MSK UE Special Tests Flashcards
Special Tests for Shoulder Dislocation (2)
- Apprehension Test, Anterior
- Apprehension Test, Posterior
Special Tests for Biceps Tendon Pathology (3)
- Ludington’s Test
- Speed’s Test
- Yergason’s Test
Special Tests for RTC Pathology/Impingement (4)
- Drop Arm Test
- Hawkins-Kennedy Impingement Test
- Neer Imingement Test
- Supraspinatus Test
Special Tests for Thoracic Outlet Syndrome (5)
- Adson maneuver
- Allen test
- Costoclavicular syndrome test
- Roos test
- Wright test (hyperabduction test)
Special Tests for Elbow Instability (2)
- Varus stress test
- Valgus stress test
Special Tests for Epicondylitis (4)
- Cozen’s test
- Lateral epicondylitis test
- Medial epicondylitis test
- Mill’s test
Special Tests for Wrist/Hand Instability
- Ulnar collateral ligament instability test
Special Tests for Vascular Insufficiency (2)
- Allen test
- Capillary refill test
Special Tests for Wrist/Hand Contracture/Tightness (2)
- Bunnel-Littler test
- Tight retinacular ligament test
Special Tests for Wrist/Hand Neurological Dysfunction (3)
- Froment’s sign
- Phalen’s test
- Tinel’s sign
Special Tests for C-Spine (2)
- Foraminal compression test
- Vertebral artery test
Apprehension Test for Anterior Shoulder Dislocation
Pt. supine, shoulder ABD 90, elbow 90
Rotate shoulder into ER
+ = look of apprehension or facial grimace prior to end range
Indicates: anterior shoulder dislocation
Apprehension Test for Posterior Shoulder Dislocation
Pt. supine, shoulder flex 90, elbow 90 (across chest)
Apply AP pressure through humeral shaft
+ = look of apprehension or facial grimace prior to end range
Indicates: posterior shoulder dislocation
Ludington’s Test
Pt. seated, hands interlocked behind their head
Ask pt. to contract and relax biceps
+ = absence of movement in the biceps tendon OR increased pain
Indicates: rupture of long head of biceps OR tendinitis of long head of biceps
Speed’s Test
Pt. seated, shoulder flexed 90, elbow straight, forearm supinated
Palpate at biciptal groove, ask pt. to resist shoulder flexion
+ = pain/tenderness in biciptal groove region
Indicates: biceps tendonitis
Yergason’s Test
Pt. seated with elbow flexed 90, forearm pronated, humerus against thorax
Palpate at biciptal groove, have pt. resist supination and ER
+ = pain/tenderness in biciptal groove
Indicates: bicep tendonitis
Drop Arm Test
Pt. seated with shoulder passively ABD to 90
Ask patient to hold arm in place OR slowly lower arm
+ = arm drops or fails to slowly lower
Indicates: RTC tear
Hawkins Kennedy Test
Pt. seated, shoulder passively flexed to 90, elbow bent, and shoulder IR
+ = pain
Indicates: supraspinatus impingement
Neer Test
Pt. seated, shoulder IR and passively flexed
+ = pain
Indicates: supraspinatus impingement
Supraspinatus (Empty Can) Test
Pt. seated shoulder ABD 90, horizontally ADD 30 and IR
Have pt. resist ABD
+ = weakness or pain
Indicates: tear of supraspinatus tendon, impingement, or suprascapular nerve involvement
Adson Maneuver
Pt. seated, located radial pulse
Ask pt. to rotate head toward testing side, then extend head while therapist ER and extends the shoulder
+ = absent or diminished radial pulse
Indicates: thoracic outlet syndrome
Allen Test
Pt. seated with shoulder ABD 90, ER, and elbow flexed
Pt. asked to rotate head away from test shoulder while therapist monitors readial pulse
+ = absent or diminished pulse
Indicates: thoracic outlet syndrome
Costoclavicular Syndrome Test
Pt. standing, located radial pulse.
Have pt. retract and depress shoulders, then move arm into 30 deg of extension and abduction, ask pt. to hyperextend neck
+ = absent or diminished pulse
Indicates: thoracic outlet syndrome caused by compression of subclavian artery between clavicle and 1st rib
Wright (Hyperabduction) Test
Pt. seated, shoulder ABD 90 and ER, elbow bent, located radial pulse
Move pt. shoulder into full ABD
+ = absent or diminished pulse
Indicates: thoracic outlet syndrome, compression of costoclavicular space
Roos Test
Pt. seated with both shoulder ABD 90, ER, and elbows bent
ask pt. to open and clsoe their hands for 3 minutes
+ = inability to maintain test position, weakness of arms, sensory loss, ischemia
Indicates: thoracic outlet syndrome
O’Brien’s Test
Pt. seated, shoulder ABD 90, horizontally ADD 30, and IR
Ask pt. to resist flexion, repeat with shoulder ER
+ = Pain with resistance in IR, no pain with resistance in ER
Indicates: glenoid tear, SLAP lesion
Clunk Test
Pt. supine, shoulder ABD and ER over head.
Place one hand behind humeral head, use other hand to place force through humeral shaft while moving through IR/ER
+ = clunk or grinding sound
Indicates: glenoid labrum tear
Median Nerve Tension Test
1: depress shoulder, ABD 110 deg, extend elbow, supinate forearm, extend wrist, extend fingers/thumb
2: depress shoulder, ABD 10 deg, extend elbow, supinate forearm, extend wrist, extend fingers/thumb, shoulder ER
Above with and without contralateral cervical side bend
Radial Nerve Tension Test
Depress shoulder, ABD 10 deg, extend elbow, pronate forearm, flex and UD wrist, flex fingers and thumb, IR shoulder
Above with and without contralateral cervical side bend
Ulnar Nerve Tension Test
Depress shoulder, ABD 10-90 deg, flex elbow, supinate forearm, extend and RD wrist, extend fingers and thumb, ER shoulder
Above with and without contralateral cervical side bend
Varus Stress Test
Pt. seated with 20-30 deg of elbow flexion
Place one hand at lateral wrist and other at medial elbow and apply varus force
+ = increased laxity while compaired bilaterally
Indicates: LCL sprain/tear
Valgus Stress Test
Pt. seated with 20-30 deg of elbow flexion
Place one hand at medial wrist and other at lateral elbow and apply valgus force
+ = increased laxity while compaired bilaterally
Indicates: MCL sprain/tear
Cozen’s Test
Pt. seated with elbow slightly flexed with therapist palpating at lateral epicondyle
Ask pt. to make a fist, pronate, flex, and RD the wrist and then resist wrist extension
+ = pain or muscle weakness
Indicates: lateral epicondylitis
Lateral Epicondylitis test
Pt. seated with elbow bent and forearm pronated
Ask pt. to resist 3rd finger extension
+ = pain at lateral epicondyle or muscle weakness
Indicates: lateral epicondylitis
Medial Epicondylitis Test
Pt. seated, therapists palpates medial epicondyle then passively supinates forearm, extends wrist and elbow
+ = pain at medial epicondyle
Indicates: medial epicondylitis
Mill’s Test
Pt. setaed, therapists palpates lateral epicondyle then passively pronates, flexes wrist and extends elbow
+ = pain at lateral epicondyle
Indicates: lateral epicondylitis
Ulnar Collateral Ligament Instability Test
Pt. seated, ask to extend thumb and resist force placed at MCP joint of thumb
+ = excessive valgus movement
Indicates: tear of ulnar collateral and accessory collateral ligaments
Allen Test (Vascular)
Pt. seated, asked to open and close hand several times than maintain a closed fist.
Palpate radial and ulnar pulse, ask pt. to release fist, release one artery and observe return of color to the hand, repeat with other artery
+ = absent of delayed flushing indicates arterial occlusion
Bunnel Littler Test
Pt. seated with MCP joint in slight extension
Attempt to flex PIP, if unable to slightly flex MCP and attempt again
Results: unable to flex in slight extension = tight intrinsic muscle or capsular tightness; able to fully flex in slight flexion = intrinsic muscle tightness without capsular tightness
Tight Retinacular Ligament Test
PIP neutral attempt to flex DIP, if unable flex PIP and attempt again
Results: unable to flex DIP in neutral = retinacular ligament and/or capsular tightness, able to fully flex DIP in slight flexion = retinacular tightness without capsular tightness
Froment’s Sign
Pt. asked to hold a piece of paper between finger and thumb, attempt to pull paper away.
+ = pt. flexing thumb DIP
Indicates: adductor pollicis muscle paralysis, ulnar nerve compromise
If pt. hyperextends MCP when paper pulled = Jeanne’s sign; indicates ulnar nerve compromise
Phalen’s Test
Pt. flexes wrists and presses back of hands into one another, holding for 60 seconds
+ = N/T in thumb, index, middle, and lateral half of ring finger.
Indicates: carpal tunnel/median nerve compression
Finkelstein Test
Pt. makes fist with thumb tucked inside fingers, therapists UD wrist
+ = pain over abductor pollicis longus and extensor pollicis brevis
Indicates: tenosynovitis of the thumb or DeQuervain’s Disease
Grind Test
Therapist grasps pt’s thumb MC, applies compression and rotates
+ = pain
Indicates: DJD in the CMC joint
Murphy Sign
Pt. asked to make fist
+ = 3rd MC remains level with 2nd and 4th MC
Indicates: dislocated lunate
Foraminal Compression Test (C-Spine)
Compress through top of head with pt’s neck side bent
+ = pain radiating into arms on the flexed side
Indicates: nerve root compression
Vertebral Artery Test
Pt. in supine, place pt’s head into extension, side bends, and rotation
+ = dizziness, nystagmus, slurred speech, or loss of consciousness
Indicates: compressed vertebral artery
