Lecture4 - Special Tests, Accessory Movements and Palpations

Question 1

Special tests are determined and performed based on:

Answer 1

History

Observations

Rule Outs

Results of Functional Testing

Question 2

Special tests are designed to test ___ structures

Answer 2

Unique

Question 3

To determine a neurological problem:

Answer 3

Myotome and dermatome testing

Deep tendon reflex testing
-Biceps

Local nerve testing
-Tinels

Upper motor neuron tests can be done
-Babinski

These may be done in a neurological scan before the functional tests if indicated in the history.

Question 4

Explain what accessory movement are.
How can they be achieved?
Voluntary or Involuntary Control?

Answer 4

Small joint movements which can only be achieved passively

Not under voluntary control

Necessary for a full painless range of motion

Sliding, translations, and glides within the joint

We need to know if there is hyper or hypo mobility of the accessory movements

Example: with shoulder abduction there is a inferior glide to prevent impingement

Question 5

Testing the accessory movements are important when:

Answer 5

there are limitations with passive movement

there is pain with passive movement

Question 6

Causes of Hypomobility of Accessory Movements:

Answer 6

Swelling

Prolonged immobilization of a joint

Severe trauma

• Fracture
• Dislocation

Question 7

Why do we palpate?

Answer 7

Determine if there is inflammation

• Amount?
• Type?

Compare to opposite side

• Atrophy
• Tone

Determine if there are any adhesions

• Scars
• Previous injuries

Locate trigger points

Locate muscle spasm

Determine if there is any tendon enlargement

Feel for crepitus with movement

Determine if ligament or bone is tender

Check for pulses

Question 8

When can special proprioception and coordination tests be done?

Answer 8

After active, passive, special tests you still aren’t able to replicate the pain. Then propio can come into play to help provoke pain. No cookie cutter method doesn’t always have to go this way