Lab final

Question 1

O’Brien SIgn

Answer 1

Pain: If deep it indicates a labrum tear, if superficial indicates AC joint Problem

Arm out straight in front of patient with thumb down, 10-15 degrees adduction toward the midline. push down while patient resists, if painful then supinate the hand and repeat

Question 2

Anterior slide test

Answer 2

Popping, cracking, or crepitus is noticed with pain on the antero-superior aspect (top front) of the shoulder indicating superior/ant Glenoid labrum tear

hand on hip, thumb facing backwards, push elbow up and forwards stressing the GH joint.

Question 3

Anterior apprehension with relocation (Jobe relocation)

Answer 3

Patient senses relief upon relocation confirming anterior instability of the GH (Ant appr = chronic anterior dislocation of GH) rules out tendinitis as false positive)

Supine ant apprehension test, after positive push A-P on the GH joint.

Question 4

Neer Test

Answer 4

Pain at the end of motion indicating impingement with overuse injury of the supraspinatus muscle or biceps tendon

Full passive shoulder flexion

Question 5

Hawkin Kennedy Test

Answer 5

Local pain dinicating supraspinatus tendinitis and impingement, Anterior pain = Anterior impingement syndrome, Posterior pain = posterior impingement syndrome

This is the test where you hook your arm under and over there’s

Question 6

Patte test (hornblower sign)

Answer 6

Pain or inability to actively externally rotate against resistance due to weakness indicating infraspinatus or teres minor tendinopathy

shoulder 90, elbow 90, stabilize elbow, have patient try to externally rotate and provide resistance

Question 7

empty can test

Answer 7

if weak it indicates a tear or rupture of the Supraspinatus muscle or tendon with possible suprascapular neuropathy

arm out to side straight, then bring 40 degrees forward keeping shoulder at 90 push down and forwards while patient resists

Question 8

Lift off test

Answer 8

inability to actively life the hand off or away from the back indicating a subscapularis tendinopathy

Question 9

sulcus sign with load and shift

Answer 9

if sulcus appears 1 cm= grade 1, 2cm= grade 2, 3cm= grade 3

Pull down on arm from the elbow, then move the Humeral head back and fourth

Question 10

Mazion shoulder maneuver:

Answer 10

inability to actively raise the elbow to the forehead due to pain and/or stiffness indicating adhesive capsulitis or non inflammatory capsular adhesions

place hand on opposite shoulder, bring elbow to forehead

Question 11

maximum elbow flexion test/ compression test

Answer 11

patient would hold for up to 3 minutes. looking for reproduction of paresthesia’s into the ulnar nerve distribution with possible weakness on handshake (power grip) indicating cubital tunnel syndrome (ulnar nerve entrapment)

Just have patient fully flex at the elbow and hold

Question 12

valgus overload test of the elbow

Answer 12

pain in the posterior elbow with a reproduction of a locking or catching sensation or an inability to fully extend the elbow due to pain indicating posterior elbow impingement syndrome

elbow at 90, add valgus stress and extend

Question 13

reverse mills

Answer 13

pain over the medial elbow indicating medial epicondylitis or golfers elbow

Question 14

Froments paper sign

Answer 14

the patient flexes the thumb during the test indicating weakness or palsy of the adductor pollicus muscle - innervated by the ulnar nerve

Question 15

hip impingement sign

Answer 15

sharp anterior catching hip pain indicating hip impingement syndrome

patient supine, hip flexed to 90, hug the thigh and internally rotate the femur

Question 16

modified ober

Answer 16

the hip does not angle down to the floor indicating tight TFL (possible contracture) with possible IT band syndrome

Question 17

test for synovial plica (patellar bowstring)

Answer 17

popping snapping clunking, ginding or stuttering of the patella. medail patella pain is medial knee synovial plica syndrome, lateral patella pain is lateral is lateral knee synovial plica syndrome

patient on side, involved side up, knee placed in 30 degrees flexion, doctor internally rotates the lower leg then pushes lateral to medial and then extends the knee, then repeats the motion with external rotation and a medial to lateral force applied before extending the knee

Question 18

noble test

Answer 18

worse pain through 30/40 degrees of flexion/extension (painful arc of the knee), Indicates IT band syndrome or lateral knee impingement syndrome

Question 19

Godfrey “sag” sign of knee

Answer 19

the tiba sags at the knee indicating a tear or sprain of the PCL

Knee and hip at 90 while patient is supine, look at the tibia

Question 20

Dreyer Sign

Answer 20

inability to raise the leg with peri-patellar pain without compression, and ability to raise the leg once you compress the quad tendons indicates patella fracture

Question 21

Distal tibio-fibular squeeze test

Answer 21

pain is reproduced either while squeezing or while releasing indicates a high ankle sprain of the tibio-fibular ligament and or the interosseous syndesmosis

Question 22

fat pad sign

Answer 22

pain diminishes when the heal is squeezed indicating fat pad syndrome, if pain remains could be plantar fasciitis, heel spur, or calcaneal stress fracture

Question 23

test for plantar fasciitis

Answer 23

sharp pain along the medial longitudinal arch indicating plantar fasciitis