MSK Special Tests UE Flashcards
What is Yergason’s test?
Integrity of transverse ligament of shoulder
Identifies bicipital tendonosis/tendonopathy
Elbow at 90, PT resists supination and ER of arm
+ when biceps pops out of groove, pain along bicep tendon
What is the Speed’s test?
Bicipital tendonosis
PT resists patient shoulder flexion while arm supinated
+ when pain along biceps tendon
What is Neer’s test?
Impingement of soft tissue structures (long head biceps, supraspinatus tendon)
SH passively abd and IR, shoulder flexion
+ reproduces pain/symptoms
What is the supraspinatues test/empty can?
identifies tear and/or immpingement of supraspinatus tendon or suprascapular nerve neuropathy
PT resists SH flexion while patient in empty can position
Repeat in full can position
+ when reproduces pain
What is the Hawkins Kennedy test?
Identifies AC joint issue
Elbow and shoulder at 90, PT passively turns SH into IR
+ with pain
What is the drop arm test?
identifies tear and/or full rupture of RC
passively place SH in ABD to 120. ask patient to lower arm
+ unable ot lower arm back to side
What is the posterior internal impingement test of the shoulder?
impingement betwee RC and greater tuberosity OR post glenoid and labrum
patient supine. Move SH into 90 ABD, max ER, and 15-20 horizontal ADD
+ pain in post SH
What is the clunk test?
glenoid labrum tear
patient supine, SH in full ABD. push hueral head ant while rotating humerus externally.
+ audible clunk is heard
what is the anterior apprehension sign?
identifies past Hx of ant SH dislocation
patient supine, shoulder in 90 ABD, slowly take SH into ER
+ patient doesn’t allow
What is the posterior apprehension sign?
past Hx of post dislocation
patient supine, SH ABD 90 with scap stabilised by table. place post force through SH via force on patients elbow while simultaneously moving SH into medial rotation and horiz ADD
+ patient doesn’t allow
What is the AC shear test?
dysfunction of AC joint (arthritis, separtation)
in sitting, arm resting at side. PT clasps hands and places heel of one hand on spine of scap, and heel of other on clavicle. Sweeze hands together to compress AC joint
+ reproduces pain
What is Adson’s test?
Pathology of structures that pass through thoracic inlet / TOS
PT finds radial pulse, elbow extended and SH ER, slowly extend SH. Patient looks towards side being tested and extends neck.
+ pusle diminished
What is the Costoclavicular syndrome test/ military brace?
thoracic inlet / TOS
Patient sitting, find radial pulse of extremity being tested. Move involved SH down and back, neck extends
+ pulse diminished, neuro symptoms
What is the Wright/hyperabduction test?
thoracic inlet / TOS
passive SH ABD
+ neuro and vascular symptoms
What is the Roos test?
thoracic inlet / TOS
SH fully ER, 90 ABD, elbows at 90. open/close hands for 3 min
+ neuro and vascular symptoms
What is the ligament instability tests of the elbow (medial and lateral)?
Identifies medial/lateral ligament laxity of elbow
elbow placed in 20-0 flexion. valgus force tests ulnar collateral lig. varus force tests radial collateral lig.
+ laxity, maybe pain
What is lateral epicondylisis / tennis elbow?
lateral epicondylopathy
elbow in 90 flex, pronated, hand in fist and supported. PT resists wrist extension
+ pain at lateral epicondyle
What is medial epicondylisis / golfers elbow
medial epicondylopathy
90 elbow flexion, pronation, hand in fist. passive supinate and extend elbow and extend wrist.
+ pain at medial epicondyle
What is Tinel’s sign?
dysfunction of ulnar nerve at olecranon
Tap region where ulnar nerve passes through cubital tunnel
+tingling in ulnar distribution
What is the pronator teres syndrome test?
median nerve entrapment within pronator teres
elbow in 90 flexion and supported. resist forearm pronation and elbow extension
+ tingling or paresthesia in median nerve distribution
What is the Finkelstein’s test?
De Quervain’s tenosynovitis
patient makes fist with thumb in fingers. passively move wrist into ulnar deviation
+ reproduces pain in wrist
What is Bunnel Littler test?
tightness in structures surrounding MCP joints
MCP joint stabilised in slight ext while PIP flexed. Then MCP flexed and PIP flexed.
+ differentiates between tight capsule and tight intrinsic muscles. If flexion limited in both cases, capsule is tight. If more PIP flexion which MCP flexion, intrinsic muscles are tight.
What is the tight retinacular test?
identifies tightness around proximal interphalangeal joint
PIP stabilised in neutral while DIP is flexed. Then PIP flexed and DIP flexed
+ differentiates tight capsule and tight reinacular ligs. If flexion limited in both cases, capsule tight. If DIP flexion with PIP flexion, then retinacular lig tight
What are the ligament instabilit tests for the IP joints?
identifies lig lacity or restriction of med and lat IP joints
fingers supported. valgus and varus forces applied to PIP joint. Repeat on DIP
+ laxity, maybe pain
What is Froment’s sign?
ulnar nerve dysfunction
patient grasps paper between thumb and index finger. pull paper out and look for IP flexion of thumb, which is compensation due to weakness of adductor pollicis
What is Phalen’s test?
carpal tunnel compression of median nerve
maximally flex both writst holding thm against each other for 1 min
+ reproduces tingling/parasthesia in median nerve distribution
what is Allen’s test?
vascular compromise
Have patient open/close fingers quickly several times and then make a closed fist. Using thumb, occlude the ulnar artery and have patient open hand. Observe palm of hand then release the compression on artery and observe for vascular filling. Repeat on radial artery.
Positive finding will present by abnormal filling of blood within hand during test. Under normal circumstances, there is a change in color from white to normal appearance on palm of hand.
