Musculoskeletal Exams Flashcards
1
Q
Adam forward bend test
A
- Scoliosis screening exam
- look for a hump on either side
2
Q
Spurling tests and distraction maneuver
A
- Test for nerve root compression
- rotate head and compress nerve roots
- cervical radiculopathy
- Pain shooting down arm is positive test
3
Q
Straight leg raise and bragards test
A
- Test for sciatic nerve tension
- lumbar radiculopathy
- Straight leg raise = sciatic nerve irritiation
- Confirmatory SLR (bragards test) = when SLR is postive, limb is lowered just until pain is relieved, then ankle is dorsiflexed (isolates nerve roots)
4
Q
Apley Scratch test
A
- Active ROM for shoulder
5
Q
Lift off test
A
- Subscapularis lift off test or Gerbers test
- Evaluates the subscapularis muscle
- patient should be able to move hand away without difficulty
6
Q
Empty Can/Jobes test
A
- evaluates Supraspinatus muscle (rotator cuff)
- Arm is in plane with scapula
- ask the patient to hold this position and resist attempts to push the arms downward
7
Q
Arm drop Test
A
- evaluates for a large rotator cuff tear
- ask patient to lift arm to abduct it up to shoulder level at 90 degrees
- have the patient slowly lower the arm to their side
- arm often drops suddenly (indicates torn rotator cuff)
8
Q
Neers test
A
- evaluates for shoulder rotator cuff impingement or tear
–> tries to reproduce subacromial pain by compressing the rotator cuff tendons between head of humerus and acromion
- examiner prevents scapular motion with one hand by pressing on scapula
- other hand raises the patients arm in forward flexion while depressing scapula (causing the compression)
- abnormal results in pain suggesting rotator cuff tear,
9
Q
Yergason test
A
- Tests forearm supination
- evaluates rotator cuff tear and also tests for inflammation of the long head of biceps tendon
- patient flexes forearm to 90 at elbow
- pronates the patients wrist
- ask patient to supinate against resistance
- Pain during this test is a positive sign
10
Q
Varus/Valgus stress test
A
- Tests collateral ligament stability of elbow
- Valgus stress = Ulnar colateral
- Varus stress = radial collateral
11
Q
Tinel sign at elbow
A
- Posterioly between MEDIAL EPICONDYLE and OLECRANON
–> Tinel sign present if tapping reproduces shooting pain/paresthesias in ulnar distribution
Dx = ULNAR NEUROPATHY or cubital tunnel syndrome
12
Q
Lateral epicondylitis
A
- “Tennis Elbow”
- Inflammation at the origin of the WRIST EXTENSORS and the supinator muscle
- Occurs AFTER REPETITIVE WRIST EXTENSION and SUPINATION
13
Q
Cozen’s Test
A
- Tests for lateral epicondylitis
- Resisted wrist extension test
- Consists of pronation of the forearm with RESISTED wrist extension and radial deviation to determine if pain occurs
–> enhanced by: straightening the elbow, making a fist, pronating the forearm, radially deviating wrist
14
Q
3rd finger Test (Maudsley’s test)
A
- Test for Lateral epicondylitis
- Resist the EXTENSION of the 3rd digit proximal interphalageal joint
- Stresses the Extensor digitorum and extensor carpi radialis brevis (ECRB)
- Positive = pain reproduced over the lateral epicondyle
15
Q
Phalen’s test
A
- Assess for median nerve compression (contained in carpel tunnel)
- Have patient hold both wrists together in a fully palmar-flexed position with dorsal surfaces together
- ask patient to hold this for 60 secs
- Positive = numbness and paresthesia in median nerve distribution
–> may indicate CARPAL TUNNEL
16
Q
Tinel’s sign
A
- assessment of the median nerve
- lightly tap the wrist with index or middle finger where median nerve passes under the flexor retinaculum and colar carpal ligamen
- Positive = reproduces paresthesias in median n distribution
17
Q
describe De Quervain’s tenosynovitis
A
- Swelling or stenosis of the sheath that surrounds the ABDUCTOR POLLICIS LONGUS and EXTENSOR POLLICIS BREVIS
–> caused by direct injury or repetitive activity
- Symptoms = pinching, gripping, wrist and thumb movements associated with pain, may radiate to proximally to forearm
18
Q
Finkelstein’s test
A
- Tests for De Quervain’s Tenosynovitis
- STEPS
- -> thumb flex and fingers “fisted” over the thumb
–> examiner twists wrist into ulnar deviation
- Maximizes tension over the tendones
- Positive = pain is reproduced over radial wrist
19
Q
SNUFF BOX TENDERNESS
A
- Snuff box floor is made up of SCAPHOID BONE
- Tenderness, particularly after fall or outstretched hand (FOOSH) injury)
- INDICATES SCAPHOID FRACTURE
20
Q
Describe Osteoarthritis (OA) of hand
A
- Caused by –> cartilage degeneration, tauma
- Progressive destruction of PIP and DIP
- Heberdens Nodes on DIP
- Bouchards nodes on PIP
**THUMB GRIND TEST USED TO CONFIRM DIAGNOSIS**
21
Q
Thumb (1st CMC) grind test
A
- Thumb base (1st metacarpal and trapezium)
- Pushing/twisting thumb metacarpal against the trapezium
- POSITIVE = PAIN, grinding
**indicates osteoarthritis**
22
Q
Rheumatoid arthritis (RA)
A
- Swan neck deformity
- boutonniere deformity
- ulnar deviation
- MCP swelling/thickening
23
Q
Define Swan neck deformity
A
- Rupture of palmar PIP ligament, synovitis
- MCP flexed, PIP hyperextended, DIP flexed
24
Q
define Boutonniere deformity
A
- Rupture of central extensor tendon at its insertion into the middle phalanx
- PIP flexed, DIP extended
25
define Dupuytren's contracture
- Fibrous contracture of palmar fascia with flexion contracture of MCP and PIP joints
- Symptoms:
--\> occurs at distal palmar crease and ring and little finger
--\> unable to extend finger actively or passively
--\> NOT PAINFUL
26
Define trigger finger
- caused by direct, reptitie trauma to flexor tendons
- ligamentous sheath thickens, tendon swells, and forms a nodule
- difficulty flexing until sudden snap on finger into full flexion with inability to extend finger
27
Define mallet finger
- Also called baseball finger
- Avulsion of extensor tendon at DIP joint
- DIP flexed, unable to extend
28
Thomas sign
- evaulates hip flexion contracture
- have uninvolved flexed leg is held against the chest of the supine patient to flatten the lumbar lordosis
- Positive test = if hip flexion contracture is present in the opposite leg, it will flex at the knee and lift up off the table
29
Trendelenburg test
- assesses weak or nonfunctional gluteus medius
30
ober test
assess for tight iliotibial band (or tensor fascia lata)
31
Ballottement test
- assess for large effusion or excess fluid in knee
- knee extended apply downward pressure on the suprapatellar pouch with the web between thumb and second finger and then push patella sharply against the femur with finger of your other hand
32
Lachmens tst
- evaluates the anterior cruciate ligament
33
ANterior drawer test
- Evaluates anterior cruciate ligament
34
Posterior drawer test
evaluates posterior cruciate ligament
35
Apleys compression
- evaluates for torn medial or lateral meniscus
- used when patient complains of knee locking
- POSITIVE = locking, clicking or pain
36
Apleys distraction test
- aply distraction test evaluates ligamentous injury
- Positive = increase or chance in location of pain
37
Mcmurrays test
- evaluates for torn meniscus in the knee on the posterior side
- used when person has popping/clicking is felt in the joint during knee flexion or extension
Positive = you feel a palpable snapping sensation at the joint being monitored
38
Anterior Drawer test for ankle
- assesses lateral instability, ATF ligament tear
39
Talar tilt (inversion stress)
- Assesses LATERAL INSTABILITY (ATF, CF)
40
Squeeze test
- Assesses for High ankle sprain/syndesmotic sprain/fracture
41
External rotation test
- Syndesmotic injury
