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midterm tests Flashcards

1
Q

log roll

A

Nonspecific to central and peripheral compartments

Roll the patient’s leg into internal & external rotation

(+) Test= Pain with motion

*A negative test does not exclude hip pathology
Indicates: central or peripheral compartment pathology

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2
Q

C-sign

A

ctr compartment

Patient characteristically points to the source of pain with two fingers or cups just above the trochanter with the thumb and index finger

Indicates: Labral pathology

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3
Q

labral loading

A

ctr compartment

Flex the patient’s knee and hip to 90 degrees, load into the femur towards the innominate

(+) Test= pain in hip or low back

Indicates: Labral or cartilaginous pathology

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4
Q

labral distraction

A

ctr compartment

Distract patient’s femur away from innominate

(+) Test= Improvement of pain

Indicates: Labral or cartilaginous pathology

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5
Q

scour

A

ctr compartment

Flex and externally rotate patient’s hip. Load into socket and articulate through annular range of motion.

(+) Test= Pain

Indicates: Labral or articular cartilage pathology

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6
Q

apprehension: FABER

A

ctr compartment

Pt hip flexed, abducted, externally rotated. Doctor induces further external rotation by applying a posterior force at the knee

(+) Test= anterior subluxation of hip or apprehension/pain, impingement

Indicates: Anterior labral pathology

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7
Q

Ely’s test

A

peripheral compartment

Patient prone, passively flex patient’s knees

+ Ipsilateral hip raises off table

Indicates: Rectus femoris contracture

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8
Q

Rectus Femoris Test

A

peripheral compartment
Patient supine. One hip flexed up to the chest. The other leg
bent over the edge of the table

(+) Test= knee flexion < 90° while thigh flat on the table

Indicates: Rectus femoris contraction ipsilaterally

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9
Q

Jump Sign

A

lateral compartment

Patient is seated, pressure is applied to greater trochanter

(+) Test= patient withdraws or “jumps” with pressure

Indicates: Trochanteric bursitis

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10
Q

Straight Leg Raise Test

A

lateral compartment

Raise the leg with knee extended, nonspecific test

(+) Test= Pain

Indicates:
Pain from 15°‐30° – Lumbar disc etiology
Pain laterally >15° – Lateral compartment pathology (As the
IT band passes over the greater trochanter)

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11
Q

Ober’s Test

A

lateral compartment

Patient lateral recumbent with doctor standing behind the
patient. Doctor abducts the top leg and then lowers leg to the
table while stabilizing hip.

(+) Test= Inability to aDduct

Indicates: IT band contracture

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12
Q

Piriformis Test

A

lateral compartment

Patient supine with hip and knee flexed, one ankle crossed
over contralateral knee. Patient abducts against resistance.

(+) Test= pain over posterior aspect of greater trochanter

Indicates: Piriformis spasm or pathology

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13
Q

Trendelenburg

A

Patient standing with doctor behind. Patient lifts one foot off
ground.

(+) Test= weakness / inability to hold hips level

Indicates: Contralateral gluteus medius weakness
(Superior gluteal nerve)
[ex: Patient lifts right foot, right hip drops = Left gluteus medius/Superior gluteal nerve pathology

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14
Q

Patrick’s : FABER, lateral

A

lateral compartment

Patient’s hip is flexed, aBducted and externally rotated.
Doctor braces contralateral ASIS, patient externally rotates/aBducts against resistance.

(+) Test= Pain or weakness

Indicates: Gluteus medius pathology

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15
Q

Patrick’s: FABER*, anterior

A

anterior/iliopsoas compartment

Patient’s hip is flexed, aBducted and externally rotated.
Doctor braces contralateral ASIS. Patient internally rotates/aDducts against resistance.

(+) Test= Anterior or medial groin pain/weakness

Indicates: Iliopsoas insufficiency or pathology

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16
Q

Psoas Test

A

anterior/iliopsoas compartment

Flex hip to 30° while patient further flexes against resistance

(+) Test= pain/inability or snapping

Indicates: Psoas contracture or pathology

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17
Q

Thomas Test

A

anterior/iliopsoas compartment

Patient supine and pulls knees to chest. One leg is lowered to
the table to test the flexibility of the hip flexors.

(+) Test= Inability to fully extend/extended leg raises off table

Indicates: Hip flexor contraction

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18
Q

valgus test of the knee

A

Patient supine and examiner supports the patient’s lower leg, with the knee flexed to 30°. Examiner’s hands are placed on the medial and lateral aspects of the patient’s knee. While providing lateral resistance at the knee, move the lower leg so that the ankle shifts laterally while holding the distal femur in place.

+ Increased laxity, soft or absent endpoint, and pain

Indicates:MCL disruption (If + at 0° with knee fully extended, indicates more serious injury, possibly joint capsule)

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19
Q

varus test of knee

A

Examiner and patient in same position as the valgus stress test. While providing medial resistance, examiner moves the lower leg so that the ankle shifts medially. This test is done at 30° flexion and neutral (0°).

+Increased laxity, soft or absent endpoint, and pain

Indicates:LCL disruption (If positive at 0° with knee fully extended, indicates more serious injury, possibly joint capsule)

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20
Q

anterior drawer of knee

A

supine with knee flexed to 90°. Examiner sits on the patient’s foot and grasps the proximal tibia with both hands, pulling the tibia anteriorly.

+Excessive translation when compared to the other knee

Indicates: ACL insufficiency

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21
Q

lachamans test

A

Examiner places cephalad hand on the distal thigh, superior to patella. Caudad hand grasps the proximal tibia. Flexing the knee to 15-30°, the examiner uses his caudad hand to pull the tibia anteriorly while the cephalad hand stabilizes the thigh.

+ Increased laxity, soft or absent end point

Indicates: ACL insufficiency

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22
Q

posterior drawer

A

supine with knee flexed to 90°. Examiner sits on the patient’s foot and grasps the proximal tibia with both hands, translating the tibia posteriorly.

+Excessive translation, particularly when compared to the opposite side

Indicates: PCL deficiency, posterior capsular injury or disruption.

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23
Q

reverse lachmans

A

supine. Examiner places cephalad hand on the distal thigh, superior to patella. Caudad hand grasps the proximal tibia. Flexing the knee to 15-30°. The proximal hand stabilizes the femur while the distal hand pushes the tibia posterior.

+ increased laxity, soft or absent end point when compared to the opposite joint

Indicates: PCL deficiency/post capsule deficiency

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24
Q

mcmurrays test

A

Patient is supine, with hip and knee flexed. Examiner uses caudad hand to control the ankle and cephalad hand placed on distal femur.
o Examiner rotates the tibia into internal rotation and applies a varus stress, then continues the leg into extension
o Examiner rotates the tibia into external rotation and applies a valgus stress, then continues the leg into extension

+Pain or a painful click during extension

Indicates: Possible medial or lateral meniscus tear

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25
Q

appley grid compression test

A

Patient prone with knee flexed to 90°. Examiner uses downward force on the foot to provide a compressive force on the meniscus, while rotating the foot internally and externally.

+Pain with rotation and/or compression

Indicates: Possible meniscal injury (collateral ligament injury, or both)

26
Q

appley grind distraction test

A

Patient in same position as for the compression. Examiner stabilizes the thigh, then applies upward traction to the leg while rotating it (traction reduces meniscal pressure, but increases ligamentous strain)

+Pain with distraction and rotation

Indicates: Possible collateral ligament damage

27
Q

patellar laxity test

A

of patellar ligaments

One hand above and one hand below the joint. Thumbs placed against the medial side of the patella. Examiner pushes the patella laterally, assessing ROM.

+sense of apprehension or instability

Indicates: possible previous patellar dislocation or severe instability.

28
Q

patellar apprehension test

A

of patellar ligaments

When testing laxity to the point of restriction, ask the patient if the maneuver provokes any discomfort or sense of instability.

+sense of apprehension or instability

Indicates: possible previous patellar dislocation or severe instability.

29
Q

patellar compression (grind) test

A

of patellar cartilage

Patient supine and knee extended. Provide compressive load to the patella with one hand while moving the patella medial and lateral.

+pain with compression

Indicates: Possible inflammation, chondromalacia, or injury to the patellofemoral articular surfaces

30
Q

patellar femoral grinding

A

of patellar cartilage

Compress patella caudally into trochlear groove and instruct patient to tighten quadriceps against resistance

+crepitation or pain

Indicates: roughness of articulating surfaces (ie:
chondromalacia)

31
Q

patellar glide test

A

of patellar cartilge

Patient sitting or supine will slowly extend and flex the knee, while physician notes quality of the articular motion. Placing hand lightly over the patella can increase sensitivity of the test

+palpable or audible crepitus, pain, or catching of the patella

Indicates: Possible damage to the articular surface

32
Q

monofilament test

A

monofilament is placed on the first and fourth pad of toes and at base of first, third and fifth plantar MTP joints with enough pressure to cause
a slight bend of the monofilament.

+ if patient cannot feel the monofilament.

Important component of diabetic foot exam.

33
Q

anterior drawer of foot

A

Doc grasps posterior calcaneus with one hand and cups distal tibia/fibula with the other hand, monitoring anteriorly at the anterior talus. Provide anterior force on calcaneus while stabilizing the distal tibia/fibula. Normal springing of calcaneus back to neutral should occur.

(+) test = pain, no springing, excessive motion anterior/laxity

= ATF ligament pathology/tear

34
Q

talar tilt test

A

Doc grasps distal tibia/fibula with one hand and the inferior
calcaneus with the other, blocking motion of the calcaneus on the talus. Invert the talus to evaluate ROM.

(+) test = laxity, increased ROM or pain

=Calcaneofibular ligament pathology/tear and some ATF

35
Q

eversion test

A

Doc grasps distal tibia/fibula with one hand and grasps the
midfoot from the plantar surface of the foot with the other hand. Doc everts the foot to evaluate ROM.

(+) test = laxity, increased ROM or pain

= deltoid ligament pathology

36
Q

squeeze test

A

Doc wraps hands around leg proximal to the ankle,
contacting the distal tibia/fibula with both thenar eminences. Squeeze for 2-3 seconds – rapidly release.

(+) test = pain at syndesmosis

= syndesmosis pathology, high ankle sprain

37
Q

cross leg test

A

For evaluation of high ankle sprain
o Patient seated
o Patient crosses affected leg over opposite knee
o Patient then applies pressure to proximal fibular of
affected leg

(+) test = pain at distal ankle

= syndesmotic injury

38
Q

thompson test

A

Pt Prone with foot off the table. Doc squeezes the calf.

(+) test = absence of plantar flexion

= Achilles tendon rupture

39
Q

Homan’s sign

A

Pt laying or seated with knee extended. Doc dorsiflexes the foot. (Some add lateral compression of calf as well)

+ pain with dorsiflexion

Indicates thrombophlebitis or acute deep venous
thrombosis in the presence of
edema, erythema, and increased warmth of the skin of
the lower leg
o Need to get a Venous Doppler to rule out clot

40
Q

Moses Sign

A

Pt seated or supine
o Physician induces an anterior compression on the
gastrocnemius muscle into the posterior aspect of the
tibia (compresses the calf towards the tibia)

+pain with anterior compression – not lateral compression

Indicates deep vein thrombosis of the posterior tibial veins

41
Q

valgus stress test of elbow

A

arm slightly abducted and externally rotated. Forearm supinated and flexed (to approx. 30º).Slight medial directed valgus stress is applied to elbow
joint.

(+) Test pain/tenderness with palpation and valgus stress; increased laxity

degree of laxity correlates to degree of injury to UCL

42
Q

varus stress test

A

arm slightly abducted and internally rotated. Elbow flexed (to approx. 15º). A slight varus
stress is applied to the elbow joint

(+) Test = pain or increased laxity in LCL

43
Q

Tinel test of elbow

A

Tap between olecranon and medial epicondyle in ulnar groove

+) Test = eliciting tingling sensation down forearm within ulnar nerve distribution

Indicates ulnar nerve entrapment, cubital tunnel syndrome

44
Q

Golfer’s Elbow test

A

Anterior forearm/flexor compartment
Patient’s elbow is flexed to 90° and forearm in supination. The examiner places one hand under the proximal forearm for stabilization and the other hand over the patient’s wrist to resist movement. Instruct the patient to flex the wrist.

(+) Test = pain/tenderness around the medial epicondyle

Indicates medial epicondylitis

45
Q

tennis elbow test

A

Posterior forearm/extensor compartment
Patient’s elbow is flexed to 90° and forearm is placed in pronation. Examiner places one hand under proximal forearm for stabilization and the other hand over the patient’s hand to resist movement. Instruct the patient to extend the wrist.

(+) Test = pain/tenderness around lateral epicondyle, may radiate down lateral forearm

indicate lateral epicondylitis

46
Q

Ok sign

A

On examination, if neuropathy of anterior interosseous n present, patient cannot make an “O” with thumb and forefinger pinched together

47
Q

tinel’s sign of wrist

A

by tapping over the transverse carpal ligament (between thenar/hypothenar eminences) with either the tip of the examiner’s finger or reflex hammer with the patient’s wrist held in extension.

+parasthesias/numbness/ tingling/pain radiating to thumb, index and middle finger (median n. distribution)

Indicates entrapment of Median Nerve or Carpal Tunnel
Syndrome.

48
Q

Phalen’s sign

A

Place dorsal aspects of patient’s hands together and force into wrist flexion. Hold for 60 seconds

+any reproduction of symptoms/parasthesias in the distribution of the median nerve

Indicates carpal tunnel syndrome

49
Q

Allen Test

A

Evaluates functioning of radial and ulnar arteries.
Occlude both arteries while patient makes a fist. Have patientopen and close fist; palm should be pale.
Release pressure on ulnar artery and observe for color return to hand within 5-10 seconds. Repeat with radial artery.

50
Q

Finkelstein Test

A

Examiner asks patient to make a fist encompassing their thumb and ulnar deviate the wrist.

+increased pain in first dorsal compartment/lateral wrist;

indicates DeQuervain’s tenosynovitis

51
Q

empty can test

A

Flex patient’s shoulders to 90° while also abducting approximately 45°. Then internally rotate both arms so thumbs are pointing down. Press down on forearms while patient resists.

(+) Test = Pain or weakness

Indicates rotator cuff pathology (specifically supraspinatus)

52
Q

drop arrm test

A

Patient abducts arm 90°‐180°. Then slowly drops arm.

(+) Test = Arm will drop or gentle tap on wrist will cause arm to drop

Indicates full thickness tear of supraspinatus

53
Q

apprehension test

A

Shoulder abducted to 90° and elbow flexed to 90°. Stabilize patient’s shoulder with one hand and force arm into external rotation with the other hand.

(+) Test = Patient apprehensive of repeat dislocation

Indicates glenohumeral instability

54
Q

sulcus sign

A

Grasp patient’s elbow and apply inferior traction

(+) Test = Indentation appears in area beneath the acromion

Indicates glenohumeral instability

55
Q

yergasons test

A

Patient’s arm at side with elbow flexed at 90°. Examiner uses one hand to palpate bicipital groove and monitors there, while the other hand grasps the patient’s wrist. Have patient supinate and externally rotate against doctor’s resistance.

(+) Test = Pain and/or tendon subluxation out of groove

Indicates unstable bicipital tendon/subluxation, bicipital tendonitis

56
Q

speeds test

A

Patient’s arm forward flexed (50°‐90°) at the shoulder with hand supinated. Slightly flex patient’s elbow. Resist at forearm while patient further flexes shoulder. (Resist cephalad motion)

(+) Test = Pain in bicipital groove

Indicates bicipital tendonitis of long head of biceps

57
Q

neer impingement test

A

Stabilize patient’s shoulder, forearm is pronated. Passively flexshoulder to fully flexed position.

(+) Test = Pain

Indicates subacromial bursa or rotator cuff impingement

58
Q

hawkins test

A

Flex shoulder to 90°, flex elbow to 90°, slightly aDduct, and passively rotate the humerus into internal rotation. This opposes the rotator cuff against the coracoacromial ligament and acromion.

(+) Test = Pain

Indicates rotator cuff (usually supraspinatus) or subacromial bursa impingement

59
Q

Apley Scratch Test

A

assess bialterally

60
Q

liftoff test

A

Place patient’s arm into internal rotation and aDduction. Patient
extends arm into as doctor resists.

(+) Test = Weakness (inability to resist)

Indicates subscapularis weakness

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