musculoskeletal Flashcards
test for shoulder rotation
apley scartch test
test the acromioclavicular joint
crossover test/sign
test for supraspinatus
empty can test
thumbs down sign
test for the teres minor and infraspinatus
resisted external rotations
test for subscapularis
resisted internal rotation
Rotator cuff tests
neers impingements sign
hawkins impingement sign
Drop arm sign
rotate shoulders and try to move it upwards
hawkin’s impingement sign
patient laterally raises arm and then you push it down
drop arm sign
test for bicep’s strength
speed test
test for bicipital tendinitis and RTC
Yergason’s test
instability tests
anterior apprehension test
relocation test
try to elicit the feeling that their shoulder will be dislocated
with their shoulder externally rotated and adducted, try to push
anterior apprehension test
patient is supine
stabilize arm and place pressure on shoulder, the ox will feel the shoulder is being dislocated
relocation test
prone to gout and infections
olecranon area
accumulation of fluid in the elbow
olecranon bursitis, septic arthritis, gour
assess the function of the proximal and distal radioulnar or humeroradial joint
forearm supination and pronation
extension
0
flexion
150
pronation
70
supination
90
resistance will aggravate lateral epicondylitis
supination of wrist
resistance will aggravate medial epicondylitis
pronation
resistance will aggravate pain of lateral epicondylitis
extension of wrist
resistance will aggravate pain of medial epicondylitis
flexion if wrist
pulls at the lateral epicondyle
resisted long finger extension
resistance tests bicep strength
elbow flexion
resistance test tricep strength
elbow extension
no creases, tight skin
sclerodema
claw hand
sclerodactyly (acrosclerosis)
distal to the radial
styloid process with lateral extension of thumb away from hand
anatomic snuffbox
Heberden’s and Bouchard’s nodes, which are
gelatinous swelling associated with join narrowing
hand osteoarthritis
There is tissue swelling, synovial thickening
different from a bony nodularity
hand rheumatoid arthritis
grasp 2nd and 3rd finger
hand grip strength
Test sensation on the palmar and dorsal surfaces
innervated by the
median - middle 3
ulnar- pinky
radial- humb
ask oc to grasp the thumb against the palm and then move the wrist toward the midline in ulnar deviation
thumb movement
ask the px to abduct the thumb while putting pressure on it
watson stress test
Pain or numbness of the first three fingers of the
hand, but not in the palm, especially at night
carpal tunnel syndrome
tingling with tapping over the median nerve as it enters the carpal tunnel
tinels test
numbness or tingling with pressing backs of hands together in acute flexion for 60 sec
phalens sign
Flexion of the neck may produce paresthesia
down the arms and legs in multiple sclerosis or
spondylosis
lhermitte sign
Downward pressure on the neck may produce
symptoms of vertebral foramina narrowing. This may be accentuated when pressing down during lateral flexion. When they will feel paresthesia, stop the procedure immediately.
spurlings maneuver
increasing intrathecal pressure may induce pain from tumor or disc collapse
valsalva
To test for thoracic outlet obstruction. After
palpating for the radial artery, the arm is raised, extended and externally rotated and then the head is rotated to the opposite arm. Weakening of the pulse is a positive sign
adson maneuver
To identify spinal nerve root
compression, which is associated with
disc protrusion and femoral nerve injury
femoral nerve stretch
To test for underlying nerve root sensitivity
lasegues
to test for meniscal tearing
bragaard’s
bony landmarks anterior aspect hips
iliac crest iliac tubercle ASIS greater trochanter pubis symphysis
bony land marks hip posterior asoect
PSIS
greater trochanter
ischial tuberosity
sacroiliac joint
when the gluteus medius is weak, the pelvis drops on the non weight bearing side when the patient stands on the affected hip
trendelenburg test
Performed while supine, with ankle placed on top
of the opposite knee in the figure-4 position. Discomfort is often seen with SI joint pathology.
faber test
Stand or hop unsupported on one leg. Look for
reproduced pain in the groin area. This test is usually positive with a femoral neck stress fracture.
hop test
Severe pain with gentle to-and-fro motion of
pelvis may indicate fracture, infection, or synovitis.
log roll test
knee joints
2 condylar tibiofemoral joints, petollofemoral joint
trochlear groove
atrophy of quadriceps muscle is a sign of
osteoarthritis
patellar tap is tapping it and the patella
seems to bounce.
balloon sign
abduction or valgus stress test
MCL
adduction or varus stress test
LCL
anterior drawer sign, kachman test
Anterior cruciate ligament
posterior cruciate ligament
posterior drawer sign
mcmurray test
medial and lateral menisci
Performed with knee in 90 degrees of
flexion and foot flat on table by pulling the
tibia anterior
RANGE OF MOTION
o The sensitivity of this exam is limited
because with the knee flexed to 90
degrees the collateral ligaments are taut
and restrain anterior motion
anterior drawer test
o Performed with both knees flexed to 90
degrees and feet flat on exam table
o A posterior directed tibial sag on the
involved knee suggests a PCL tear with
significant posterior laxity.
sag sign
Performed by flexing and extending the
knee, combined with internal and
external rotation
o A significant clunk with this maneuver
may indicate a displaced meniscal tear
o May cause a torn meniscus to displace
and lock the knee joint
o High rate of false-positives
mcmurrays
○ Performed with the knee bent to 90
degrees while lying prone on the exam
table
○ Clunk during knee flexion and extension
while applying an axial load in both
internal and external rotation
○ High false positive rate
apley compression test
bent PIP
hammer toe
mallet toe
bent DIP
claw toes
all joints are bent
normally abt 20 degrees
dorsiflexion
about 50 degrees
plantar flexion
about 30 degrees
inversion
about 10 degrees
eversion
performed by stabilizing the lower leg w one hand while cupping the heel with the other, then pulling forward on the calcaneous/talus complex
laxity compared to the uninvolved side suggests lateral ligament rupture
anterior draw test
same with anterior draw test except that theres inverting of the ankle joint
talar tilt test
Inversion laxity compared to the uninvolved side
suggests tearing of the lateral ligaments, while pain with this maneuver suggests ligament injury
talar tilt test
Performed by squeezing at the base of the calf
muscle and looking for ankle plantarflexion
• A lack of plantar flexion suggests a complete achilles tendon rupture
thompson test
