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MSK Special Tests > MSK > Flashcards

MSK Flashcards

1
Q

Objective Assessment

A

Observation, AROM, PROM, Palpation, Muscle testing, Accessory Movements, Functional Test, Special Test, Treatment

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2
Q

What does AROM and PROM test ?

A

AROM - Contractile tissues + intert.

PROM - Inert tissues and contractile tissues on end range.

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3
Q

Palpation - Signs + Warnings

A

Looking for swelling, anything abnormal, pain on touch.

Warnings - heat, redness, open wound, recent acute fracture.

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4
Q

Muscle Tests - Oxford Scale

A
  • 0 no contraction
  • 1 flicker of contraction
  • 2 movement through range with gravity counterbalanced
  • 3 movement through range against gravity
  • 4 movement through range against gravity + some resistance
  • 5 normal movement against strong resistance, equal to the unaffected side. Able to use muscle as agonist, antagonist, fixator and synergist. Able to work equally well with reversed origin to insertion. Able to work isotonically and isometrically.
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5
Q

Components of strength - Types

A

Endurance - Contractions over a period of time.
Power - Maximum strength relative to time. (Force X Velocity)a

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6
Q

Hip Joint - Accesory Movements

A

Longitudinal Caudad - Leg under arm and pull inferiorly

AP + PA - In side lying, find Greater Trocanter of femur, stablise pelvis and apply force with palm .

Distraction - Hug the leg and pull laterally, like you’re trying to dislocate.

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7
Q

Hip Joint - Special Tests - Modified Thomas test

A

Modified Thomas Test - Rect fem or Hip flexor tightness, patient LL off the bed and laying backwards, looking for increased angles.

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8
Q

Hip Joint - Special Tests - Obers Test

A

Obers Test - Test length of ITB + Glute Med and Min. In sidle lying hold patients leg up and see for ADD resistance.

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9
Q

Hip Joint - Special Tests - Trendelunbergs

A

Trendelungbergs - Patient standing on one leg, if hip drop on opposite side + reproduction of pain then a positive test for Glute Tendinopathy

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10
Q

Ankle Joint - Accessory movements

A

Talar Tilt - Holding Calcaneus put the foot into inversion in difference ranges of PF + DF and press on ligaments. AP + PA of Talocural joint - Stabilise the Tib and push down or up on calcaneus Longitudinal Distraction - Holding tibia and pulling on the calcaneus down.

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11
Q

Ankle Joint - Special Tests - Anterior Draw

A

Anterior Draw - PA of Talocural joint - Stabilise the Tib and push down or up on calcaneus Good to test for ATFL acute rupture but not for chronic laxity. Laxity = positive

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12
Q

Ankle Joint - Special Tests - Talar Tilt

A

Talar Tilt - Holding Calcaneus put the foot into inversion in difference ranges of PF + DF and press on ligaments. Good to test lateral ankle ligaments

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13
Q

Ankle Joint - Special Tests - Thompson Test

A

Thompson Test - Squeeze gastrocs and looking for plantar flexion, if no PF then positive test for Achilles Rupture.

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14
Q

Knee Joint - Accessory Movements

A

AP + PA - Sit on foot in knee flexion on the bed and apply force by pulling or pushing on tibia.

Patella Glides - Lateral, Cephalad, Medial, Caudad

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15
Q

Knee Joint - Special tests - McMurray’s

A

McMurray’s Test - Patient in 90 flex of knee and hip and you hold the knee and calcenus and slowly extend the knee and circumduct the leg. MENISCUS TEST - Looking for locking, clicking, giving way, pain.

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16
Q

Knee Joint - Special tests - Thessaly

A

Thessaly’s Test - Patient stands on the affected leg and is asked to turn side to side. MENISCUS TEST - Looking for locking, clicking, giving way, pain.

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17
Q

Knee Joint - Special tests - Lachman Test

A

Lachman’s Test - Knee in 30 flex + slight lat rotation. Trap foot between bed and you then do a PA ACL TEST - Looking for laxity + soft end feel.

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18
Q

Knee Joint - Special tests - Anterior Draw

A

Anterior Draw Test - Knee in flexion. Sit on foot and do a PA ACL TEST - Looking for laxity + soft end feel.

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19
Q

Knee Joint - Special tests - Posterior Draw

A

Posterior Draw Test - Knee in flexion. Sit on foot and do a AP PCL TEST - Looking for laxity + soft end feel.

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20
Q

Knee Joint - Special tests - Varus (Bowed) + Valgus (knock knee)

A

Varus + Valgus Stress Test - Knee straight and apply leverage force to try and put the leg into varus or valgus. MCL + LCL TEST - Looking for excessice movement

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21
Q

Knee Joint - Special tests - Clarke’s Test

A

Clarke’s Test - To test the quadriceps tendon. With Quads relaxed place hand above patella and wrap thumb around. Ask patient to contract their quads and positive test of no resistance felt. PAINFUL ON ANYONE DON’T DO!!!

22
Q

Shoulder Joint - Accessory Movements

A

AP + PA of GHJ - Side-lying and apply force onto head of humerus

Longitudinal Caudad - Hold their elbow and they hold your forearm and then pull down.

Acromioclavicular Joint - Push the clavicle in and out from either side.

23
Q

Shoulder Joint - Special Tests - Hawkins Kenedy Test

A

Hawkins Kenedy Test - Rotator Cuff Pain. Into elbow flexion and shoulder flexion to 90 and horizontal. Stabilise scapular and hold elbow and apply internal rotation. Pain = positive

24
Q

Shoulder Joint - Special Tests - Empty Can Test

A

Empty Can Test - Shoulder in 90 of scapula plane and thumbs down apply pressure on top of arm and they resist. Positive = Weakness or pain. Rotator Cuff pain.

25
Q

Shoulder Joint - Special Tests - Drop arm sign

A

Drop Arm Sign Test - ABD to 90 and external rotation, support arm and tell patient to hold. NO Control = issues with Infra and Suprascauplaris Rotator Cuff Tear.

26
Q

Shoulder Joint - Special Tests - Lift Off Sign

A

Lift off sign - Patient with hand behind their back palm facing outwards, ask patient to lift hand off and then see if possible with resistance. Positive = Pain or weakness. Rotator Cuff Tear .

27
Q

Shoulder Joint - Special Tests - Apprehension Test

A

Apprehension Test - Patient shoudler off bed and supported by you. Put elbow in to 90 and shoulder into 90 of flex. Examinar will provide external roation. postive = Patient says it feels like it’s going to go. Shoudler instability.

28
Q

Elbow, Wrist and Hand - Special Tests - Mill’s Test

A

Mill’s Test - For lateral epidcondylagia (Tennis Elbow). Find common wrist extensors and palpate. Flex the wrist and extend the elbow. Positive if pain is reproduced.

29
Q

Elbow, Wrist and Hand - Special Tests - Cozen’s Test

A

Cozen’s Test - Lateral Epidcondylagia (Tennis Elbow). Patient in slight elbow flexion then make them use active wrist extensors. Pain is produced is Positive.

30
Q

Elbow, Wrist and Hand - Special Tests - Phalen’s Test

A

Phalen’s Test - Carpal tunnel syndrome. Backs of hands pressed together to compress median nerve. Positive if paraesthesia is reproduced.

31
Q

Elbow, Wrist and Hand - Special Tests - Tinel’s test

A

Tinel’s Test - Carpal Tunnel Syndrome. Tap from base of wrist along median nerve pathway to index finger and if paraesthesia is produced = positive.

32
Q

Elbow, Wrist and Hand - Special Tests - Finkelstein’s test

A

Finkelstein’s Test - De Quervains Tendonsynovitis. Thumb in hand and make a fist, then Unlar deviation (push down) and if there’s pain along APL + EPB then positive test.

33
Q

Shoulder Joint - Special Tests - Belly Press test

A

To test Subscapularis, Patient puts hand on tummy and presses into it, if shoulder comes around and elbow flares ant, +ve

34
Q

Shoulder Joint - Special Tests - Sulcus Test

A

Inferior Gleno-Humeral instability - Top off patient, support forearm and pull humerus down at the elbow joint, longitudional distraction, looking for gap between acromiam and humeral head + Pain

35
Q

Shoulder Joint - Special Tests - Load and Shift

A

Gleno-Humeral instability - Stabalise as clav/traps area and using thumb slightly lift and move humeral head out of joint space. Pain + Laxity = +ve

36
Q

Elbow, Wrist + Hand - Special Test - Golfers Elbow

A

(Golfer’s Elbow) Medial Epicondylalgia- Similar to Mill’s and Cozen’s. Palpate medial epicondyle and passively ext wrist and supination. Actively resist wrist flexion. Pain = +ve

37
Q

Balance Testing

A

Flat ground, unstable, eyes closed.

Balance Error Score, Hands on hips and do normal feet together, one leg, tandem, then do again on balance mat, 1 point per error.

Y Balance Test - Using appartatus, using one foot push all blocks away and measure. Bestof 3.

Load Acceptance Tests - Single leg hop, and the triple hop, how far on each leg. Use QASLS and calculate Limb Symmetry by doing involved/uninvolved x100.

38
Q

Hip Joint - Special Test - FADER-r

A

For Gluteal Tendinopathy. Flex the hip adduct the hip and externally rotate and add resistance so they push back. Putting leg to the other side of the body.

39
Q

Hip Joint - Special Test - FABER

A

FAI, Labrum Tear, OA - Flexion, ABDuction and External Rotation. Slowly push them into external rotation.

40
Q

Hip Joint - Special Test - FADDIR

A

FAI, Labrum Tear, OA - Flexion, ADDuction, Internal Rotation.

41
Q

Ankle Joint - Special Test - Syndesmosis Squeeze

A

To rule out AITFL PITFL sprain. Find proximal head of tibia and femur and squeeze, this will cause the distal ends to seperate and if there’s an injury there will be movement and pain.

42
Q

UL Neuro Assessment - Dermatomes

A

C4 -Traps

C5 - Ant deltoid

C6 - Lateral Forearm and lateral palm, thumb and index.

C7 - Middle finger and mid forearm.

C8 - Medial Forearm, Ring + Pinky finger.

T1 - Upper medial forearm.

T2 - Inner bicep to armpit.

43
Q

UL Neuro Assessment - Myotomes

A

C1 - Upper Cervical Flex

C2 - Neck Extension

C3 - Side flexion

C4 - Shoulder Elevation

C5 - Shoulder ABD

C6 - Elbow Flexion

C7 - Elbow Extension

C8 - Thumbs up

T1 - Finger ADD

44
Q

Neuro Assessment General Overview

A

Nerver Conduction - Dermatomes, Myotomes, Reflexes

Neuro Dynamics Testing - Using stretches to put neural tissue on a stretch to see if that’s the issue.

CNS Tests - Clonus Test -Sharp Dorsiflex then hold

Babinski’s - From lateral foot to big toe looking for curl of toes

Hoffman’s Test - Isolate finger joint and ping nail

45
Q

UL Neuro Assessment - Reflexes

A

Biceps - Feel for bicep tendon, Relax arm on pillow

Tricep - Go into shoulder abd and wrist facing down.

46
Q

UL Neuro Assessment - Neuro Dynamics

A

ULNT 1 - Median - Depress Shoulder, supination, lateral rotation, wrist ext, finger ext, then take them into elbow ext slowly.

ULNT 2a - Median - Depress Shoulder supinate, ext elbow and then lateral raise. (use if shoulder weak)

ULNT 2b - Radial - Like posing for triceps. Thumb in fist, Shoulder depression, Wrist Flex, Pronation, ABD.

ULNT 3 - Ulnar - Teapot - Shoulder ABD, Elbow Flex, Pronation for palm is away from face, then wrist ext, then flex shoulder to face.

47
Q

LL Neuro Assessment - Dermatomes

A

L2 - Medial thigh, boxer line

L3 - Below L2 from high lateral going inferiorly and medially.

L4 - high around knee cap and central shin.

L5 - Lateral Shin

S1 - Lateral foot goes round to lateral post calf

S2 - Medial foot, post medial calf

48
Q

LL Neuro Assessment - Myotomes

A

L2 - Hip flexion

L3 - Knee Extension

L4 - Ankle Dorsi Flexion

L5 - Big toe extension

S1 - Ankle Plantar Flexion

S2 - Knee Flexion.

Do S1 last and test it by making them stand on single leg toes.

49
Q

LL Neuro Assessment - Reflexes

A

Patella - Feel Patella tendon and swing try and use the pendular force

Achilles Tendon - Facilitate DF and relax leg. Slight force .

50
Q

LL Neuro Assessment - Neuro Dynamics

A

SLR - Straight Leg Raise. Ext Knee, Flex hip and dorsi flex to stretch Sciatic

Femoral Nerve Test - Side Lying, Patient goes into fetal position with Lying leg, flex top knee, ext hip. Ext neck when pain and should go further.

Slump Test - Patient - Hands behind back, slump shoulders, flex neck.

Then Ext knee and Dorsi flex.

CNS Tests - Babinski’s

Hoffman’s

Clonus.

MSK Special Tests (1 decks)

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