NMS Flashcards
O’Donohue
can be performed on any joint
patient actively moves against resistance, and then doctor passively moves part through full ROM
positive: pain
indicates: sprain if pain during passive ROM/strain if pain during active ROM
Homan’s sign
don't do in real life patient supine in 90/90 position doctor squeezes calf and dorsiflexes the foot simultaneously positive: deep calf pain indicates: DVT
Dejerine’s triade
patient reporst pain is brought on by coughing, sneezing or straining at stool
indicates:SOL
Schepelmann’s
patient raises both arms over head while seated and laterally bends to both sides
positive/indications: pain on teh concave side is intercostal neuralgia; pain on convexity is is pleurisy or myofascitis, sprain/strain
rust sign
paitent spontaneously grasps head with both hands when rising from recumbent position
indicates: cervical instability due to sprain/strain, fracture, RA
libman’s
doctor applies finger pressure over mastoid process. pressure increased until patient feels discomfort
used to determine pain threshold of patient
lhermitte’s sign
patient seated or supine. patient actively/passively flexes head toward chest
positive: sharp electric shock like sensation down the spine into extremities
indicates: MS, myelopathy, other demyelinating cord lesions
Gower’s sign
when arising from supine position, patient turns to prone position and then climbs up on themselves
indicates muscular dystrophy
Kernig’s sign
patient supine. doctor flexes hip and knee 90/90 position and then attempts to extend knee
positive: patient resists extension; resistence causes kicking motion
Brudzinski’s sign
patient supine. doctor passively flexes patient’s head approximating the chin to chest
positive: buckling of knee
meningeal irritation
patient will present with fever, headache, photophobia, nuchal rigidity
evaluation of CSF: increase in protein indicates viral, decrease in glucose indicates bacterial
amoss sign
patient is asked to go from a side lying position to a seated position
positive: localized thoracolumbar pain &/or lack of ROM
indication: AS, IVD syndrome, severe sprain/strain
lewin supine test
patient supine, doctor supports legs on the table; patient is then asked to sit up without using hands
positive: unable to perform
forrestier’s bowstring sign
while standing the patient performs side bending to both sides
positive: muscle tightening on concave side
chest expansion test
tape measure placed around the 4th intercostal space. patient exhales completely, measurement taken then patient inhales deeply, measurement taken.
normal: 1.5-3 in
positive: <1.5” in women, <2in in men
mannkopf’s sign
doctor takes resting pulse rate. doctor then applies pressure over painfularea and takes pulse rate again
positive: increase of 10 beats per minute
indicates: not a malingerer
magnusson’s
at the beginning of the case history, patient is asked to point to the site of pain on the back; the examiner marks it with a skin pencil. later on, patient is again asked to point to the site of pain
positive: patient doesn’t point to the same spot
lasegue’s sitting
patient is sitting upright on the edge of a table or chair which has no backrest. the doctor faces the patient and usually under the guise of “checking circulation” extends the patient’s legs below the knee, one at a time, so that the limb is parallel with the floor
positive: no pain when there has been a +SLR
hoover’s sign
patient supine. doctor places one hand under each heel and asks patient to lift affected limg
positive: doctor doesn’t feel the unaffected side pressing downward
burn’s bench test
patient instructed to kneel on a table 18 inches from the floor, bend forward at the trunk, and touch the floor. doctor holds ankles
positive: patient refuses to perform
thompson’s test
AKA simmond’s sign
patient prone, feet hanging off table, doctor flexes knee to 90 degrees and squeezes calf
positive: no plantar flexion of foot
indicates: achilles tendon rupture
medial/lateral stability test
patient is seated or supine. doctor grasps the patient’s foot and pasively inverts and everts it
positive: excessive gapping
indicates: during inversion: ant. talofibular or calcaneofibular lig tear (add. stress test)
during eversion: deltoid lig tear (abd stress test)
anterior food drawer test
patient supine. doctor places hand around anterior aspect of lower tibia while grasping calcaneous in palm of other hand and then pulls calcaneusforward
positive: talus slides forward
indicates: anterior talofibular ligament instability
