Musculoskeletal: Assessment techniques Flashcards
Shoulder flexion
“Lift your arms in front of you and over your head”
Shoulder Extension
“Raise your arms behind you”
Shoulder Adduction
“cross your arm in front of your body”
Should Abduction
Should Internal Rotation
“Place one hand behind your back and touch your shoulder blade”
Identify the highest midline spinous process patient can reach
Shoulder External Rotation
“Raise your arm up and try to scratch your opposite shoulder blade”
Test supraspinatus strength
“empty can test”
Raise patient arms to 90 degress and internally rotate so thumbs point down (like emptying a can). push down and ask patient to resist
Test infraspinatus strength
“full can test”
Have patient place arms at sides with elbows bent at 90 degrees with thumbs up. Ask patient to hold position while you press inward
Drop Arm Test
Have patient lift arm out to side at shoulds height and slowly lower arm back down to side. Watch for smooth movement
Inspect Hands/wrists
palmar and dorsal side for joint swelling, suface contour, alignment of fingers and wrist
Palpation of wrist
distal radius and ulna at the wrist
Palaption of MCP joints
Palpation of anatomical snuff box
Palpation of PIP joints
Palpation of DIP joints
Same technique as PIP but on the joint at the tip of the finger
Wrist flexion
“With palms down, point your fingers toward the floor”
Full ROM= 90 degrees
Wrist extension
“with palms down point fingers toward ceiling”
Full ROM = 90 degrees
Wrist adduction
“With palms down, bring your fingers inward”
Full ROM=20 degrees
Wrist Abduction
“With palms down, point fingers away from body”
Full ROM = 20 degrees
Hand abduction/adduction
Ask patient to spread fingers wide apart and close them back together
Purpose of Tineal’s sign
Check for median nerve compression
Technique” Tineal’s sign
Tap lightly over the course of the median nerve
(tingling or pain with tapping is positive test)
Purpose of Phalen’s sign
Check for median nerve compression
Phalen’s sign tehnique
Ask patient to flex wrists 90 degrees and push the back of the hands togenter. Hold for 60 seconds
(numbness or tingling is positive)
Hand grip
Have patient squeeze your second and third finger
Thumb movement
Thumb ROM
ROM of finger joints
Have patient make a fist with thumbs on outside of fingers and release and straighten. Watch for even, equal movement of DIP and PIP joints
Nerves in the hand
Test sensation of hands
Test that patient has feeling in all areas supplied by each nerve on both palmar and dorsal surfaces
Palpate carpal bones
Spinal inspection from the side
cervical, thoracic, and lumbar curves
Spinal inspection from behind
- Upright spinal colum
- Alignment of shoulders, iliac crests, and gluteal folds
- skin markings, tags, or masses
Palpation of spine
Each spinous process down spine
- 7 cervical
- 12 thoracic
- 5 limbar
Palpation in lower lumbar area
Check for step offs (one spinous process unusually prominent)
Palpation of neck
Palpate facet joints
Neck flexion
“Bring your chin to your chest”
Neck extension
“look up at the ceiling”
Neck rotation
“look over one shoulder, then the other”
Neck lateral bending
“Bring your ear to your shoulder
Spinal flexion
“Bend forward and touch your toes”
Spinal extension
“Lean back as far as you can”
Spinal rotation
“Rotate from side to side”
Spinal lateral bending
“Bend to the side from the waiste”
Hip flexion
“Bend your knee to your chest and pull it against your abdomen”
Hip extension
“Lie face down, bend your knee and lift it up” OR “Lying flat, abduct lower leg and hang it off the table”
Hip abduction
“Lying flat, move lower leg away from midline”
Hip adduction
Lying flat, bend the knee and move leg toward midline
Hip External/Internal rotation
Flex the leg 90 degrees. and stabilize knee and thigh with one hand. Grasp ankle with other and swing lower leg
Lateral = internal rotation Medial = external rotation
Hip internal rotation
Flex the leg 90 degrees. and stabilize knee and thigh with one hand. Grasp ankle with other and swing lower leg laterally
McMurray test
Bring patient’s heel to buttocks and internally rotate tibia. Hold rotation while you straighten the leg and feel lateral meniscus for pooping or clicking. Repeat with external rotation of tibia while palpating medial meniscus for popping or clicking
Knee Abduction
(valgus stress test)
Fully extend leg and secure ankle. Appy pressure medially to side of the knee while pulling laterally on ankle. Repeat with knee slightly bent at 30 degree angle
Knee Adduction
(varus stress test)
Fully extend leg and secure ankle. Appy pressure laterally to side of the knee while pulling medially on ankle. Repeat with knee slightly bent at 30 degrees
Anterior/Posterior drawer test technique
atient lays on back with hips at 45 degrees angle and knee bent at 90 degree angle. Sit on patient’s foot to stabilize it. Place thumbs on superio, anterior aspect of tibia and give a brisk pull or push
Lachman test
Flex knee 20-30 degrees. Stabilize distal femur laterally with one hand and hold proximal tibia on the medial side with the other. Pull tibia forward and femur back simultaneously. Should feel a clunk
Assessing for ACL tear
What does anterior drawer test for
Anterior cruciate ligament
(ACL)
What does anterior drawer test for
Posterior cruciate ligament
(PCL)
What does valgus stress test assess
Medial cruciate ligament
(MCL)
What does varus stress test assess
Lateral cruciate ligament
(LCL)
Palpate anterior aspect of ankles
For bogginess, swelling, tenderness
Palpate achilles tendon
for nodules or tenderness
Palpate heel
for tenderness
Palpate medial and lateral malleolus
for tenderness
Palpate metatarsophalangeal joints
Compress forefoot between thumb and fingers
Palpate heads of the 5 metatarsals
Compress between your thumb and forefinger
Ankle flexion
(plantar flexion)
Point foot towards floor
Ankle extension
(dorsiflexion)
Point your toes towards the ceiling
Ankle inversion
Bend heel inward
Ankle eversion
Bend heel outward
