Ortho Exams Flashcards
Adams Sign
Vertebral
Dx: structural scoliosis
How: patient bends forward, scoliosis not improved
Adson’s Test
Vertebral
Dx: thoracic outlet sydrome (anterior scalene)
How:
- Patient in upright position.
- Passively extend, abduct and externally rotate affected arm while palpating the radial pulse.
- Ask patient to take a deep breath and hold it in.
- Ask patient to extend neck and rotate the head towards affected side.
Braggard’s Test
Vertebral
Dx: sciatica d/t disc herniation
How: during SLR, dorsiflex foot of leg that’s raised
Bechterew’s Test
Vertebral
Dx: sciatica
How: while seated with flexed neck, pt extends one leg at a time; if no symptoms, pt extends both legs simultaneously
Burns Bench Test
Vertebral
Dx: malingering
How: pt askted to touch floor while kneeling on a chair/bench. (+) if pt is not able to perform.
-More likely to see as a distractor-
Cervical Spine Compression Test
Vertebral
Dx: nerve root compression/impingement
How: push down on pt’s head, (+) if sxs reproduced
Cervical Spine Distraction Test
Vertebral
Dx: nerve root compression/impingement
How: pull up on pt’s head, (+) if sxs relieved
East’s Test / Roo’s Test
Vertebral
Dx: thoracic outlet syndrome
How: pt hands up, open/close hands for 3 minutes.
(+): weakness of arm, numbness and tingling of the hand, inability to do for 3 min
Hoover’s Test
Vertebral
Dx: malingering
How: pt supine, doc’s hands under pt’s heels, pt asked to flex one hip
(+): pt does not press down with non-active leg
Kemp’s Test
Vertebral
Dx: disc herniation vs. facet
How: rotate, extend, flex – push on lumbar SP’s
(+) local pain = facet irritation
(+) radiating pain = nerve root irritation/disc herniation
Kernig’s Test
Vertebral
Dx: meningitis
How: passively flex knee and hip 90 degrees, then attempt to extend the knee while keeping the hip stable
(+): resistance, pain
Lasegue’ Test (SLR)
Vertebral
Dx: disc herniation OR sciatica
How: passively raise pt’s leg to 70 degrees
(+): pain between 30 and 70 degrees suggests disk hernia, any radiating pain suggests sciatica
Lindner Test
Vertebral
Dx: nerve root irritation
How: pt seated or supine, neck passively flexed
Milgram’s Test
Vertebral
Dx: disc herniation
How: supine, raise extended legs for 30 seconds
(+): inability to hold feet off the table for full 30 sec
Minor’s Sign
Vertebral
Dx: sciatica
How: patient rises from a sitting position by supporting body weight on the unaffected side, placing one hand on the back
Shoulder Depression Test
Vertebral
Dx: brachial plexus lesions (nerve root irritation)
How: apply downward pressure to shoulder while flexing patients head to opposite side
Soto Hall
Vertebral
Dx: cervical disc herniation/cervical nerve root compression
How: patient supine, examiner passively flexes neck & applies pressure on sternum.
Valsalva
Vertebral
Dx: space occupying lesion
How: bear down
Vertebral Artery Test
Vertebral
Dx: vertibral artery insufficiency or compression
How: passively extend head, lat flex, rotate to same side– hold 30 sec (side of compression is restricting blood flow)
(+): dizziness, visual chagnes, nystagmus
(+) means cervical manipulation is CONTRAINDICATED
Wright’s Test
Vertebral
Dx: thoracic outlet syndrome, brachial artery compression
How: while palpating both radial pulses, life the patients arms slowly into abduction
(+): disappearance of pulse
Apley’s Scratch Test
Shoulder
Dx: rotator cuff tear, tendonitis
How: touch finger tips at middle of back
(+): pain in shoulder region
Drop Arm Test (Codman’s)
Shoulder
Dx: rotator cuff tear
How: passively raise patient’s arm above 90 degrees (abduction), then patient lowers arm back to neutral
(+): patient’s arm drops suddenly or experiences pain
Glenohumeral apprehension test
Shoulder
Dx: shoulder dislocation or glenohumeral instability
How: pt shoulder and elbow at 90 degrees, examiner externally rotates shoulder
(+): pt feels/shows apprehension
Impingement Test (Hawkins-Kennedy)
Shoulder
Dx: impingemnet (biceps, rotator cuff, supraspinatus)
How: pt. shoulder flexed and horizontally adducted toward midline. Stabilize elbow, and internally rotate shoulder by maneuvering forearm down.
Impingement Test (Neer’s)
Shoulder
Dx: supraspinatus or biceps tendon impingemnet
How: examiner internally rotates the pt’s arm and passively elevated the arm in the scapular plane.
Lippman’s Test
Shoulder
Dx: bicipital tendinosis
How: pt arm flexed to 90 degress, examiner palpates bicipetal groove (think “Lipps”) while passively internally + externally rotating
Speed’s Test
Shoulder
Dx: bicipital tendinosis
How: resisted shoulder flexion with pt forearm supinated
Yergason’s Test
Shoulder
Dx: bicipital tendinosis
How: pt flexes elbow to 90 degress, resisted supination/lat rot
Thoracic possible diagnoses?
- Scoliosis
- TOS
- Sciatica/impingement
- Disc herniation
- Meningitis
- Vertebral artery compression
- Space occupying lesion
Shoulder possible diagnoses?
- Rotator cuff tear
- Tendonitis
- Dislocation
Wrist/hand/elbow possible diagnoses?
- Tennis elbow
- Dequervain’s
- Carpal tunnel
Cozen’s Test
Wrist/hand/elbow
Dx: tennis elbow (lateral epicondylitis/extensor tendonitis)
How: pt arm out and pronated; resisted wrist extension
Finkelstein’s Test
Wrist/hand/elbow
Dx: DeQuervain’s disease
How: pt holds thumb in closed fingers and ulnar deviates
Mill’s Test
Wrist/hand/elbow
Dx: tennis elbow (lateral epicondylitis/extensor tendonitis)
How: palpate patient’s lateral epicondyle while pronating the patient’s forearm, flexing wrist, extending elbow
Phalen’s Test
Wrist/hand/elbow
Dx: carpal tunnel
How: backwards prayer for 30-60 seconds
Retinacular Test
Wrist/hand/elbow
Dx: tight retinacular ligaments or capsule
How: hold PIP, pt flexes DIP. If can’t flex DIP, hold PIP in flexed position and have patient try to flex DIP again.
Tinel’s Sign
Wrist/hand/elbow
Dx: carpal tunnel
How: tap over median nerve in wrist
(+): median nerve distrubution pain or tingling (thumb, index, middle, half of the fourth digit)
Valgus/Varus Stress Tests
Wrist/hand/elbow
Dx: medial (ulnar) or lateral (radial) collatoral lig instability
How: stabilize elbow, apply medial (valgus) and lateral (varus) force
Ely’s Test
Hip/pelvis
Dx: muscle tightness, TFL/iliotibial tightness
How: prone, flex knee to contralateral buttock
Gaenslen Test
Hip/pelvis
Dx: SI or L4 lesions
How: supine, one leg off table, bring the other knee to your chest
Hibb Test
Hip/pelvis
Dx: SI or hip pathology, spondylolisthesis
How: prone, flex knee, move leg laterally (opposite of Ely’s)
(+):
- pain in hip –> hip pathology
- pain in buttock/pelvic –> SI pathology or spondylolisthesis
Nachlas Test
Hip/pelvis
Dx: ddx between SI, lumbar, femoral nerve source (upper lumbar)
How: pt prone, examiner flexes knee to ipsilater buttock (Ely’s is contralateral)
(+): location of pain suggests source
Ober Test
Hip/pelvis
Dx: TFL/iliotibial band contracture
How: lateral decubitus, affected leg up, flex knee, raise leg, let it fall
Patrick Test (FABER)
Dx: SI joint pathology
How: flex, abduct, externally rotate pt hip (make a 4)
Pelvic Rock Test
Dx: SI pathology
How: compress iliac crests towards midline
Thomas Test
Dx: hip flexor tightness
How: pt supine and brings one knee to chest
(+): non-active leg lifts off table
Yeoman’s Test
Dx: SI joint pathology
How: pt prone, extend hip with knee extended/flexed to 90
