Hand Tingling Wk 6 Flashcards
Roos Test aka?
aka Elevated arm stress test
seated. bring arms and elbows to 90. open and close fists rapidly up to 3 min
-ischemic pain, heaviness of arms, or numbness and tingling of hand indicates thoracic outlet syndrome on side involved
Adsons Test aka?
aka scalene maneuver and scalenus anticus test
seated. establish radial pulse. then bring arm straight and back past body. tell patient to look up(brings scalenes over neurovascular bundle) then rotate to currently tested shoulder. then take breath and hold. then turn and look to other side.
-pain and/or parathesia, decreased or absent radial pulse, pallor indicates compression of neurovascular bundle by scalenus anticus or cervical rib
Halstead Maneuver
seated. find radial pulse. traction arm downward. have patient look up. turn and look away from me
- pain and/or parasthesia, decreased or absent pulse, pallor indicates compression of the neurovascular bundle by scalenus anterior or cervical rib
Eden aka?
aka Costoclavicular manuever
seated. establish radial pulse. tell patient to sit up, shoulders back, chest out, touch chin to chest and hold breath
-pain and/or parathesia, decreased or absent pulse, pallor indicates compression of the neurovascular bundle between the clavicle and first rib
Hyperabduction maneuver aka?
aka Wright Test
establish radial pulse and slowly hyperabduct the arm
-pain and/or parathesia, decreased or absent pulse, pallor indicates compression of the axillary artery by pectoralis minor or coracoid process, thoracic outlet syndrome
Soft Tissue Palpation Shoulder
- rotator cuff muscles as group
- supraspinatus
- infraspinatus
- teres minor
- subscapularis - subacromial bursa
- subdeltoid bursa
- axillary borders
- pec major
- serratus anterior
- axillary lymph nodes
- latissimus dorsi
- bicipital tendon - SCM
- biceps
- deltoid (ant, middle, post)
- traps
- Rhomboid major and minor
Bony Palpation of Shoulder
- sternoclavicular articulation
- clavicle
- coracoid process (birds peak)
- acromioclavicular articulation
- acromion
- greater tuberosity of humerus
- bicipital groove
- lesser tuberosity of humerus
- spine of scapula
- body of scapula
- scapulothoracic articulation
ROM shoulder
flexion 180 extension 60 abduction 180 adduction 50 external rotation 90 internal rotation 70 scapular protraction, retraction, elevation
Dugas Test
ask pt to grab opposite shoulder and compress elbow to chest
-inability to touch the opposite shoulder and/or inability of the elbow to touch the chest indicates acute dislocation of the glenohumeral joint
Anterior Apprehension Test
stabilize back of shoulder, bring arm to 90 at shoulder and elbow, hold just below wrist, forearms together, bring into external rotation and WATCH FACE
-pt will have noticeable look of apprehension or alarm on their face with possible pain indicates chronic anterior dislocation of glenohumeral joint
Posterior Apprehension Test
pt supine, bring to 90 at elbow and shoulder, have humerous straight up. press A to P and internal rotation (towards you)
-pt will have look of pain or apprehension on face with possible pain indicating chronic posterior dislocation of glenohumeral joint
Drop Arm Test aka
-aka Codman test
abduct the arm slightly higher than 90 and have them hold, then slowly lower arm
-pt has an inability to hold their own arm and/or arm drops suddenly indicates rotator cuff tear, usually supraspinatus
Dawbarn Test
palpate subacromial bursa, then abdcut arm to greater than 90
-decrease in pain and/or tenderness indicates subacromial bursitis
Yergason Test
- have pt with elbow at 90 and in thumbs up position. have them show you the arc motion (supination) pull down on arm then have them do arc motion with active resistance
- localized pain/tenderness at the bicipital groove indicates bicipital tendonitis OR audible click or biceps tendon subluxes or dislocates indicates instability of biceps tendon possibly associated with torn transverse humeral ligament
Abbott-Saunders Test
find groove for biceps groove (rotate forearm to find) then bring arm into full abduction (180), external rotation(palm facing midline), then slowly lower arm
-palpable or audible click indicates subluxation or dislocation of the biceps tendon, rupture of transverse humeral ligament or tendon subluxation beneath subscapularis muscle belly
Speed Test
have pt elbow flexed palm facing up, raise up. palpate groove for biceps tendon, have them do raising motion with resistance
-pain and/or tenderness in the bicipital groove indicates bicipital tendonitis
Apley Test
ask pt to scratch opposite shoulder behind head, then ask pt to touch bottom of opposite shoulder behind back
-exacerbation of pain indicates degenerative tendonitis of rotator cuff tendons usually supraspinatus
Impingement Sign
start with arm straight and slightly abducted, take into full glenohumeral flexion, stabilze posterior aspect of shoulder
-pain in the shoulder indicates overuse injury to the supraspinatus and possibly biceps tendon
Crude touch
ask pt to identify when they’re being touched with dull end of neurotip in 5 dermatomes
-inability spinothalamic involvement
Pain (pinprick)
ask pt to say when they feel touch with the pin of neurotip
-inability is spinothalamic involvement
Vibration/ Pallesthesia
place handle of vibrating 128 fork on bony parts of extremities. tell them to say when they feel and when it stops
-inability is dorsal column involvement
Light Touch
say when you feel the touch of cotton swab
-inability is dorsal column involvement
Joint position sense
stabilze lateral surface of fingers or toes and them them what is up and what is down. then ask them to close eyes and tell you if they’re up or down. DIP PIP MCP
-inability is dorsal column
Romberg Test
ask pt to stand with feet shoulder width and eyes closed
-swaying or falling is dorsal column involvement
Topognosis
aka point location
ask pt to identify multiple points the dr touches them with dull end of neurotip
sharp vs dull
ask pt to identify whether its the sharp or dull end of tip
Stereognosis
ask pt to identify familiar objects with eyes closed
graphesthesia
ask pt to identify letters and numbers traced on skin
barognosis
ask pt to identify difference between to objects
two point discrimination
touch pt with paperclip opened wide enough that two separate stimuli are felt, then bring them closer together until one is felt, repeat 3 locations
double simultaneous stimulation
touch patient on each side individually then same points at same time bilaterally
- extinction=only 1 side felt
- displacement=one side is felt normal and the other displaced toward midline
- synesthesia= one side is felt normal and the other is vague burning
Adam Sign
pt standing,inspect for scoliosis, then bends forward at waist with fingers extended, hands together
-a C or S shape is observed to straighten indicates a negative and is evidence of a functional scoliosis, trauma or subluxation. a C or S shape that does not straighten indicates a positive for evidence of a pathologic or structure scoliosis
Schepelmann Sign
pt seated, arms fully abducted and raised overhead, instruct pt to laterally flex to left then the right
-pain on the concave side indicates intercostal neuritis while pain on the convex side indicates fibrous inflammation of the pleura or possible intercostal myofascitis
Beevor Sign
supine, instruct pt to cross arms across chest and perform partial situp
-superior movt of umbilicus indicates of spinal cord lesion at T10 or lower ab weakness. inferior movt of umbilicus is indicative of nerve root involvement T7-T10
Diadochokinesia akas/types
aka patting test
rapid alternating movement as fast as possible
aka supination/pronation test
pronate and supinate as fast as possible
Dysmetria aka/types?
index finger test-
touch nose, then drs finger in all quadrants, note for tremors or lack of coordination
heel-shin test–
run heel down shin
Tandem giat
have pt walk heel to toe like DUI test
Forced gait
ask pt to walk on heels 6 steps and toes 6 steps
Orientation
ask name date location
level of alertness, attention, cooperation
ask spell a word forward and backward
ask them to reapeat integers forward and backward
ask them to name months forward and backward
recent memory
ask them to recall items after 5 min
remote memory
ask them where they went to high school
object naming
ask pt to name 3 shapes
repetition
ask pt to repeat words of a sentance
reading
ask pt to read sentance
calculations
ask simple 3 step calculation
what is 2 times 3 plus 4
apraxia
ask pt to pretend to comb hair
sequencing taks
ask pt to tap table with rock paper scissors in that order
abstraction
ask pt to interpret early bird gets the worm
