fall 2023 CP practical final

Question 1

apley scratch test

Answer 1

purpose: ROM (abduction, flexion, external rotation, pronation, adduction, extension, internal rotation and supination)

Pt. pos: standing

prac. pos.: behind pt.

procedure: pt. is asked to touch both hands together behind the back with one arm going over the shoulder and the other arm under the shoulder

positive: asymmetry

Question 2

spring test (SC)

Answer 2

purpose: sterno-clavicular joint (anterior and posterior sc ligaments, costo-clavicular lig. and inter clavicle lig.)

Pt. pos: standing

prac. pos.: in front of pt. 2-3 fingers placed on proximal clavicle

procedure: prac. pushes clavicle posteriorly and inferiorly. done several repetitions and performed bilaterally

positive: excessive movement of proximal clavicle as it springs back into place

Question 3

spring test (AC)

Answer 3

purpose: acromio-clavicular ligament (superior and inferior acromio-clavicular ligament, conoid and trapezoid portion of CC ligament)

Pt. pos: standing

prac. pos.: in front of pt. 2-3 fingers on distal clavicle

procedure: push distal clavicle inferiorly. done several repetition and performed bilaterally

positive: excessive movement of distal clavicle

Question 4

AC/ SC compression test or crossover test

Answer 4

purpose: check sc or ac joints or clavicle fracture

Pt. pos: seated or standing, affected arm brought across the body and rests on the opposite shoulder

prac. pos.: in front of pt., hand on the pt.s affected elbow

procedure: push elbow to opposite shoulder

positive: pain in either the AC or SC joint or clavicle

Question 5

AC shear test

Answer 5

purpose: check AC joint (superior and inferior ac lig., conoid and trapezoid portion of CC lig)

Pt. pos: standing or sitting

prac. pos.: in front of pt. interlaced fingers are placed over the spine of the scapula and mid-clavicle

procedure: prac. squeezes scapula and mid clavicle

positive: excessive movement of the distal clavicle; pain

Question 6

traction

Answer 6

purpose: check AC joint (& associated ligaments), stability of the inferior glenohumeral joint

Pt. pos: standing with arms at the side

prac. pos.: standing in front of pt. grasping pt.’s wrists

procedure: prac. pulls uniformly down on each arm and looking for step up or sulcus sign

positive: step off of AC joint and pain AND/OR sulcus sign seen on superior, anterior shoulder and pain and instability

Question 7

apprehension (crank) test

Answer 7

GOLD STANDARD FOR SHOULDER INSTABILITY

purpose: anterior/ inferior shoulder instability

Pt. pos: can be standing or lying supine

prac. pos.: standing: in front of Pt. with one hand on wrist and other on elbow, bring arm into external rotation. Supine: one hand can be placed on mid forearm with thumb up the forearm and one hand pushing gh joint back to push the humerus back into place

procedure: move the humerus into abduction and external rotation, look for facial expression

positive: facial expression that indicate pain, pt. feels instability or apprehension with ROM

Question 8

relocation (fowler or Jobe or surprise) test

Answer 8

purpose: confirmation of a positive apprehension test

Pt. pos: supine, arm abducted and external rotated

prac. pos.: to the side of pt. one hand on wrist and the other on the anterior shoulder

procedure: once an uncomfortable or painful ROM in apprehension, prac. places the palm of hand over the anterior shoulder while maintaining the abducted and externally rotated position, the hand can be pushed down and releases to discern pain levels

positive: a relief of pain levels with pressure or release of pressure on anterior GH

Question 9

adson

Answer 9

purpose: Thoracic outlet syndrome

Pt. pos: sitting

prac. pos.: standing behind pt.

procedure: prac. feels for radial pulse, externally rotate and extends the shoulders. pt. is instructed to look towards the effected Side and hold breath for 10-15 sec.

positive: reduced or diminished pulse

Question 10

allen’s (wright’s) test

Answer 10

purpose: thoracic outlet syndrome

Pt. pos: sitting

prac. pos.: behind pt.

procedure: prac. finds radial pulse and abducts and externally rotates (90 90). pt. is then instructed to look away from the affected side (for Wright’s test= take arm into hyperabduction and check for pulse)

positive: reduced or diminished radial pulse

Question 11

speeds

Answer 11

purpose: tendinitis of long head of the biceps

Pt. pos: standing with arms at 90 degrees of forward flexion and supination

prac. pos.: facing pt. with one hand on the bicipital groove and the other hand on the distal wrist

procedure: pt instructed to hold at 90 degrees while the prac. provides resistance into flexion

positive: pain and/or inability to complete the maneuver, or crepitus at the biceps tendon

Question 12

Yergason’s

Answer 12

purpose: bicipital tendonitis, or rupture of the transverse humeral ligament

Pt. pos: sitting, elbow straight, internally rotated and pronated

prac. pos.: next to pt. one hand on the bicipital groove and other hand on the distal wrist

procedure: pt. instructed to move from an internally rotated and pronated position to external rotation and supination against resistance. start in pronation and extension then resist against supination and elbow flexion

positive: pain in bicipital groove, long head of the biceps moving out of the bicipital groove, weakness

Question 13

empty can

Answer 13

purpose: isolated contraction of the supraspinatus muscle

Pt. pos: standing with arms raised to 90 degrees, horizontal abducted to 45 degrees and pronated (thumb down)

prac. pos.: in front of pt. one hand stabilizing shoulder and the other on the distal wrist

procedure: pt is instructed to resist downward movement through the motion of the scaption. perform with both arms at the same time

positive: pain, inability to complete maneuver

Question 14

impingement

Answer 14

A
purpose: impingement, pinching long head of biceps tendon, supraspinatus, and sub-acromial bursa under coracoaromial ligament

Pt. pos: standing

prac. pos.: in front of pt. one hand on distal wrist and one hand supporting arm at the elbow

procedure: arm is take into forced abduction and external rotation

positive: anterior shoulder pain

Question 15

painful arc

Answer 15

purpose: shoulder impingement

Pt. pos: standing with arms held at sides

prac. pos.: in front of pt. slight resistance may be placed on pt. wrists as needed

procedure: the pt. is instructed to move through full ROM in abduction from the hands at the side to fully overhead

positive: only pain in ROM from 45-120 degrees.

Question 15

clunk

Answer 15

purpose: tear of glenoid labrum

Pt. pos: supine with arm flexed fully overhead

prac. pos.: standing at head of pt. with both hands under and grasping the head of the humerus

procedure: push arm straight in towards the body and lift humerus straight up towards the ceiling.

positive: clunking, clicking, catching

Question 16

drop arm

Answer 16

purpose: tear of the rotator cuff musculature

Pt. pos: standing with arms abducted to 90 degrees

prac. pos.: standing in font of pt., hands may be placed on pt.s wrist as necessary

procedure: pt. is instructed to slowly lower arms. prac. may add resistance pushing arms down

positive: pain, an inability to slowly lower arms, sudden dropping of one arm

Question 17

hawkins- Kennedy impingement

Answer 17

GOLD STANDARD FOR SHOULDER IMPINGEMENT

purpose: shoulder impingement

Pt. pos: standing with shoulder flexed to 90 degrees and internally rotated

prac. pos.: standing in front of pt. one hand supporting the elbow and the other on the distal forearm

procedure: downward pressure is applied on the wrist, while other Hand remains stationary

positive: pain, facial expression, apprehension

Question 18

neer impingement

Answer 18

A
purpose: shoulder impingement

Pt. pos: standing

prac. pos.: standing next to pt. one hand stabilizing the scapular region and the other hand placed on distal wrist

procedure: shoulder is taken into full flexion and the practitioner applies a slight overpressure. pressure to scapula forward

positive: pain

Question 19

pectorals major contracture

Answer 19

purpose: tightness through pectorals major muscle

Pt. pos: lying on back with fingers laced behind head

prac. pos.: standing at head of pt. with hands on elbows if needed

procedure: pt. is instructed to allow the elbows to relax and try to touch the table; pressure by the prac. may be performed to check end feels

positive: inability to move elbows closer to the table

Question 20

Military brace position (eden test)

Answer 20

purpose: costo-clavicular syndrome

pt. pos: standing with arms to the side and supinated

prac. pos: standing behind pt. with fingers on radial pulse and the other hand on the clavicle

procedure: redial pulse is palpated and the shoulder is drawn down and back with slight traction. hand over from scapula to clavicle squeezes while other hand is palpating radial pulse

positive: decreased or diminished pulse

Question 21

anterior/ posterior drawer test

Answer 21

purpose: posterior shoulder instability

pt. pos: sitting relaxed with forearm RESTING on thigh

prac. pos: next to pt. one hand stabilizing hand on spine of scapula and clavicle and the other hand over the head of the humerus

procedure: head of humerus is moved anterior and posteriorly while other hand stabilizes

positive: excessive movement at GH joint and or pain

Question 22

Load and Shift

Answer 22

purpose: Labral tears

pt. pos: sitting, relaxed, forearm relaxed on thigh

prac. pos: next to pt. one hand stabilizing of scapula and clavicle and other hand over the head of the humerus

procedure: same procedure as anterior/ posterior drawer + pressure applied on humerus towards the joint

positive: pain, clicking, and/or catching

Question 23

Rowe test

Answer 23

purpose: GH instability (ligaments structures)

pt. pos: supine with hands behind the head

prac. pos: balled fist under posterior head of humerus and other hand on top of bent elbow

procedure: downward pressure is applied at the elbow towards the table

positive: pain, anterior instability

Question 24

posterior apprehension (humeral shear or posterior glide)

Answer 24

purpose: posterior shoulder instability pt. pos: supine, forward flexion to 90 degrees elbow bent to 90 degrees prac. pos: standing next to pt., one hand on pt. elbow procedure: humerus is pushed posteriorly straight back positive: pain, excessive glide of humerus, apprehension

Question 25

Liu Crank

Answer 25

purpose: Labral tear pt. pos: supine arm abducted to 160 degrees with 30 degrees of horz. adduction prac. pos: standing next to pt. hand on pt. elbow procedure: humerus is pushed back posteriorly and the arm is taken into internal and external rotation positive: pain, clicking, apprehension, especially with external rotation

Question 26

bear hug

Answer 26

purpose: subscapularis weakness or neuro deficit pt. pos: standing, arm resting of opposite shoulder with the shoulder flexed to 90 degrees prac. pos: put hand under pt. hand that is one opposite shoulder. standing in front of pt. procedure: pt is instructed to maintain the position and push down on the opposite shoulder positive: pain and/or inability to push down

Question 27

lift off sign (belly lift off)

Answer 27

A purpose: subscapularis weakness or neruo deficit pt. pos: standing arm internally rotated and resting on low back prac. pos: behind pt. with one hand on the mid humerus and other hand on the distal wrist procedure: slight resistance may be applied by the prac. as the pt. attempts to lift the hand off the low back positive: pain and/or inability to raise hand

Question 28

feagin (inferior drawer)

Answer 28

purpose: shoulder instability (inferior middle and superior gh ligaments) pt. pos: standing with arm abducted to 90 degrees or flexion to 90 degrees prac. pos: shoulder abduction: standing next to pt. with both hands on top of head of humerus OR shoulder flexion: standing in front of pt. with both hands on top of humerus procedure: with both hands on top of humerus head, a downward force is applied positive: instability of the GH joint and/or anterior sulcus and/or pain

Question 29

Roos

Answer 29

purpose: thoracic outlet syndrome pt. pos: abducted and externally rotated arms (90 90 field goal position) with hands open prac. pos: next to pt. procedure: pt is instructed to open and close hands for 3 minutes positive: decrease in motor function of the hand, loss of sensation, inability to maintain test position

Question 30

O’brien’s

Answer 30

purpose: SLAP lesion pt. pos: sitting or standing, shoulder flexion to 90 degrees, full horz. adduction and full internal rotation prac. pos: in front of pt. one hand on the elbow and other on the distal wrist procedure: pt is instructed to resist against the downward force of the prac. The test is repeated wit external rotation. have pt go from opposite asis to opposite shoulder positive: pain and/or popping that is alleviated with the external rotation component

Question 31

shoulder scouring

Answer 31

purpose: instability of the GH joint, labral tears pt. pos: sidling, arm abducted to 90 degrees prac. pos: standing behind pt., pt arm is resting on prac. elbow/ forearm. one hand on lateral joint line on the proximal humerus, the other hand stabilizing the scapula posteriorly procedure: anterior and inferior and posterior and superior forces are placed on the humerus, feeling for instability or clicking or popping positive: clicking or popping (labrum); instability or apprehension (ligamentous instability)

Question 32

SLAP series

Answer 32

purpose: slap lesion, particularly from the bicipital pull on the superior labrum pt. pos: supine with arm hanging off the table. pt. abducts arm to 120 degrees, shoulder rotation neutral, pronated and elbow flexed to 65-70 degrees prac. pos: standing next to pt. one hand is stabilizing the upper arm mid humerus while the other grasps the pt. wrist procedure: the pt is instructed to spinate the hand against maximal resistance while the pt. moves the shoulder into full abduction and external rotation (1). the elbow is then flexed against maximal resistance (2) positive: clicking or popping, pain deep in the GH joint with resisted actions of supination (1) or elbow flexion (2) predictability/ percentage: 81-96%

Question 33

valgus stress

Answer 33

purpose: test integrity of ulnar collateral ligament pt. pos.: seated with arms in anatomical position prac. pos.: standing in front of pt. supporting arm, one hand at lateral elbow and other is placed on medial distal arm near wrist procedure: valus stress is applied to elbow at 0 and at 30 degrees of flexion positive: increased valgus movement with a diminished or absent end point

Question 34

varus stress

Answer 34

purpose: test integrity of radial collateral ligament pt. pos.: seated with arms in anatomical position prac. pos.: standing in front of pt. supporting arm, one hand at lateral elbow and other is placed on medial distal arm near wrist procedure: varus stress is applied to elbow at 0 and at 30 degrees of flexion positive: increased varus movement with a diminished or absent end point

Question 35

cozen’s test

Answer 35

purpose: lateral epicondylitis pt. pos.: seated next to table, wrist and hand hanging off the edge. hand in a fist, pronated and radial deviated prac. pos.: seated opposite pt. one hand stabilizing arm, other on dorsal hand resisting movement procedure: pt moves into extension, supination, and ulnar deviation against resistance positive: pain along lateral epicondyle of humerus; general muscular weakness and discomfort in the lateral elbow

Question 36

Mill’s test

Answer 36

purpose: lateral epicondylitis pt. pos.: standing or sitting prac. pos.: standing next to pt., one hand on the elbow and the other on the posterior hand procedure: forearm is passively pronated, radially deviated and wrist flexed and the elbow is taken into extension positive: pain over the lateral epicondyle

Question 37

Maudley’s test

Answer 37

purpose: lateral epicondylitis pt. pos.: seated with hand flat on table prac. pos.: seated next to pt. wit one finger over the pt.’s middle finger procedure: instruct pt to extend middle finger against resistance positive: pain over lateral epicondyle

Question 38

Kaplan’s sign

Answer 38

purpose: lateral epicondylitis pt. pos.: standing or sitting, elbow slightly flexed, forearm neutral and wrist slightly extended prac. pos.: standing in front of pt. two fingers in the pt. hand procedure: have the pt. grasp your two fingers or a dynamometer, put a strap or have someone constrict the forearm 1-2 inches distal to the elbow and recheck grip positive: a decreased in pain and/ or an increase in grip strength following the strap

Question 39

milking sign

Answer 39

purpose: test the integrity of the ulnar collateral ligament pt. pos.: shoulder and elbow flexion with thumb pointing down. (as if reaching behind the head) prac. pos.: standing behind pt. holding pt. thumb procedure: apply a downward force to pt.’s thumb positive: pain on the medial joint line

Question 40

Andrew’s UCL test

Answer 40

purpose: determine integrity and laxity of the ulnar collateral ligament pt. pos.: seated, facing away from the prac. shoulder is abducted and externally rotated, elbow fully flexed prac. pos.: standing behind pt. one hand on the elbow (thumb on UCL) and other on the wrist procedure: PT. is instructed to extend the elbow while the prac. provides a valgus force at the elbow positive: pain and/or laxity at any point in the ROM

Question 41

Table top Test

Answer 41

purpose: determine integrity and laxity of the ulnar and radial collateral ligament pt. pos.: standing facing away from the table. forearm is supinated and shoulder externally rotated. arm is placed flat against the table prac. pos.: stading to the side of the table. both hands placed around the elbow procedure: prac. takes elbow into both valgus and varus forces positive:

Question 42

golfer’s elbow (medial epicondylitis Test #1

Answer 42

A purpose: medial epicondylitis pt. pos.: forearm supinated with wrist and elbow in extension and hand hanging off the end of the table prac. pos.: standing next to pt. procedure: pt. is instructed to pronate and flex wrist against resistance. opposite of Mill’s test positive: pain in medial epicondyle region of humerus

Question 43

Golfer’s elbow (medial epicondylitis) Test #2

Answer 43

purpose: medial epicondylitis pt. pos.: forearm supinated with wrist in extension prac. pos.: standing next to pt. hand on maintaining supination and wrist flexion procedure: pt. is instructed to extend the elbow with arm in supination and wrist flexion positive: pain in medial epicondyle region of humerus

Question 44

bicep squeeze test

Answer 44

purpose: potential bicep rupture pt. pos.: seated with arm resting in lap at approx. 60-80 degrees of flexion and arm in pronation prac. pos.: standing or seated next to pt. with one hand over the musculotendinous juncture of the bicep and the other on the belly of the muscle procedure: squeezing with both hands along the bicep positive: if the arm does not supinate= indicative of a bicep rupture

Question 45

tinel’s sign

Answer 45

purpose: determine abnormal pathology of a nerve, particularly the ulnar nerve pt. pos.: seated or standing with elbow in slight flexion prac. pos.: standing next to pt. supporting distal arm procedure: while supporting distal arm, tap the ulnar nerve on the ulnar notch with index finger positive: tinging along ulnar nerve distribution in forearm, hand, or fingers

Question 46

wartenberg sign

Answer 46

A purpose: test for ulnar nerve problem pt. pos.: sitting with hands on table prac. pos.: sitting across from pt. procedure: instruct pt. to abduct fingers then bring them back together positive: inability to adduct little finger is indicative of a ulnar nerve pathology

Question 47

elbow flexion

Answer 47

purpose: cubital tunnel syndrome pt. pos.: standin or sitting, with elbows in flexion and wrists extended prac. pos.: sitting across from pt. procedure: instruct pt. to hold position of full elbow flexion and wrist extension for 3-5 minutes positive: numbness, tingling indicative of cubital tunnel syndrome (typically last finger and 1/2)

Question 48

ulnar nerve compression

Answer 48

A purpose: test for involvement of ulnar nerve or cubital tunnel syndrome pt. pos.: standing with arm in supination prac. pos.: standing next to pt. with one finger just proximal to the cubital tunnel on the medial elbow procedure: apply a force for 30 seconds and note any changes in sensation through the ulnar nerve distribution positive: numbness and tingling or shooting pain through the ulnar nerve distribution

Question 49

pinch grip

Answer 49

purpose: nerve entrapment pt. pos.: may be seated or standing prac. pos.: standing or sitting next to pt. procedure: instruct pt. to pinch the tips of fingers between thumb and fingers positive: inability to touch tips of fingers and thumb together, touching pad to pad

Question 50

capillary refill

Answer 50

purpose: determine vascularity of upper extremity pt. pos.: standing or sitting, fingers extended prac. pos.: standing next to pt. procedure: apply pressure to fingernail (nail should turn white) positive: should return to pink color. whiteness or a slow return to pink are abnormal

Question 51

brachial pulse

Answer 51

purpose: determine vascularity of the upper extremity pt. pos.: standing or sitting prac. pos.: standing next to pt. fingers along medial humerus procedure: pressure is applied to the brachial area, medially on the humerus, and a pulse is determined positive: diminished or weak pulse as compared bilaterally

Question 52

isosceles triangle

Answer 52

purpose: fracture of the medial or lateral epicondyle or the olecranon process pt. pos.: seated or standing prac. pos.:standing across from pt . procedure: fingers are placed on medial epicondyle, lateral epicondyle and olecranon process in full extension and then the elbow is flexed positive: the three landmarks should form a straight line in extension and for an isosceles triangle in full flexion

Question 53

Finkelstein

Answer 53

A purpose: DeQuervain’s syndrome (inflammation of the extensor polices brevis and abductor pollicus) pt. pos: sitting or standing prac. pos.: standing next to pt. procedure: have the pt. make a fist holding the thumb and passively move into ulnar deviation positive: pain over the dorsal surface of the thumb

Question 54

tinel’s

Answer 54

purpose: median nerve pathology (carpal tunnel syndrome) pt. pos: standing or sitting prac. pos.: facing pt. procedure: nerve is tapped with the tip of one finger, in this instance, on the medial nerve distribution on the anterior wrist at the retinaculum positive: shooting pain along the distribution of the median nerve

Question 55

phalan’s

Answer 55

purpose: carpal tunnel syndrome presence pt. pos: sitting or standing prac. pos.: standing next to pt. procedure: pt is instructed to push the dorsal aspects of both hands together, with the fingers pointing downward and hold the position for 1 minute positive: numbness or tingling along the median nerve distribution; the solar aspect of the thumb and 2 1/2 fingers

Question 56

carpal compression

Answer 56

purpose: carpal tunnel syndrome presence pt. pos: sitting or standing prac. pos.: standing in front of pt. procedure: entire length of a finger or the thumb is placed on the volar aspect of the wrist, at the retinaculum and compressed positive: tingling, pain or numbness along the median nerve distribution

Question 57

allen’s test for the wrist

Answer 57

purpose: to determine vascularity of the hand pt. pos: sitting or standing, palm supinated prac. pos: standing in front of pt. one thumb on the radial artery and one on the ulnar artery on the volar aspect of the wrist procedure: thumbs are compressed over both arteries and the pt. is instructed to compress and relax the hand several times until the hand turns white. one finger (done twice) is released and the hand should return to it’s normal pink color positive: slow return of blood flow or the hand staying white

Question 58

varus/ valgus

Answer 58

purpose: ligamentous instability, particularly collateral ligaments pt. pos: standing or sitting prac. pos: standing in front of pt. procedure: distal finger is stabilized and the valgus or varus force is applied through the joint line and an anterior r and posterior glide is applied positive: instability with any movements

Question 59

gamekeeper’s test

Answer 59

purpose: ulnar collateral ligament of the thumb pt. pos: standing or sitting prac. pos: standing in front of pt.. one hand stabilizing the metacarpal of the thumb, the other hand grasping the distal thumb procedure: valgus force is applied positive: excessive moment of the joint or pain

Question 60

tap

Answer 60

purpose: determine presence of a fracture of a phalanx or metacarpal pt. pos: standing or sitting prac. pos: standing in front of pt. procedure: light tap with the pad of one finger is applied through the long axis of the phalanx or metacarpal. the finger can be flexed at the PIP or MP joints and tapped there for proximal segments positive: pain long the shaft of the bone

Question 61

Murphy’s sign

Answer 61

purpose: dislocation of the lunate carpal bone pt. pos: standin or sitting with hand in fist. prac. pos: standing in front of pt. procedure: pt is instructed to make a fist. observe 3rd MCP joint (knuckle) positive: 3rd MCP joint will be lower or equal level to all the other joints (knuckles)

Question 62

march test

Answer 62

purpose: si joint dysfunction pt. pos: standing Prac. pos: standing or sitting behind pt. with both thumbs over the SI joint procedure: pt is instructed to alternately raise one knee to the chest and prac. will note the movement of SI joint positive: no movement or unilateral asymmetry in movement

Question 63

Trendelenburg test

Answer 63

purpose: weakness in glute medius or involvement of superior gluteal nerve pt. pos: standing Prac. pos: sitting behind pt. procedure: pt is instructed to alternately lift one knee to their test while prac. observes hip jolting out positive: hip jutting laterally or pt is leaning to involved side

Question 64

heel and toe walking

Answer 64

purpose: neurological involvement/ motor function of lower extremity pt. pos: standing Prac. pos: standing next to pt. procedure: have pt. walk on their toes and then walk on their heels positive: inability to perform the procedure

Question 65

stork standing

Answer 65

purpose: check for proprioception pt. pos: standing Prac. pos: standing next to pt. procedure: have the pt. lift one leg and check for balance positive: inability to perform the test, unable to balance

Question 66

hip distraction test

Answer 66

purpose: apprehension due to an unstable hip or osteoarthritis or ligamentous issue pt. pos: supine with test hip flexed to 30 degrees, slightly abducted and slightly externally rotated Prac. pos: at foot of pt.; holding ankle with both hands procedure: a distraction force is applied just to the point of the pt. beginning to move positive: apprehension with distraction= unstable hip or ligamentous relief of pain= osteoarthritis or leg calf perthes or OCD

Question 67

hoover test

Answer 67

purpose: malingering or lying pt. pt. pos: lying on table Prac. pos: at foot of pt. both heels of pt. cupped in prac. hands procedure: pt is instructed to raise one leg positive: failure of the opposite leg to push down on the prac. hand indicated a sub maximal effort

Question 68

SLR test

Answer 68

purpose: neurological involvement in lower extremity pt. pos: supine with hip flexed Prac. pos: standing next to pt. one hand maintaining knee extension and the other on the distal leg procedure: hip is passively extended to the end of the range of motion. combination movements may be added such as the chin to the chest and/or dorsiflexion positive: shooting pain, numbness, tingling. pain in the lumbar spine = then it would be indicative of bulging disc

Question 69

well SLR test

Answer 69

purpose: neurological involvement in the lower extremity pt. pos: supine with hip flex Prac. pos: standing next to pt. one hand maintaining knee extension and the other on the distal leg procedure: the hip passively extended to the end of the range of motion. combination movement may be added such as the chin to the chest and/or dorsiflexion positive: shooting pain, numbness, tingling down the non-test leg

Question 70

bowstring test

Answer 70

purpose: neurological involvement of tibial nerve or common perineal nerve pt. pos: supine Prac. pos: at foot of pt. procedure: perform a SLR to the point of pain, flex the knee until pain is relieved then apply pressure to the popliteal fossa with the practitioner’s thumb positive: reduced to eliminated pain with knee flexion that returns with popliteal pressure

Question 71

pelvic compression

Answer 71

purpose: SI joint dysfunction pt. pos: supine Prac. pos: standing next to pt. arms are crossed and placed on ASIS of pt. procedure: downward and outward pressure is applied uniformly on ASIS positive: posterior pain along the SI joint

Question 72

pelvic distraction

Answer 72

purpose: si joint dysfunction pt. pos: supine Prac. pos: next to pt. hands placed on superior portion of gluteus Maximus procedure: prac. raises both hands, spreading the SI joint positive: pain in the SI region

Question 73

FABER/ Figure 4/ Patrick’s test

Answer 73

purpose: SI joint dysfunction or tight hip flexors pt. pos: supine with ankle crossed above opposite knee, flexion, abduction, and external rotation (FABER) Prac. pos: standing next to pt. one hand on crossed knee, one hand on opposite asis procedure: pressure is applied at the knee and asis simultaneously positive: posterior pain= SI joint dysfunction, anterior pain= tight hip flexors

Question 74

Thomas test

Answer 74

purpose: tight hip flexors pt. pos: supine with legs hanging off the table, knees flexed to 90 degrees Prac. pos: standing next to pt. procedure: pt is instructed to bring knee to chest and lean back onto table positive: opposite leg lifts from table flexing at the hip

Question 75

Pubic symphysis

Answer 75

purpose: ascertain problems in the pubic symphysis or SI joint pt. pos: supine Prac. pos: standing next to pt.; heel of hand is moved from the umbilicus to the pubic symphysis procedure: downward pressure is applied to the pubic symphysis positive: pain in the pubic symphysis or SI joint, indicating pelvis involvement

Question 76

piriformis test

Answer 76

purpose: tight piriformis or tibial/ common peroneal nerve (sciatic nerve) pt. pos: supine Prac. pos: standing next to pt. procedure: pt. knee is taken to the opposite shoulder and the foot is then internally rotated positive: increased pain in the area of the piriformis or any neurological symptoms= nerve involvement

Question 77

FADIR

Answer 77

purpose: femoral acetabular joint impingement pt. pos: supine Prac. pos: standing next to pt. one hand on flexed knee and the other no the ankle of the same leg in a motorcycle grip procedure: knee is taken into full flexion and moved by the prac. to opposite shoulder. leg is then taken into internal rotation positive: deep pain, clicking or limited range of motion indicated the necessity of x-ray to confirm diagnosis

Question 78

babinski test

Answer 78

purpose: neurological deficit or impairment pt. pos: supine or siting with legs extended Prac. pos: at foot of pt. procedure: a finger or hard object is run along the bottom of the foot from first toe to lateral foot towards heel positive: toes should curl or do nothing. splaying or extension of the toes indicate a positive result

Question 79

Oppenheim test

Answer 79

purpose: neurological deficit or impairment pt. pos: supine or sitting Prac. pos: at foot of pt. procedure: a finger or hard object is run along the rest of the tibia positive: same as for babinski. toes should curl or do nothing. splaying or extension of the toes indicate a positive result

Question 80

milgram’s test

Answer 80

purpose: to determine muscular strain of the low back pt. pos: supine Prac. pos: at foot of pt. procedure: pt is instructed to hold both legs in the air for 30 seconds positive: inability to perform the procedure due to back pain

Question 81

Beevor’s sign

Answer 81

A purpose: determine the presence of a neurological or muscular disorder of the abdomen/ lumbar spine pt. pos: supine with hands behind head Prac. pos: at foot or next to pt. procedure: have pt perform a sit up positive: the umbilicus should stay in a straight line. side to side movement is a positive

Question 82

springing test of back

Answer 82

purpose: check for hyper or hypo-mobility of an individual vertebrae pt. pos: prone Prac. pos: standing next to pt. the pisiform of the hand is placed on the spinous process of each vertebrae sequentially in the lumbar spine procedure: anterior/ posterior movement in very small increments is initiated with differences noted in movements of each individual segment positive: a level with extreme motion or lack of motion as compared to other levels

Question 83

active spinal extension

Answer 83

purpose: to determine muscular involvement of the low back pt. pos: prone with hands behind the back Prac. pos: next to pt. procedure: have the pt. move into active spinal extension positive: pain with movement or inability to complete maneuver

Question 84

sphinx position (done after active spinal extension)

Answer 84

purpose: to determine the possibility of a spondy (spondylosis, spondylolisis, spondylolisthesis) pt. pos: prone with elbows on table Prac. pos: next to pt. procedure: have the pt. extend the spine using their arms on the able positive: pain directly over the spine

Question 85

spondyloysthesis’s test

Answer 85

A purpose: check for spondylolisthesis or slippage of the vertebrae pt. pos: side lying with both knees flexed Prac. pos: standing in front of pt. one hand under both knees the other hand on the lumbar spine procedure: knees are taken into flexion and extension and the lumbar spine is palpated at each vertebral level positive: vertebrae that does not line up with the others with flexion and extension

Question 86

Ober’s test

Answer 86

purpose: IT band syndrome pt. pos: side lying on the table Prac. pos: standing behind pt. one hand may be placed on the distal leg and the other could stabilize the pelvis procedure: pt is instructed to let top leg hang over the back of the table positive: inability to adduct; pain; asymmetry

Question 87

noble

Answer 87

purpose: IT band syndrome pt. pos: side lying on table Prac. pos: standing behind pt. one hand on the distal leg, one thumb on the IT band, 2-4 cm proximal to the knee procedure: the knee is alternatively flexed and extended while the force is applied with the thumb proximal to the knee positive: pain, particularly at 30 degrees of flexion

Question 88

femoral nerve traction test

Answer 88

purpose: determine involvement of the L2-L4 nerve roots or femoral nerve irritation pt. pos: side lying Prac. pos: standing behind pt., with top of pt’s foot on hip, one hand on the knee and the other on the PSIS for stabilization procedure: the knee is passively flexed and the hip extended simultaneously positive: pain, shooting pain, numbness, tingling