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Part 4 > Ortho / Neuro Exams > Flashcards

Ortho / Neuro Exams Flashcards

1
Q

Valsalva’s sign

A

A - Seated, take a deep breath, hold, bear down
Postive - Radicular pain
Indicates - SOL

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2
Q

Naffziger’s

A

P - Seated, digitally compress both internal jugular veins

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3
Q

Milgram’s

A

A - Supine, raise and hold legs 3” off the table (may help patient raise legs)

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4
Q

Dejerine’s Triad

A

Patient has pain when coughing, sneezing, or during a bowel movement

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5
Q

Swallowing

A

A - Seated, instruct patient to swallow (esp. esophageal lesion)

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6
Q

Rust’s sign

A

A - Look to see if patient holds their head (ADI instability) - ask to change positions and observe

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7
Q

Foraminal Compression Test

A

P - Seated, direct compression (head rotated to each side with pressure)
Positive = radicular pain
Indication - Nerve Root Compression

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8
Q

Jackson’s Compression Test

A

P - Seated, laterally flex and compress on each side
Postive - Radicular pain
Indicates - Nerve Root Compression

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9
Q

Maximal Cervical Compression Test

A

A - Seated, rotates and extends the neck to one side. If no pain the patient is asked to maximally laterally flex the neck. Repeat on other side. No compression
Positive - Radicular pain
Indicates - Nerve Root Compression

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10
Q

Spurling’s

A

P - Seated, fist strike after “Maximal position” (Disc and IVF encroachment)

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11
Q

Bakody’s

A

A - Seated, hand on head (+ sign = decreased pain) (Nerve root syndrome)

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12
Q

Shoulder Depression Test

A

P - Seated or supine, lateral flexion stretch neck away from one shoulder. Repeat on other side.
Positive - pain
Indicates - Nerve Root Adhesion

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13
Q

Distraction Test

A

P - Seated, lift head avoiding face and TMJ

Positive - Decreased pain = Nerve Root Compression; Increased pain - sprain / strain

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14
Q

O’Donoghue’s Test

A

Patient actively moves against resistance, and then the Dr. passively moves the part through a full ROM
Positive - Pain
Indicates - Sprain: passive; Strain: active

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15
Q

Lhermitte’s

A

A - Seated, neck flexion (Cord degeneration, MS = electric-like sensations)

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16
Q

Sternal compression

A

P - Supine, cross arms on chest and apply pressure on sternum (Rib or thorax lesion)

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17
Q

Soto Hall

A

P - Supine, cross arms on chest with passive neck flexion and sternum stabilization
Positive - localized pain
Indicates - fracture with ant. pain; ligament with post. pain

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18
Q

Libman’s

A

P2 - Seated, pressure on mastoid - assessment patient pain threshold

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19
Q

Brudzinski’s

A

P - Supine, flex neck (+ sign = knees buckle)

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20
Q

Kernig’s

A

P - Supine, hip and knees flexed, extend knee (+ sign = knee kicks)

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21
Q

VBAI (Maigne’s)

A

A2 - Seated, rotate and extend (auscultate carotids if stethoscope present)

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22
Q

DeKleyn’s

A

P2 - Supine Maigne’s - supported rotation and extension (head on table)

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23
Q

Hallpike’s

A

P2 - Supine, extend head off table, add rotation and lat. flexion, then unsupported ext.

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24
Q

Dizziness Test

A

A2 - Seated, Patient rotates head, Patient rotates body as Dr. holds head neutral

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25
Q

Mittlemeyer’s

A

A - standing, march in place eyes opened and then closed (+ sign = rotate to side of lesion)

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26
Q

Barany-Nylen

A

A2 - Seated, turn head, lay supine with head off table (+ nystagmus fatigues) (BPV)

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27
Q

Barany-Caloric

A

P2 - Seated with head extended, irrigate ear with cold and then warm water

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28
Q

Hall Pike Caloric

A

P2 - Supine Barrany-Caloric

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29
Q

Allen’s Test

A

A/P2 - Seated, patient extends both hands (palm up) squeezes one, doctor compresses radial and ulnar arteries, patient opens fist and doctor releases one artery (done on both arteries bilaterally)

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30
Q

Buerger’s

A

P2 - Supine, elevate leg to 45 degrees, hold, lower leg and help patient sit up with both legs dangling
(+ sign = immediate blanching when elevated or more than 2 minutes for color to return when seated) (lower arterial incompetency)

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31
Q

Barre-Lieou’s

A

A2 - Seated, maximally rotate head from side to side several times (VBAI)

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32
Q

Homan’s

A

Supine, leg in 90/90 position, squeeze calf and dorsiflex foot.
Positive is Deep Pain
Indicating Deep Vein Thrombosis

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33
Q

Claudication

A

A - Standing, marching in place, when pain occurs bend forward (relief = neurogenic)

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34
Q

Perthes’ (Tourniquet)

A

A - Standing with tourniquet around thigh, exercise

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35
Q

Bicycle / Stoop

A

A - Cardiovascular exercise (bicycling) “upright” until claudication, then stooped forward (+ relief of pain) (Neurogenic claudication, DJD, canal stenosis)

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36
Q

Adson’s

A

A - Seated, rotate towards involved side and extend (Scalenus Anticus, cervical rib)

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37
Q

Modified Adson’s

A

A - Seated, rotate away from involved side and extend (Scalenus medius, cervical rib)

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38
Q

Halstead’s

A

A - Seated, extend head and traction arm down

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39
Q

Eden’s

A

A - Seated, shoulders down and back, break frontal plane (costoclavicular)

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40
Q

Wright’s

A

P2W - Seated, hyperabduct each arm (pect. minor)

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41
Q

Allen’s maneuver

A

A/P - Seated, flex elbow 90 degrees, extend arm horizontal, externally rotate arm, patient rotates head

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42
Q 
Roos maneuver
AKA EAST (Elevated Arm Stress Test)
A

A2W - seated, “hostage position” pump hands

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43
Q

Reverse Bakody

A

A - Seated, hand on head (+ increase in pain)

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44
Q

Apley’s scratch test

A

A2W - Seated, touch ipsilateral scapula behind head from superior and inferior

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45
Q

Mazion Shoulder Rock

A

A - Seated, touch opposite shoulder and bring elbow up and down

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46
Q

Dugas test

A

A - seated, touch opposite shoulder and bring elbow down (dislocation)

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47
Q

Apprehension Test

A

P - Seated with arm in hostage position, stress humerus anterior (dislocation)

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48
Q

Calloway’s

A

P2 - Seated, measure vertical shoulder circumferences (+ increased girth) (dislocation)

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49
Q

Dawbarn’s

A

P - Seated, press on bursa while abducting arm (+ is decrease in pain) (subacromial bursitis)

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50
Q

Abbot Saunders

A

P - Seated, Dr passively abducts arm, ext rot then lowers arm

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51
Q

Yergason’s

A

AR - Seated, resist patient elbow flexion and supination (bicipital tendon instability)

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52
Q

Speeds

A

AR - Seated with arm extended, resist patient shoulder flexion (bicipital tendonitis)

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53
Q

Impingement

A

P - Seated, fully flex patient’s arm (biceps or supraspinatus tendonitis)

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54
Q

Supraspinatus arc

A

AR - Standing, resist patient arm abduction throughout entire 180 degrees
(+ pain at 10-20 and 90-110 = supraspinatus) (20-90 = deltoid)

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55
Q

Supraspinatus press aka empty can

A

AR2 - Seated, thumb down

  1. patient arm 90 degrees abduction, resist abduction
  2. angle arms forward 30 degrees, resist abduction
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56
Q

Codman’s

A

A/P - Standing abduct past 90 degrees (rotator cuff)

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57
Q

Cozen’s

A

AR - Seated, resist patient wrist extension (lat. epicondylitis)

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58
Q

Mill’s

A

P - Seated, pronated and flex wrist (lat. epicondylitis)

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59
Q

Reverse Cozen’s

A

AR - Seated, resist patient wrist flexion (medial epicondylitis)

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60
Q

Tinel’s tap for elbow

A

P2 - Seated, tap btn. olecranon and medial epicondyle (ulnar n.)

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61
Q

Tinel’s tap for wrist

A

P2 - Seated, tap over flexor retinaculum (median n.)

62
Q

Phalen’s aka wrist flexion

A

A - Seated, dorsum of hands together, flexing wrists (carpal tunnel)

63
Q

Reverse phalen’s

A

A - Seated, palms of hands together, extending wrists (prayer sign) (carpal tunnel)

64
Q

Pinch

A

A2 - Seated, bring index and thumb tips together (median n)

65
Q

Froment’s paper sign

A

A - Seated, pull paper from btn. patient’s index and thumb (ulnar n)

66
Q

Finkelstein’s

A

A - Seated, thumb in palm, make fist, ulnar deviate (DeQuervain’s)

67
Q

Bunnel-Littler’s (PIP)

A

P - Seated, 1. with MCP extended, flex PIP
2. With MCP flexed, flex PIP
(decrease motion in 2 = PIP joint problem; increase motion in 2 = intrinsic m. problem)

68
Q

Retinaculum (DIP)

A

Same as bunnel littler, except using the PIP to test DIP flexion

69
Q

Bracelet test

A

Seated, grasp and compress patient’s distal radius and ulna (RA, ganglion cyst, carpal tunnel)

70
Q

Finsterer’s

A

Seated, pronated fist, strike base of 3rd metacarpal (Kiencock’s disease)

71
Q

Wrinkle Shrivel

A

Seated, place hand in tepid water for 5 minutes (+ no pad wrinkle) (Denervation)

72
Q

Adam’s

A

Standing, examine spine as patient flexes with their shoes off.
Improvement = functional scoliosis
No improvement = strutcural scoliosis

73
Q

Adam’s positions

A

Standing, kneeling, sitting

74
Q

Rib Compression

A

Seated, from behind, squeeze the patient’s forearms on side

75
Q

Schelpelmann’s

A

Seated or standing, have the patient laterally flex, clasping hands over head
Ipsilateral pain = intercostal neuritis
Contralateral pain = pleurisy / myofasciitis

76
Q

Forestier’s bowstring

A

A2 - Standing, feel paraspinals, as patient laterally flexes (+ ipsilateral contraction)

77
Q

Chest expansion

A

A - Seated erect or standing, tape measure at T4 lvl, patient expires, then inspires
(+ less than 2” male or 1.5 for female)

78
Q

Lewin supine

A

A - supine, stabilize legs as patient attempts a sit-up (+ inability)

79
Q

Amoss’ sign

A

A - supine or side lying, patient rises to a sitting position (+ if action causes localized thoracic pain)

80
Q

Minor’s sign

A

A - Patient pushes off uninvolved side leg or chair arm when getting up (sciatica)

81
Q

SLR (Lasegue’s)

A

P1 - Supine, flex hip on involved side (+ radiculopathy)

82
Q

Seated Lasegue’s

A

P1 - Seated, extend knee on involved side (+ radiculopathy)

83
Q

Lasegue’s differential sign

A

P1 - Supine, SLR until radiculopathy pain elicited, Dr. then flexes knee (relieves pain = rules out hip involvement)

84
Q

Braggard’s

A

P1 - Supine, SLR, lower foot 5 degrees, then dorsiflex (+ radiculopathy)

85
Q

Sicard’s

A

P1 - Supine, SLR, lower foot 5 degrees, then extend big toe (+ radiculopathy)

86
Q

Turyn’s

A

P1 - Supine, extend big toe (+ radiculopathy)

87
Q

WLR

A

P1 - Supine, lift uninvolved side (+ radiculopathy affected side) (medial disc)

88
Q

Fajersztajn’s

A

P1 - Supine, WLR, lower foot 5 degrees, dorsiflex foot (+ radiculopathy affected side) (medial disc)

89
Q

Lindner’s

A

P - Supine, flex upper trunk into a C (+ radiculopathy) (lateral disc)

90
Q

Bowstring’s AKA Cram test and Popliteal pressure sign

A

Supine, SLR, relax knee, apply popliteal pressure (+ radiculopathy)

91
Q

Kemp’s

A

A/P2 - Seated or standing, rotate, laterally flex, and extend trunk (localized pain = facet) (radiculopathy = nerve root)
Ipsilateral pain = lateral disc
Contra pain = medial disc

92
Q

Bonnet’s

A

P1 - Supine, SLR with hip adduction and internal rotation (+ sciatica) (piriformis)

93
Q

SOTO

A

P1 - Supine, SLR with hip abduction and external rotation (relieves piriformis)

94
Q

Bechterew’s

A

A2 - Seated, with hands on their lap, extend one knee, then other knee, then both (+ sciatica/hamstrings) (disc)

95
Q

Prone Lumbar Hyperextension test

A

A2 - Prone, Dr. stabilizes ankles and patient attempts to extend torso off the table (pain = lumbar sprain/strain)

96
Q

Reversal Sign

A

A - standing, bend forward (+ pain when getting up), chronic facet syndrome

97
Q

Femoral Nerve Traction Test

A

P2 - Side lying, Dr. grasps affected leg and extends hip while knee is bent

98
Q

Stork test

A

A2 - standing on one leg, patient leans back (+ pain = pars instability)

99
Q

Tripod sign

A

A2 - seated, observed during Bechterew’s (tight hamstrings)

100
Q

Beery’s sign AKA Chair sign

A

A - Sitting relieves discomfort

101
Q

Neri Bowing AKA Bowing, Curtsy, Buckle

A

A2 - standing, trunk flexion without / with knee flexion

102
Q

Lewin Standing

A

A/P2W - Standing, pull each knee into extension, then both, while stabilizing pelvis

103
Q

Anterior innominate AKA Advancement, Mazion’s Pelvic Maneuver

A

A2 - Standing, advance uninvolved leg and flex trunk

104
Q

Supported Adam’s Belt

A

A - Standing, flex trunk without / with support (pain better = SI; worse = lumbar)

105
Q

Goldthwait’s

A

P - Supine, flex hip while palpating low back

106
Q

Gaenslen’s

A

P - Supine, knee to chest, involved side hip ext. off edge of table (Best SI test)

107
Q

Lewin=Gaenslen’s

A

P - Side-lying Gaenslen’s, stabilize pelvis and extend hip (SI)

108
Q

Iliac Compression

A

P - Side-lying, press down on SI

109
Q

Hibb’s

A

P - Prone, flex knee and internally rotate hip (SI, may suggest hip)

110
Q

Double leg raiser

A

P2 - Supine, SLR one side, then the other…note what angle pain occurs. Then raise both legs, again noting angle when pain occurs. (SI, lumbosacral)

111
Q

SI resisted abduction

A

A - Side-lying, abduct and extend affected leg; Dr. exerts downward force (pain = SI)

112
Q

Piedallu AKA Seated Flexion Sign

A

A - Seated, on flat surface; Palpate PSIS, patient flexes, low side becomes high (SI)

113
Q

Erichsen’s

A

P - Prone, squeeze SI joints together bilaterally (SI)

114
Q

Squish AKA Distraction, Gapping

A

P - Supine, hands on ASIS, facing feet, push downward at 45 degree angle (SI)

115
Q

Yeoman’s

A

P - Prone, flex knee and Extend hip with SI stabilization (SI)

116
Q

Nachlas’

A

P - Prone, flex knee and bring heel to buttock with SI stabilization (SI, L/S, femoral nerve stretch)

117
Q

Ely’s sign

A

P - Prone, flex knee and Bring heel to buttock (no stabilization) (+ buttock hunch) (psoas contacture)

118
Q

Ely’s test

A

P - Prone, flex knee and bring heel to contralateral buttock (no stabilization) (general low back)

119
Q

Trendelenburg’s

A

A - Standing, raise uninvolved foot off the floor (+ glueus drop) (gluteus medius)

120
Q

Ludloff’s

A

A - Seated, raise inovled thigh off table (lesser trochanteric fracture)

121
Q

Noble’s

A

P - Supine with hip and knee flexed, press lateral femoral condyle with thumb while extending knee to 30 degrees (iliotibial band friction syndrome)

122
Q

Ober’s

A

P - Side-lying, abduct and extend hip and release (TFL contacture)

123
Q

Gauvain’s

A

P - side-lying, extend and continually rotate hip, feeling abdominals (TB of the hip)

124
Q

Anvil

A

P - Supine, leg straight and strike heel (Hip)

125
Q

Thomas

A

A - Supine, uninvolved knee to chest (+ involved side raises) (Hip flexor contracture)

126
Q

Patrick Fabere

A

P - Supine, rest heel on opposite knee (aka sign of 4) (Hip)

127
Q

Laguerre’s

A

(P - Supine, “fabere in the air” (hip)

128
Q

Apparent functional leg length

A

P2 - Supine, compare measurement from umbilicus to each medial malleolus

129
Q

Actual structural leg length

A

P2 - Supine, compare measurement from ASIS to each ipsilateral lateral malleolus

130
Q

Allis

A

P2 - Supine with knees flexed and feet together, compare femur and tibia lengths

131
Q

Tinel’s tap for knee

A

P2 - Seated or supine, tap over lateral fib head (common peroneal nerve)

132
Q

Drawer’s test for knee

A

P2 - Supine with knees flexed
Anterior: P-A pull (ACL)
Posterior: A-P push (PCL)

133
Q

Slocum’s

A

P2 - Anterior drawer with rotation (ACL and MCL / LCL) (rotary instability)

134
Q

Lachman’s

A

P2 - Supine, knee slightly flexed, stabilize femur and P-A pull on leg (best ACL test)

135
Q

Fouchet’s (Grind)

A

P2 - Supine, compress patella, if no pain, rub sideways (Perkin’s sign) (CMP)

136
Q

Clarke’s (Comp)

A

(AR) - supine, traction patella inferior and patient contracts quadriceps

137
Q

Ballotment

A

P - Supine, compress patella, release (+ rebound) (major effusion)

138
Q

Patellar tap

A

P - supine, milk down to superior pole and press patella (+ feel) (minor effusion)

139
Q

McMurray’s

A

P2W - Supine with hip and knee flexed (90/90 position)

  1. externally rotate and extend leg (checks medial)
  2. internally rotate and extend leg (checks lateral)
140
Q

Apley’s

A

P2W - Prone with knee flexed, compression: press down with rotation (twice) (Menisci)
Distraction: pull up with rotations (twice) (collateral ligaments)

141
Q

Fairbanks AKA Patella Apprehension AKA Knee Apprehension

A

P - Supine, knee extended, manually displace patella laterally. Look at patient’s face. + is indicated by look of fear in the patient’s face

142
Q

Ext. Post. Sag Sign

A

P - Supine, doc lifts both legs by heels off table, comparing knee sag (PCL)

143
Q

Sag Sign

A

P - Supine, patient bends knees, doc observes (PCL)

144
Q

Godfrey Sag Sign

A

P - Supine, patient bends knees, doc lifts ankles off table (PCL)

145
Q

Ankle draw

A

P2W - Supine with foot off table.
Anterior = Stabilize tibia, pull calcaneus (ant. talofib lig)
Posterior = Stabilize foot dorsum, pull tibia (post. talofib lig)

146
Q

Thompson’s AKA Simmond’s

A

P - Prone with knee flexed, squeeze calf (+ lack of plantar flexion) (Achilles rupture)

147
Q

Morton’s AKA Squeeze Test

A

P - Supine, squeeze metatarsals (+ pain indicates Morton’s neuroma)

148
Q

Hoover’s

A

Malingering Test
A1 - supine, place hands under heels and patient attempts to raise weakened leg (+ no downward pressure on uninvolved side) (for leg paresis/paralysis)

149
Q

Burn’s bench

A

Malingering Test

A - kneeling on table, bend forward (+refusal) (for LBP)

150
Q

Magnuson’s

A

Malingering Test

A - Ask patient to locate pain, distract, ask again (+ change in location)

151
Q

Mannkopf’s

A

Malingering Test

P - Monitor pulse and press into painful site (+ no increase in pulse)

Part 4 (19 decks)

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