Exam 1 Lab Content Flashcards
T/F: With distraction, you want to mobilize out of the pts. pain range.
True, don’t want to cause pain
Q: In what direction is distraction performed?
Towards the motion barrier
Defn: Grade 1 Distraction
Not enough force to separate the joint surfaces
Defn: Grade 2 Distraction
Enough force to separate the joint surfaces and eliminate the joint play
Defn: Grade 3 Distraction
A distraction force strong enough to stretch the joint capsule
Q: What are the 4 c-spine screens?
- Flexion AROM, OP 2. Extension AROM, OP 3. Rotation AROM bilateral, OP 4. Quadrant AROM, No OP
Q: Describe the quadrant AROM c-spine screen.
Combination of side bend, rotation, and extension - have pt. follow your finger
T/F: If there is no change in symptoms with the c-spine screen you do not need to apply OP.
False; apply OP to check is symptoms are reproduced
Q: How do you apply OP to the c-spine?
A couple of bounces at end range
T/F: You should always help someone out of an OP position.
True
Q: What are the 3 lumbar spine screen?
- Flexion ROM, OP 2. Extension ROM, OP 3. Quadrant ROM
Content: Shoulder Exam - Standing Observations (4)
- Step Sign - AC separation 2. Scapular location 3. Scapular position/alignment 4. General - swelling, guarding, compensation, skin changes
T/F: With shoulder impingement there is equal movement at the GH joint and the scapula.
False: less at GH, more at scapula
Content: Shoulder Exam - AROM (5)
- Elevation/Flexion 2. ABD (Painful Arc) 3. HBB (Ext/ADD/IR) 4. HAC (ADD) 5. HBH (Scap/ER)
Special Test: Cross Over Impingement - Assessment
Impingement
Special Test: Cross Over Impingement - Position
Standing
Special Test: Cross Over Impingement - Method
Apply OP in ADD
Special Test: Cross Over Impingement - Positive Test of Anterior Pain (3)
- Subscapularis 2. Supraspinatus 3. Long head of biceps
Special Test: Cross Over Impingement - Positive Test of Superior Pain
AC joint
Special Test: Cross Over Impingement - Positive Test of Posterior Pain (3)
- Infraspinats 2. Teres Minor 3. Posterior Capsule
T/F: The cross over impingement test is an AROM test.
False: PROM
Special Test: Hawkins-Kennedy - Assessment
Impingement of supraspinatus tendon
Special Test: Hawkins-Kennedy - position
Sitting
Special Test: Hawkins-Kennedy - Method
Move pt. into 90 shld flexion and 90 elbow flexion, then IR
Special Test: Hawkins-Kennedy - Positive Test
Reproduction of symptoms/Pain
T/F: The Hawkins-Kennedy test is a PROM test.
True
Special Test: Neer’s - Assessment
Impingement of supraspinatus tendon
Special Test: Neer’s - Position
Sitting
Special Test: Neer’s - Method
Elevate the pt.’s arm overhead in the scapular plane with arm IR, stabilize behind scapula and press into end range
Special Test: Neer’s - Positive Test
Pain
T/F: Neer’s test is a PROM test.
True
T/F: With a Neer’s test the pt.’s elbow should be bent.
False: Straight
Special Test: Speed’s - Assessment
Biceps Tendinitis
Special Test: Speed’s - Position
Sitting with elbow in extension and forearm supinated
Special Test: Speed’s - Method
Apply resistance to a shoulder in 90 degrees of flexion while palpating the biceps tendon
Special Test: Speed’s - Positive Test
Increased tenderness in the bicipital groove
T/F: The Speed’s test is a PROM test.
False; AROM
Special Test: Empty Can - Assessment
Supraspinatus tendonitis
Special Test: Empty Can - Position
Sitting, shoulders elevated to 90 in the scapular plane and IR (thumbs pointed down)
Special Test: Empty Can - Method
Apply resistance downward
Special Test: Empty Can - Positive Test
Weakness or pain - indicates partial tear
Special Test: Drop Arm - Assessment
RC rupture
Special Test: Drop Arm - Position
Sitting
Special Test: Drop Arm - Method
Passively move arm to 90 ABD, ask pt. to hold arm up, remove support
Special Test: Drop Arm - Positive Test
Inability to hold the arm in test position - indicated complete tear
Special Test: O’Brien’s - Assessment
AC adhesion and Labral tears
Special Test: O’Brien’s - Position
Sitting, 90 Shld flexion, 10-15 H-ADD IR
Special Test: O’Brien’s - Method
Apply doward pressure at wrist, to confirm repeat test with ER
Special Test: O’Brien’s - Positive Test
Pain with IR and no Pain with ER - indicates labral tear (SLAP)
Special Test: GH Instability Test - Position
Sitting, arm relaxed at side
Special Test: GH Instability Test - Method
Stabilize scapula, gram humeral head/distal humerus, move humerus anterior/posterior
Q: How do you grade anterior/posterior GH Instability?
1 cm = G1 laxity 1.5 cm = G2 laxity > 1.5 cm = G3 laxity
Special Test: Sulcus Sign - Assessment
GH instability - particularly inferiorly
Special Test: Sulcus Sign - Position
Sitting, arm relaxed at side
Special Test: Sulcus Sign - Method
Stabilize scapula, grasp humerus near elbow and distract inferiorly
Q: How do you grade the inferior GH instability?
1 cm = G1 laxity 1-2 cm = G2 laxity > 2 cm = G3 laxity
Q: What directions must be lax to be termed multidirection GH instability?
anterior, posterior, and inferior
Defn: Primary impingement
Painful arc is positive
Defn: Secondary impingement
Painful arc and laxity are positive
T/F: When you test ligaments/instability you do not need to compare sides.
False.
T/F: With a Neer’s or Hawkin’s-Kennedy test you need to test both sides.
False
Special Test: Clunk - Assessment
Torn glenoid labrum
Special Test: Clunk - Position
Supine, arm overhead in full ABD
Special Test: Clunk - Method
Support under humeral head and apply anterior force while simultaneously applying compression and rotation to the humerus
Special Test: Clunk - Positive Test
Pain, clunk, grinding, pseudolocking
Special Test: Apprehension and Relocation - Assessment
Anterior GH stability
Special Test: Apprehension and Relocation - Position
supine, with glenoid at edge of table
Special Test: Apprehension and Relocation - Method
Bring arm into 90 ABD, ER shld slowly, if pain is elicited, apply posterior force to reduce the humeral head into place (relocate)
Special Test: Apprehension - Positive Test
Pain or apprehension
Special Test: Relocation - Positive Test
Relief of pain or apprehension