): one that reproduces the patient’s pain or limits their range of movement.
   This test is positive if the test leg remains above the opposite leg which can be an indication of an affected hip joint or SI (sacroiliac) joint.
   -> hip joint, SI joint