Diagnostic physical tests Flashcards
<p>Reflex Scale</p>
<p>0-4+</p>
<p>2 (++) is normal</p>
<p><2 = hypoactive</p>
<p><2 = Hyperactive</p>
<p>Wrights Test</p>
<p>Tests for Thoracic outlet syndrome. Hyper-abduct arm (lift away from body, over shoulder) if the radial pulse disappear, it is considered positive.</p>
<p>Babinski Test</p>
<p>Stroke bottom of foot with pencil like tool. If the toes dorsi-flex and fan out, test is considered positive and there is a CNS problem. This response is a primitive response and is normal in infants.</p>
<p>Brudzinski's test</p>
<p>Test for meningitis</p>
<p><span>Severe neck stiffness causes a patient's hips and knees to flex when the neck is flexed</span></p>
<p>Kernig sign</p>
<p><strong>diagnosis of meningitis</strong><span>. A positive test is the elicitation of pain or resistance with passive extension of the patient's knees past 135 degrees</span></p>
<p>Schilling Test</p>
<p>Tests for pernicious Anemia - Vitamin B12 deficiency. Take radioactive B12 and track quantity in urine</p>
<p>Lachman's Test</p>
<p><span>Test ACL. More specific test. This test is done by </span><strong>bending the hip 45 degrees and the knee 90 degrees, then pulling the knee forward with a sudden jerk to test the leg's range of motion</strong><span>. If it moves 6 mm beyond its normal range of motion, then you may have an ACL tear or injury.</span></p>
<p><span>Slight medial tibial external rotation</span></p>
<p>Mcmurray test</p>
<p>Tests for <span>tear in the posterior portion of the lateral meniscus.</span>. Patient lays <a>supine </a>on the table with the knee maximally flexed. With the affected extremity relaxed the examiner grasps the ankle and palpates the knee while simultaneously rotating the lower leg internally and externally and extending the knee. The test is considered positive for a torn meniscus if the examiner appreciates a palpable or auditory click while rotating and extending the knee.</p>
<p>Valgus - medial (G, gum - gluing knees together)</p>
<p>Veris - knees apart</p>
<p></p>
<p></p>
<p></p>
<p>Posterior Drawer Test</p>
<p><strong>Tests PCL tear. bend the affected knee to </strong><span>a 90º angle and push the tibia posteriorly. If it moves 6+mm posterior, the PCL is considered torn.</span></p>
<p>Drop Arm Test</p>
<p><span>Positive shows rotator cuff tear- The examiner supports the patient’s arm to be tested and abducts it to 90+ degrees. The patient is asked to actively lower their arm from abduction to their side in a slow and controlled manner. A positive test is determined by the patient’s inability to smoothly control the lowering of their arm or the inability to hold the arm in 90 degrees of abduction.</span></p>
<p>Tinsels Sign</p>
<p><strong>A way to detect irritated nerves associated with CT</strong><span>. It is performed by lightly tapping (percussing) over the nerve to elicit a sensation of tingling or "pins and needles" in the distribution of the nerve.</span></p>
<p>Phalens sign</p>
<p><strong>Tests for CT. when flexing the wrist to 90 degrees for 1 minute elicits symptoms</strong><span> in the median nerve distribution</span></p>
<p>reverse phalens test</p>
<p><span>A reverse Phalen's maneuver involves </span><strong>wrist and finger extension held for 1 minute and symptoms are reproduced = Positive for CT</strong></p>
<p>Empty Can Test</p>
<p>Tests <span>supraspinatus muscle and tendon.</span></p>
<p><span>he patient is tested at 90° elevation in the scapular plane and full internal rotation (empty can). The patient resists downward pressure exerted by the examiner at the patients elbow or wrist.</span></p>
<p>Apley compression Test</p>
<p><strong>Tests meniscus injury</strong><span>.</span></p>
<p><br></br><span>The examiner laterally and medially rotates the </span><strong>tibia</strong><span>, combined first with distraction: The Apley's Distraction test is used to </span><strong>detect the presence meniscus tear</strong><span>. With the patient in the prone position, flex the patient's knee to 90˚ while stabilizing the distal thigh against the table. while noting any excessive movement, restriction or discomfort. The process is then repeated using compression instead of distraction.</span></p>
<p><span>Usually performed with the Apley distraction test, which assesses for ligamentous injury.</span></p>
<p>Anterior Drawer Test</p>
<p>Tests the ACL</p>
<p>Posterior Drawer</p>
<p>Tests PCL</p>
<p></p>
<p>Painful Arch Test</p>
<p></p>
<p>Tests Infringment of supraspinatus cuff</p>
<p>like reverse drop test (pain when arms at a T)</p>
<p></p>
<p>Hawkins- Kennedy</p>
<p>Tests supraspinatus. Shows subachromial impingement syndrome</p>
<p>Neer Test</p>
<p>Tests rotator cuff impingement</p>
<p>Stabilize scapula and abduct</p>
<p>Obriens Test</p>
<p>Tests Labral Abnormalities and SLAP lesions. </p>
<p>Pain with internal rotation that goes away with external rotation.</p>
<p>Athletes Scratch Test</p>
<p>Test Adhesive Capsulitis or Frozen Shoulder</p>
<p>Reach back to scratch scapula and movement is restricted both via passive or active movement.</p>
<p>Lift off Test</p>
<p>Tests rupture of subscapularitis</p>
<p>Broken wing position and lift hand off back causes pain.</p>
<p></p>
<p>Speed Test</p>
<p>Tests bicep tendon.</p>
<p>Arm is extended and supinated and practitioner pushes down which creates pain in the bicipital groove.</p>
<p>Addison Test</p>
<p>Tests Thoracic outlet syndrome</p>
<p>Drop head back and turn to one side and radial pulse disappears shows positive test.</p>
<p>Bakody's Sign</p>
<p><span>To assess for cervical radiculopathy at the levels of C4-C6.</span></p>
<p><span>Either have the patient actively, or you as a clinician passively, place the patient’s hand on top of his/her head. A decrease in pain is a </span><strong>positive</strong><span> test.</span></p>
<p>Yergason's test</p>
<p><span>Tests transverse humoral ligament - Test for biceps tendon pathology, such as bicipital tendonitis and an unstable superior labral anterior posterior (SLAP)</span></p>
<p><span>Patient brings arm to ninety degrees and tries to supinate and adduct arm. If snapping or pushing out of the ligament = positive test.</span></p>
<p>Spurling Test</p>
<p>Tests for Cervical Compression</p>
<p><span>The Spurling test is a medical maneuver used to assess nerve root pain. The examiner turns the patient's head to the affected side while extending and applying downward pressure to the top of the patient's head. If pain and tingling along the arm = positive test</span></p>
<p>Apprehension test</p>
<p><span>Test the integrity of the </span><a>glenohumeral</a><span> joint capsule, or to assess </span><a>glenohumeral instability</a><span> in an anterior direction.</span></p>
<p><span>The patient should be position in supine. The therapist will flex the patient's elbow to 90 degrees and abducts the patient's shoulder to 90 degrees, maintaining neutral rotation. The examiner then slowly applies an external rotation force to the arm to 90 degrees while carefully monitoring the patient</span><a>[1]</a><span>. Patient apprehension from this maneuver, not pain, is considered a positive test.</span></p>
<p>Murphey's Sign</p>
<p><span>Murphy's sign is elicited in patients with </span><strong>acute cholecystitis</strong><span> by asking the patient to take in and hold a deep breath while palpating the right subcostal area. If pain occurs on inspiration, when the inflamed gallbladder comes into contact with the examiner's hand, Murphy's sign is positive.</span></p>
<p>Boas Sign</p>
<p><span>A clinical sign that is defined as </span><strong>hyperesthesia felt by the patient to light touch in the right lower scapular region</strong><span> or the right upper quadrant of the abdomen. It is classically seen in patients with acute cholecystitis.</span></p>
<p>Rovsings Sign</p>
<p><span>Pain felt in the right lower abdomen upon palpation of the left side of the abdomen. A positive Rovsing's sign is indicative of </span><strong>acute appendicitis</strong><span>, characterized by inflammation, infection, or swelling of the appendix.</span></p>
Apley’s scratch test
Type of ROM test.
Frozen shoulder - problem with external rotation or abduction
Drop arm teset
Tests rotator cuff inury. Supposed to drop arm slowly but will drop fast because of pain.
Speed tests
Biceps tendinitis test.
ptaient supinates aram and tries to push up as physician pushes down
Empty Can Test
Tests for supraspinatous tear (most common in rotator cuff)
90degree shoulder, internal rotation of 30degrees, like your emptying cans. Dr. pushes down as client pushes up. Pain indicates
Supraspinatus
infraspinatus
subscapularis
teres Minor
Lift off test
tests subscapularis rupture or dysfunction.
adduction, internal rotation (broken wing), try to lift hand away from body.
De Quervain Syndrome Test
Blackberry thumb/texting/video games
Test with Finkelstein test. Put thumb inside fist, and physician pushes down
pain over abductor pollicus and extensor pollicus brevis
Lasegue’s Test
Test is used to evaluate sciatic nerve compression
Pain between 30-70 is considered positive
Lift leg straight. Normally a leg can extend to 70-80degrees of hip flexion.
`
Ober Test
Tests tightness of iliotibial band
Lachmens test
ACL test (more specific test) moves forward >6mm
Trendelenburg’s Test
Tests Weak Gluteus medius/mimimus are weak -
hips are uneven if positive
FABERE Test
Leg moved through FABERE motions Tests hip joint and SI joing F- Flexion AB - ABduction ER - External rotation E - Extension
Thomas Test
Problems: Contralateral hip flexes
iliopsoas
Hip flexion
flex one hip, other leg will not be bale to stay straight, it will raise up
Posterior Drawer Test
PCL - moves posterior
Weber and Rinne Test for
Hearing loss
<p>Homan's sign</p>
<p>Dorsi flex the foot makes calf muscle pain - positive sign of possible DVT - Deep vein thrombosis -</p>
<p>embolism detaches and is more dangerous</p>
<p>Tests for Bicipital tendon</p>
<p>Speed test - patient supinates arm while extended to 90 degrees while practitioner pushes down and patient resists - If there is pain→ positive test</p>
<p>Yergasons test - <span>The patient should be seated or standing in the anatomical position, with the humerus in a neutral position and the elbow in 90 degrees of flexion in a pronated position. The patient is asked to externally rotate and supinate their arm against the manual resistance of the therapist produced by wrapping the hand around the distal forearm (just above the wrist joint).</span><a>[2]</a><span> Yergason's Test is considered positive if the pain is reproduced in the bicipital groove and a biceps or a SLAP (</span><strong>tear of tissue that is located on top of the shoulder</strong><span>. SLAP stands for “Superior Labrum Anterior Posterior.) </span><span>lesion is suspected.</span></p>
Directions of rotator cuff muscles of shoulder
Internal rotation - subscapularis
External rotation- infraspinatous and teres minor
Inability to actively or passively rotate arm suggests what?
Dislocated shoulder
Force associated with medial meniscus tears
Torsional force with compression and rotation associated with cutting activities.
Steinman’s Sign
Done to diagnose meniscal lesions at the knee joint
Normal shoulder flexion using passive ROM
170-180 degrees
extension - 60 degrees
Normal knee flexion using passive ROM
Normal 120-150 degrees
degrees of normal forearm supination and pronation to neutral
90 degrees
Supination/pronation to neutral
Normal range of motion for the knee
0-140 degrees
Neutral is fully extended (like standing straight)
Muscles of the Hamstring?
Biceps femoris - Long head and short head
Semitendinosus
semimembranosus - KD10 between this and semitendinosus
which muscle is the hip flexor?
Rectus femoris (cnx ilium and tuberosity)
The gastrocnemius muscle is supplied by which nerve?
The Tibial nerve goes via UB channel
2 branches break off of sciatic nerve, this and the common fibular nerve - GB channel
Unhappy triad includes?
ACL, MCL, Medial meniscus
What is the normal range of motion for plantar flexion of the ankle
plantar flexion - 50 degrees
Dorsiflexion - 20 degrees
Normal ROM for internal rotation of tibia on femur
20-30 degrees
Andersons Mediolateral Grind test
Used to ID meniscus lesions
When knee is flexed, valgus stress is applied
Knee in extension, Varus stress
Maneuver creates circular movement
Apley Test
Used to ID torn meniscus
Clinician applies internal and external rotation with compression and distraction to lower leg and notes any pain response.
Patellar injuries are usually the result of?
Overuse
Which force nomally causes ACL tear?
Hyperextension
Normal ROM for external rotation of tibia on femur
30-40
