OPP Special Test

Question 1

Answer 1

Apley Scratch Test

external rotation and abduction

patient reaches behind his head to touch the superior medial angle of the opposite scapula

Question 2

Answer 2

Apley Scratch Test

internal rotation and adduction

patient reaches behind his back to touch the inferior angle of the opposite scapula

Question 3

Answer 3

AC Joint Dysfunction

PT adduct the arm

place hand on contralateral shoulder

Flex Elbow to 90

pt actively resist downward force from physician

Question 4

Answer 4

Drop Arm Test

screen for possible rotator cuff tear (supraspinatus tear)

the patient fully ABduct the arm (160-180)

slowly lower the arm to the side

+ test = not be able to lower the arm slowly and smoothly

Question 5

Answer 5

Empty Can/JOBE Test

test for supraspinatus weakness

90° Abduction

30° horizontal flexion anterior of coronal plane

internal rotation (Thumbs DOWN)

Question 6

Answer 6

Infraspinatus/Teres Minor Test

marked external rotation against resistance

Elbow flexed to 90 and @ sides

Patient Attempts to Externally Rotate Against the physician’s counterforce

Question 7

Answer 7

Subscapularis Lift Off Test

internally rotate arm w/ dorsum of hand on lumbar spine

patient pushes away from back w/ resistance from physician

Question 8

Answer 8

Subscapularis Internal Rotation Test

Pt attempts to internally rotate arm against physicians resistance

Question 9

Answer 9

Hawkin’s Test

Impingement of supraspinatus

Pronated Arm is Passively Flexed to 90

then Internally Rotated while stabilizing the scapula

Impingement btw greater tuberosity of the humerus against the coraco-humeral ligament

Question 10

Answer 10

Neer’s Test

Impingement of supraspinatus

Pronated + internally rotate arm

Passively Flexed while stabilizing scapula

Impingement occurs @ > 90 Flexion

(near ear)

Question 11

Answer 11

Apprehension Tests

evaluates stability of shoulder joint

ligamentous laxity/injury or dislocated/subluxed

pt supine w/ arm off table

ABduction and External Rotation shoulder

(position of shoulder vulnerability)

Question 12

Answer 12

Relocation Tests

evaluates stability of shoulder joint w. pressure

pt supine w/ arm off table

ABduction and External Rotation shoulder w. pressure on GH joint

looking for relief of pain

Question 13

Answer 13

Yergason’s Test

test stability of long head of biceps tendon

in the bicipital groove

test transverse humeral ligament integrity

pt flexes elbow to 90 + pronates forearm

pt actively flexes + supinate arm against physician resistance + external rotation

+ test = biceps tendon pops out or pain

Pain w.o. subluxation = bicipital tendonitis/tendonosis

Question 14

Answer 14

Speed’s Test

Testing for Bicipital tendonitis

pt flexes arm to 90 + supinates

physician applies downward force/resistance

+ test = pain in anterior shoulders (site of biceps tendon)

Question 15

Answer 15

O’ BRIEN’S TEST

maximally load and compress the ACJ

Flex arm to 90° w. elbow fully extended

Adduct arm 40° medial to sagittal plane

arm maximally internally rotated

pt resists physician’s downward/medial force

Question 16

Answer 16

Roos Test

Shoulder Abduction + External Rotation

Elbows flexed to 90

hands perform repetitive opening/closing for 3 minutes

+ test = Paresthesias/Numbness/Tingling

Question 17

Answer 17

Adsons Test

Scalene Entrapment

Arm in Slight Extension and Abduction

head turned toward affected side

+ test = weakened radial pulse or paresthesias

Question 18

Answer 18

Wrights Test

Pectoralis Minor Entrapment

Hyperabduct arm above head

patient turning head away

palpate radial pulse

+ test = weakened radial pulse or Paresthesias

Question 19

Cubital Tunnel Syndrome

Answer 19

Ulnar Nerve (C8-T1) entrapment at elbow

Numbness + Tingling in medial portion of hand

caused by repetitive elbow extension/flexion

Question 20

Answer 20

Tinel’s Test at Elbow

reproduced s/s of numbness/tingling felt in medial hand

tap where ulnar nerve runs in cubital tunnel

Question 21

Lateral Epicondylitis

tennis elbow

Answer 21

Pain at the lateral epicondyle at point of forearm extensor

MOI: extensor carpi radialis brevis

caused by repetitive supination motion

Pain with Resisted Supination

Question 22

Answer 22

Lateral Epicondylitis

Maudsley’s test

pain at lateral epicondyle w. resisted middle finger extension

Mills test

pain at lateral epicondyle w. resisted wrist extension

Question 23

Medial Epicondylitis

golfers elbow

Answer 23

Pain at the medial epicondyle at point of forearm flexor complex attachment

MOI: flexor carpi radialis

Pain with resisted pronation

Question 24

Answer 24

Medial Epicondylitis

Pain noted with resisted pronation and/or wrist flexion

Question 25

Carpal Tunnel Syndrome (CTS)

Answer 25

Median Nerve (C5-T1) entrapment beneath Flexor Retinaculum

Numbness, Weakness, Tingling in Median Nerve distribution of hand

caused by repetitive motion of wrist

Question 26

Answer 26

Tinel’s Test for Carpal Tunnel

Percuss w/ index/middle finger tips on Flexor Retinaculum

+ test = numbness/tingling sensation in Median nerve distribution

Question 27

Answer 27

Phalen’s Test

Hyperflexion of wrists and hold for 30-60 seconds

+ test = reproduced numbness/tingling in Median nerve distribution

Question 28

Answer 28

Reverse Phalen’s Test

Hyperextension of wrists and hold for 30-60 seconds

+ test = reproduced numbness/tingling in Median nerve distribution

Question 29

Answer 29

Finkelstein’s Test

test for De Quervain’s Tenosynovitis

MOI: extensor pollicis brevis and the abductor pollicis longus

place thumb inside fist while applying ulnar deviation to the wrist

+ test = pain in region of snuff box

Question 30

Answer 30

Allen’s Test

test collateral blood supply to the hand

Fist is held for 20-30 seconds

Pressure is applied to Radial/Ulnar arteries

blanching occurs

release pressure from radial or ulnar artery

color should return w.i. 5-7 seconds