Cumulative Lab Material Flashcards
Abbott-Saunders Test
( + ) Audible or palpable click
( i ) Subluxation or dislocation of the biceps tendon due to a rupture of transverse ligament or tendon subluxation beneath the subscapularis muscle belly
Allen Test
( + ) A delay of more than 10 seconds (Evans says 5) in returning a reddish color to the hand
( i ) Radial or ulnar artery insufficiency. The occluded artery is not the artery being tested
Allis Sign
(Galeazzi Sign, Pediatric Test)
a. ( + ) Difference in knee height with one low knee
a. ( i ) Ipsilateral congenital hip dislocation or tibial discrepancy (anatomical short leg)
- - - - - - - - - - - - - - - - - - -
b. ( + ) Difference in knee anteriority with an anterior knee
b. ( i ) Ipsilateral congenital hip dislocation or femoral discrepancy (contralateral anatomical short leg)
Ankle Dorsiflexion Test
(Hoppenfeld)
- “My patient presents with difficulty dorsiflexing the foot. I try and also cannot dorsiflex the foot with the knee in extension. I will place the knee in flexion and try again to dorsiflex the foot. One of two things will happen…”*
a. ( + ) the foot cannot dorsiflex with knee extended, but is able to with knee flexed
a. ( i ) contracture of the gastrocnemius muscle - b. ( + ) the foot cannot dorsiflex in either knee position
b. ( i ) contracture of the soleus muscle
Anterior Apprehension Test
( + ) Patient will have a noticeable look of apprehension or alarm on their face with possible pain
( i ) Chronic anterior dislocation of the glenohumeral joint
Anterior Inominate Test
(Mazion’s Pelvic Maneuver/Advancement Sign)
a. ( + ) radiating pain along sciatic nerve, either unilateral or bilateral
a. ( i ) sciatic neuralgia or radiculopathy
b. ( + ) low back pain (lumbar or pelvic region)
b. ( i ) anterior (rotational) displacement of ilium relative to the sacrum
Anvil Test
( + ) Localized pain in long bone or hip joint
( i ) Possible fracture of long bones, or hip joint pathology
Apley Compression Test
( + ) Patient points to side of pain
( i ) Pain on medial side is medial meniscus tear. Pain on the lateral side indicates lateral meniscus tear
Apley Distraction Test
( + ) Patient points to side of pain
( i ) Pain on medial side is medial meniscus tear. Pain on the lateral side indicates lateral meniscus tear
Apley Test
(Apley Scratch Superior/Inferior)
( + ) Exacerbation of pain
( i ) Degenerative tendonitis of rotator cuff tendons, usually supraspinatus
Apprehension Test for the Patella
(Patellar Apprehension Test)
( + ) Apprehension, distress of facial expression, contraction of quadriceps to bring patella back in line
( i ) Chronic patella dislocation or pre-disposition to dislocation
Bechterew Test
( + ) reproduction of radicular pain or inability to perform correctly due to tripod sign
( i ) sciatic radiculopathy
Bounce Home Test
( + ) Knee does not go into full extension (slight flexion remains)
( i ) Diffuse swelling of the knee, accumulation of fluid due to possible torn meniscus
Bowstring Sign
( + ) pain in lumbar region or radiculopathy
( i ) sciatic nerve root compression, this rules out tight hamstrings
Bragard Sign
( + ) Radiating pain in posterior thigh
( i ) Sciatic radiculopathy
Buckling Sign
(Cipriano)
( + ) Pain in the posterior thigh with sudden knee flexion or buckle
( i ) Sciatic radiculopathy
Bunnel-Littler Test
- “My patient presents with an inability to flex their proximal interphalangeal joint. I place their metacarpophalangeal joint in extension and attempt to flex their proximal interphalangeal joint, and it does not flex. I then place their metacarpophalangeal joint in slight flexion. One of two things will happen…”*
a. ( + ) Flexion of the proximal interphalangeal joint cannot be achieved
a. ( i ) Joint capsule contracture - b. ( + ) Flexion of the proximal interphalangeal joint is achieved
b. ( i ) Tight intrinsic muscles
Cervical Distraction
a. ( + ) Diminished or absence of local pain
a. ( i ) Foraminal encroachment
- - - - - - - - - - - - - -
b. ( + ) Diminished or absence of radicular pain
b. ( i ) Nerve root compression
- - - - - - - - - - - - - -
c. ( + ) Increase in cervical pain
c. ( i ) Muscular strain, ligamentous sprain, myospasm, facet capsulitis
Cervical Spine Bony Palpation
hyoid bone
thyroid cartilage
first cricoid ring
mandible
mastoid processes
inion (EOP)
occiput
superior nuchal line
spinous processes of cervical vertebrae
facet joints
Cervical Spine ROM
Flexion - 50°
Extension - 60°
Lateral Flexion/Bending (L/R) - 45°
Rotation (L/R) - 80°
Cervical Spine Soft Tissue Palpation
sternocleidomastoid
anterior cervical chain
posterior cervical chain
carotid pulse
thyroid gland
supraclavicular fossa
trapezius
superior nuchal line
greater occipital nerves
Cozen
( + ) Pain over the lateral epicondyle
( i ) Lateral epicondylitis (Tennis Elbow)
Dawbarn Test
( + ) Decrease in pain and/or tenderness
( i ) Subacromial bursitis
Drawer Sign
(Anterior Drawer Sign of the Ankle)
( + ) Translation with the talus moving away from or toward the tibia
( i ) With tibia pushed/foot pulled; a tear/instability of the anterior talofibular ligament. With tibia pulled/foot pushed; a tear/instability of posterior talofibular ligament
Drawer Test
a. ( + ) Gapping more than 6mm (tibia moves posterior) when the leg is pushed
a. ( i ) torn posterior cruciate ligament
- - - - - - - - - - - - - - - - -
b. ( + ) Gapping more than 6mm (tibia moves anterior) when the leg is pulled
b. ( i ) torn anterior cruciate ligament
Drop Arm Test
(Codman’s Drop Arm Test)
( + ) Inability to lower the arm slowly or the arm drops suddenly
( i ) Rotator cuff tear, usually supraspinatus
Dugas Test
( + ) Inability to touch the opposite shoulder and/or inability of the elbow to touch the chest
( i ) Acute dislocation of the glenohumeral joint
Elbow Bony Palpation
medial epicondyle
groove for the ulnar nerve
trochlea
olecranon
olecranon fossa
lateral epicondyle
radial head
lateral supracondylar line of the humerus
medial supracondylar line of the humerus
Elbow ROM
Flexion 150°
Extension 0°
Forearm supination 80°
Forearm pronation 80°
Elbow Soft Tissue Palpation
biceps
triceps
brachial artery
supracondylar lymph nodes
medial collateral ligament
ulnar nerve
olecranon bursa
lateral collateral ligament
wrist flexor muscles:
- pronator teres
- flexor carpi radialis
- palmaris longus
- flexor carpi ulnaris
elbow flexor muscles (mobile wad of three)
- brachioradialis
- extensor carpi radialis longus
- extensor carpi radialis brevis
Ely Heel to Buttock Test
a. ( + ) inability to raise the thigh
a. ( i ) iliopsoas spasm
- - - - - - - - - - - -
b. ( + ) pain in anterior thigh
b. ( i ) inflammation of lumbar nerve roots
- - - - - - - - - - - -
c. ( + ) pain in lumbar region
c. ( i ) lumbar nerve rood adhesions
Ely Heel to Buttock Test - Hip and Pelvis
a. ( + ) Inability to raise the thigh
a. ( i ) Iliopsoas spasm
- - - - - - - - - - - - - - - - - - -
b. ( + ) Pain in the anterior thigh
b. ( i ) Inflammation of lumbar nerve roots
- - - - - - - - - - - - - - - - - - -
b. ( + ) Pain in the lumbar region
b. ( i ) Lumbar nerve root adhesions
Ely Sign
(Ely Test - Cipriano)
“I will be getting ready to perform Nachlas, Yeoman or Hibbs test…”
( + ) Hip on side being tested will flex, causing the buttock to raise off the table
( i ) Rectus femoris or hip flexor contracture
Evaluation of C5 Nerve Root
Nerve Root: C5
Disc Level: C4
2 Muscle Tests:
- shoulder ABduction: deltoid (axillary nerve)
- forearm flexion: biceps (musculocutaneous)
Reflex: - biceps
Sensation: - lateral arm
Evaluation of C6 Nerve Root
Nerve Root: C6
Disc Level: C5
1 Muscle Test:
- wrist extension: extensor carpi radialis longus and brevis, and extensor carpi ulnaris (radial nerve)
Reflex:
- brachioradialis
Sensation:
- anterior lateral forearm, palm, thumb and 2nd digit
Evaluation of C7 Nerve Root
Nerve Root: C7
Disc Level: C6
3 Muscle Tests:
- Elbow extension: triceps (radial nerve)
- Wrist flexion: flexor carpi radialis (median nerve), flexor carpi ulnaris (ulnar nerve)
- Finger extension: extensor digitorum communis, extensor indicis profundus, extensor digiti minimi (radial nerve)
Reflex: triceps
Sensation: 3rd digit, middle of palm
Evaluation of C8 Nerve Root
Nerve Root: C8
Disc Level: C7
1 Muscle Test:
- finger flexion: flexor digitorum superficialis, flexor digitorum profundus, lumbricals (median and ulnar nerves)
No Reflex
Sensation: 4th and 5th digits, antero-medial hand and forearm
Evaluation of Nerve Root L4
Nerve Root: L4
Disc Level: L3
1 Muscle Test:
- Foot Dorsiflexion and Inversion:
- tibialis anterior (deep peroneal)
Reflex: Patellar Tendon
Sensation: Medial aspect of leg, medial foot, medial aspect of big toe
Evaluation of Nerve Root L5
Nerve Root: L5
Disc Level: L4
4 Muscle Tests:
- Foot Dorsiflexion:
- peroneous tertious (deep peroneal)
- extensor digitorum longus and brevis (deep peroneal)
- extensor hallicus longus (deep peroneal)
- Big Toe Dorsiflexion:
- extensor hallicus longus (deep peroneal)
- Toes 2,3,4 Dorsiflexion:
- extensor digitorum longus and brevis (deep peroneal)
- Hip and pelivs abduction:
- gluteus medius and minimus (superior gluteal)
Reflex: none
Sensation: lateral leg, dorsum of foot, middle three toes
Evaluation of Nerve Root S1
Nerve Root: S1
Disc Level: L5
3 Muscle Tests:
- Foot Plantarflexion and Eversion:
- peroneus longus and brevis (superficial peroneal)
- Foot Plantarflexion:
- gastrocnemius and soleus (tibial)
- Hip Extension:
- gluteus medius and minimus (superior gluteal)
Reflex: none
Sensation: lateral leg, dorsum of foot, middle three toes
*S2 Sensation: posterior aspect of thigh over popliteal fossa onto posteromedial calf*
Evaluation of T1 Nerve Root
Nerve Root: T1
Disc Level: T1
2 Muscle Tests:
- finger abduction: dorsal interossei (ulnar nerve)
- finger adduction: palmar interossei (ulnar nerve)
No Reflex
Sensation: antero-medial arm (distal aspect of arm to proximal aspect of forearm
Finkelstein Test
( + ) Pain distal to the radial styloid process
( i ) Stenosing tenosynovitis of the abductor pollicis longus and extensor pollicis brevis tendons (DeQuervain’s Disease)
Foot and Ankle Bony Palpation
medial malleolus
lateral malleolus
calcaneus
talus
cuboid
navicular
3 cuneiforms
5 metatarsals
metatarsophalangeal joints
sustentaculum tali
navicular tubercle
Foot and Ankle ROM
Ankle Dorsiflexion 20°
Ankle Plantarflexion 50°
Subtalar Inversion 5°
Subtalar Eversion 5°
1st MTP Joint Flexion
1st MTP Joint Extension
Foot and Ankle Soft Palpation
achilles tendon
fibular/peroneus brevis
tibialis posterior tendon
tibialis anterior tendon
deltoid ligament
spring ligament
anterior talofibular ligament
dorsal pedal artery
posterior tibial artery
plantar aponeurosis