Examination Tests

Question 1

Burger’s Test

Answer 1

Ischemia
Supine -> elevate legs to 45º for 1-2mins; Pallor indicates ischemia -> sit patient up w/ legs over bed; colour = blue-> red

Question 2

Cough Test

Answer 2

Thrills at the saphenofemoral junction?

Question 3

Tap Test

Answer 3

Incompetent saphenofemoral junction
One finger on SFJ and one on any varicosities of the long saphenous vein; tap on SFJ -> transmitted percussion wave if incompetent

Question 4

Prethe’s Test

Answer 4

Deep Vein Patency
Patient lying, place high thigh tourniquet -> stand and go on tiptoes x10; if the superficial veins drain then deep veins are patent

Question 5

Trendelenberg’s Test (PVE)

Answer 5

Is saphenofemoral junction the problem?

raise leg for 1-2mins -> high thigh tourniquet -> stand; if varicose veins do not refill then SFJ = problem

Question 6

Trendelenberg’s Test (Lower Limb)

Answer 6

Hip Abductor strength

Stand on 1 leg; weak if pelvis drops on contralateral side

Question 7

Tinel’s Test

Answer 7

Carpal Tunnel Syndrome

Tap over the median nerve -> tingling sensation that radiates outwards

Question 8

Phalen’s Test

Answer 8

Carpal Tunnel Syndrome

Palmar Flexion held for 1min -> elicits symptoms in the median nerve distribution

Question 9

Compression Test

Answer 9

Carpal Tunnel Syndrome

Apply firm pressure to carpal tunnel for 30s -> reduces symptoms

Question 10

Murphy’s Sign

Answer 10

Acute Cholecystitis

Inspiration prevented by placing hand below RCM in the mid-clavicular line

Question 11

Squeeze Test

Answer 11

MSK Inflammatory Joint Disease

Question 12

Patella Tap

Answer 12

Joint Effusion

Supine, press area above patella w/ palm -> pushes fluid under patella and lifts it; +ve = floating/bouncing patella

Question 13

Thomas’s Test

Answer 13

Fixed Flexion Deformity of Hip

Supine, fully flex one knee to chest, +ve if other straight leg raises off bed

Question 14

Bulge Test

Answer 14

Joint Effusion

one hand superior to patella pushes inferiorly, other presses medially to force fluid laterally -> fluid wave

Question 15

Posterior Sag

Answer 15

PCL Damage

Knee @ 90º w/ foot flat on bed; PCL damage indicated if there is posterior sag of upper tibia

Question 16

Anterior Draw

Answer 16

ACL Damage

Fingers behind knee and thumbs on tibial tuberosity, forward full -> significant movement if ACL is damaged

Question 17

Lachman’s Test

Answer 17

ACL Laxity
Hip 45º, Knee 90º, one hand w/ fingers behind knee and thumb on tibial tuberosity, one hand above knee, pull anteriorly; soft endpoint suggests ACL damage

Question 18

McMurray’s Test

Answer 18

Meniscus Tear
Hip 90º, Max Knee flex -> externally rotate & fully extend -> repeat w/ interal rotation; +ve = audible/palpable/painful click over medial/lateral joint line

Question 19

Transillumination

Answer 19

Clear Fluid-Filled Mass

Question 20

Straight Leg Raise

Answer 20

IV Disc Prolapse
Supine, passively raise extended leg; +ve = pain (nerve root distribution = root effected)
Lasegue’s Sign - lower until pain disappears then dorsiflex foot -> pain)

Question 21

Bowstring Test

Answer 21

IV Disc Prolapse
Straight leg raise, if pain flex knee and firm pressure w/ thumb in popliteal fossa -> radiating pain/paraesthesia in distribution of irritated nerve root

Question 22

Femoral Stretch Test

Answer 22

IV Disc Prolapse

Prone, flex knee -> pain (can be aggravated by hip extension)

Question 23

Scarf Test

Answer 23

Acromioclavicular Joint Pathology

Place arm in forced adduction @ 90º of shoulder -> pain

Question 24

Ankle Clonus Reflex

Answer 24

Interruption of UMN

slightly flex knee, rapidly dorsi/plantarflex ankle then hold forced dorsiflexion -> oscillation against pressure