Last practical Flashcards
Causes of Thoracic Outlet Syndrome
Cervical Rib
Scalenus Anticus/Medius problem
Costcoclavicular Syndrome
Pectoralis Minro Problem
ROM for Cervical Neck
Flexion 60
Extension 75
Lateral Flexion 45
Rotation 80
Rust’s Sign
Upper Cervical Instabillity
Libman’s Test
Press on Mastoid- Pain threshold
Bakody’s Test
LOWER brachial plexus, POSITIVE if pain allivieted
Reverse Bakody’s Test
Worse pain in Bakody’s sign- THORACIC OUTLET SYNDROME
Bikele’s Test
Abduct should to 90, Brachial Plexus Lesion
Brachial Plexus Tension Test
Hands behind head and pulling on elbows; Brachial Plexus lesion
Valsalva’s Test
Ask patient to bear down; SPACE OCCUPYING LESION
Dejerine’s Triad
SPACE OCCUPYING LESION
Herniated IVD
Spinal Cord tumor
Spinal Compression
Swallowing Test
Have patient swallow liquid, positive if pain in doing so
S.O.L., Sprain, Strain, Fracture, Disc Protrusion, Tumor, or Osteophyte @ Anterior portion of cervical spine
Naffzigner’s Test
Test Doctor stands behind patient and occludes the EXTERNAL JUGULAR VEINS @ level of CLAVICLE, then ask patient to cough
- NOT for cardiac patients
- Purpose is to find a pooling of venous venous sinuses that will cause an increase in CEREBRAL SPINAL FLUID PRESSURE- Positive + Sharp accentuating level at level of lesion
Barre-Lieou Test
Instruct patients to rotate their head back and forth as fast as thy can- any symptoms associated with this procedure is a positive.
Vertebrobasilar Functional Maneuver
To rule out vascular insufficiency
Auscultate Carotid and subclavian on both sides of patient–if no asymmetry/bruits exist instruct patient to EXTEND AND ROTATE their head and tell the to count from 20 down by 1’s
DeKleyn’s Test
Vetebrobasilar artery Insufficiency;
Patient is supine and doctor stimulates ROM
Distraction Test
Cup occiput with web of hand and palm on forehead and lift upwards; Decrease pain is IVF encroachment
Foraminal Compression Test
Neutral Compression; IVF Compression
Jackson’s Compression Test
Laterally Bend head both head and press down; IVF compression
Maximum Cervical Compression Test
Patient turns head and looks up and down without passive influence of doctor
IVF Encroachment. Pain on opposite side-Strain
Spurling’s Test
Couples ROTATION AND LATERAL FLEXION for compression
Lhermitte’s Test
Tucking chin to chest passively by doctor ; cord inflammation usually of C4/C5
O’Donahue’s Cervical Test
Patient flex/extends/laterally bends with doctor holding head in place
Sprain/Strain
Kernig’s Sign
Patient is supine and doctor flexes hip and knee to 90* THEN extends leg; meningitis
Brudzinski Test
Patient is supine and doctor flexes head; meningitis
Shoulder Depressor Test
Depress shoulder while stabilizing the cervical region; IVF encroachment
Soto Hall Test
Patient is supine chin to chest- resist with hand on sternum can be active or passive
Allen’s Test
Patient holds up hand with elbow flexed at 90*, pumps hand 5 times, doctor hangs on to both ULNAR AND RADIAL ARTERY —> Extend elbow down release occlusion of radial first THEN CHECK bilateral side THEN ULNAR pulses
Adson’s Test
Doctor holds onto radial pulse–> patient then turns head to SAME SIDE and extends head back and patient holds breathe, CHECK for change in pulse
Modified Adson’s Test
Doctor holds onto radial pulse–> patient then turns head to OPPOSITE SIDE and extends head back and patient holds breathe, CHECK for change in pulse
Halstead’s Test
Feels pulse of radial artery while extending arm at elbow joint. patient turns head away and holds breathe
Allen’s Maneuver Test
Check pulse, raise are to side (WITH elbow at 90*), Head turned AWAY, looking for amplitude decrease
Roos’ Test
Patient holds BOTH hands up with elbows flexed at 90* ( Stick’em up position) and holds position for 60 seconds THEN PATIENT PUMPS HANDS for 3 minutes —> looking for pain while performing maneuver
Wright’s Test
Feel radial pulse and raise arm with elbow fully extended and hyper-ABduct arm, note where and if pulse decreases. Check bilaterally
Costoclavicular Maneuver Test
Grab radial pulse on both sides from behind patient, extend elbows and brings arms backwards (extending shoulders), checking for change in AMPLITUDE, PATIENT FLEXES HEAD FORWARD
Apley’s Scratch Test
Checking for shoulder RANGE OF MOTION (ROM)
1st arm from above THEN opposite arm
2nd from BELOW THEN opposite arm
-Common finding include a greater ROM in non-dominant hand
+ Test: Rotator Cuff injury, usually SUPRASPINATOUS TENDON
Apprehension Test
Passively abduct arm and externally rotate with elbow at 90*,
THEN have patient lay down and doctor brings arm across body elbow flexed and doctor pushes straight down on arm
-Patient will be apprehensive as a positive because it will feel like the shoulder is going to dislocate again
+ Test: Anterior Shoulder dislocation
Codman’s Arm Drop Test
Brings arm up with the THUMB DOWN and quickly releases arm once the patents arm is at 90*; patient should be able ‘to catch’ it with minor recoil down and up
+Test: SUPRASPINATOUS TENDON INJURY
Dawbarn’s Test
Doctor pinches area around shoulder joint FIRST, Then abducts arm with palm down and with elbow is straight/fully extended, ask if there is any pain while performing the passive movement
+ Test: SUBACROMIAL BURSITIS
Dugas Test
Patient grabs opposite shoulder by hand and doctor presses elbow into patients chest
+ Test: Possible Joint dislocation
Impingement Test
Bring arm up with elbow extended; ask patient if this passive motion illicit any pain
+ Test: BICIPITAL TENDONITIS, Supraspinatous oversue, or possible Degenerative Joint Disease
Speed’s Test
Have patient flex elbow against resistance of Doctor’s stabilization at wrist, allow patient to move arm by flexing shoulder through ROM
+ Test: BICIPITAL TENDONITIS
Supraspinatus Press Test
Abduct shoulder passively with elbow fully extended and THUMB DOWN. THEN have patient resist downward motion provided by doctor (similar to muscle test of supraspinatous)
Yergason’s Test
Yergason’s Test- Doctor places one hand pinching shoulder while the other hand is being held by the patient.
Elbow is FLEXED, Forearm SUPINATES doctors hand, Doctor externally rotates arm while feeling for a CLICK in shoulder
+ Test: TRANSVERSE HUMERAL LIGAMENT and/or Bicipital TENDONITIS
Load and Shift Test-
Doctor places one hand on trap/shoulder while the other hand
FIRST pulls down on arm–> LOOKING for SULCUS SIGN
THEN push shoulder up, forward and pull backwards feeling for laxity
+ Test: Supporting ligaments of shoulder
O’Brien’s Test
Have patient cross arm 30* (CROSSING STERNUM, to PERFORM CORRECTLY) with elbow extended and lift shoulder up THUMB UP FIRST and doctor will press against patients arm to test resistance
THEN perform same with THUMB DOWN; ask patient which hurts worse
+ Test: Labral region of shoulder joint
Lift off Test
Patient brings arm backwards with elbow slightly flexed. Doctor is seeing if the patient can move hand away from back in both arms equally on both sides
+ Test: Supporting ligaments of shoulder
Elbow Flexion Test
Instruct patient to flex both elbows with hands going towards shoulders; ask patient if hold position illicit and pain, numbness, or tingling
+ Test: Cubital Tunnel Syndrome
Tinel’s Test at the Elbow
Elbow extended
Tapping 1-2 inches above and below medial and lateral side of elbow;
Ask patient if any of 4 sights per arm illicit any radiating pain/numbness/tenderness/tingling in arm
+ Test either Ulnar or Radial Nerve
Cozen’s Test
ARM ON LAP with PRONATED GRIP AND WRIST/HAND UP
Doctor has hand on dorsum of hand and the other holding onto cubital fossa
Doctor instructs patient to resist and doctor tries pressing down
+ Test for Lateral Epicondylitis
Golfer’s Elbow Test
ARM ON LAP with SUPINATED GRIP and WRSIT/HAND UP (FLEXED)
Doctor has hands on patient’s hand and proximal forearm
Doctor instructs patient to resist and doctor tries pressing down
+ test Medial Epicondyle
Lift Test
Patient hold forearm out in space and doctor stabilizes forearm with both hands
Instruct patient to grab sandbag and EXTEND WRIST FIRST
SECOND patient will supinate hand and FLEX WRIST
Ligament Instability Test
Doctor extends patients elbow and presses on patients elbow both laterally and medially
Stressing LATERAL COLLATERAL–> VARUS STRESS
Stressting MEDIAL COLLATERAL –VALGUS STRESS
Mill’s Test
Have patient “Make a muscle” with flexed wrist
forearm is pronated and extended
After “Make a muscle” move have patient turn hand away from them and extend elbow
After elbow is extended have patient bring arm backwards
Doctor may passively flex wrist further if no pain is illicit when arm is behind shoulder
+ test LATERAL EPICONDYLE
