Joint Specific Examinations Upper Extrem. and Spine Flashcards
1
Q
Describe the supine straight leg test
A
- patient lies supine on table and examiner lifts each straight leg until maximal hip flexion is reached or patient complains of increased pain
- note the angle necessary to reproduce pain
- tests for nerve root impingement (sciatica)
1
Q
Describe the sitting straight leg test
A
- patient sits on exam table with legs over edge
- examiner straightens leg until knee is fully extended
- tests for nerve root impingement (sciatica)
2
Q
Describe the crossover straight leg test
A
- this is the straight leg test, but pain (if present at all) is felt in the contralateral leg
- tests for nerve root impingement
3
Q
Describe the dorsiflexion test
A
- With leg elevated to the point of pain, dorsiflex the ankle
- this increases sciatic tension
- note where pain is felt and how far it radiates
- tests for nerve root impingement
- AKA “Lasegue’s Test”
4
Q
Describe Kernigs Test
A
- flex hip and knee to 90’ at chest
- then attempt to extend the knee
- (this motion is like a hamstring stretch)
- this is actually a meningeal irritation test, but we’re using to increase sciatic tension to test for nerve root impingement
5
Q
Describe the Yergason’s Test
A
- patient’s shoulder is in anatomical position with elbow flexed to 90’ and the forearm pronate
- while you have a hand on patient’s biceps tendon, have patient flex and supinate against resistance
- Positive: feel a snapping or popping; means patient has a tear, laxity, or bicipital tendinitis
6
Q
Describe Speed’s test
A
- patient’s arm is flexed to 90’ with elbow extended and supinated
- patient holds position against downward resistance
- positive = pain; indicates bicipital tendinitis
7
Q
Describe the Drop-Arm Test
A
- patient passively abducts fully-extended arm to 90’
- release the arm and ask patient to hold it there
- can also apply downward pressure
- tests for rotator cuff strength
7
Q
Describe the Apprehension test?
A
- patient’s arm is slowly abudcted and externally rotated
- Positive: patient feels apprehension; may indicate an anterior glenohumeral instability
8
Q
Describe the relocation test
A
- patient lies supine with shoulder flexed to 90’, abducted to 90’, externally rotated, and elbow flexed to 90’
- posteriorly directed force is applied on the anterior aspect of the patient’s shoulder
- positive: apprehension; confirms impression of anterior shoulder instability
8
Q
describe the throwers test
A
- similar to apprehension test, but done with posterior resistance on patient’s palm
- do this when a patient has had a dislocation and you’re suspecting a HAGL tear
- positive: reproduces anterior capsule pain; indicates anterior capsular laxity
9
Q
Describe the Rowe test
A
- patient’s arm is passively pulled inferiorly as it hangs by patient’s side
- positive: sulcus sign; indicates multidirectional joint laxity
9
Q
describe the empty can test
A
- have patient forward flex shoulder, abduct about 45’, and internally rotate so thumbs are pointing down (emptying cans) against resistance
- positive: pain; may indicate tendon irritation, impingement, or tear of the supraspinatus muscle
10
Q
describe the Hawkins impingement test
A
- patient forward flexes shoulder and elbow to 90’ so forearm is parallel to the body and the floor
- passively internally rotate the shoulder while keeping the arm in the forward flexed position
- positive: pain; may indicate rotator cuff, A/C joint, subacromial bursa, or coracoid ligament pathology
10
Q
describe the neer impingement sign
A
- patients passively flexes shoulder to complete end point of movement while stabilizing the patient’s scapula with the other hand
- positive: pain
- tests for rotator cuff, A/C joint, subacromial bursa, or coracoid ligament pathology
11
Q
Describe Yocum’s test
A
- patient places the hand of the affected side on the shoulder of the unaffected side, then raises the elbow with out elevating the shoulder
- tests for shoulder impingement
11
Q
Describe the O’brien’s test
A
- patient forward flexes shoulder to 90’ with elbow extended, then brings the arm an additional 15’ toward the midline
- patient then maximally internally rotates (thumb down) and externally rotates (palm up)
- patient then resists a downward force
- positive: pain
- Tests for A/C or glenoid labrum pathology
12
Q
describe the passive cross-chest adduction test and what it tests for
A
- arm is passively brought into maximal cross-chest adduction
- positive: pain; may indicate A/C pathology or posterior capsular tightness
