Ortho / Neuro Exams Flashcards
1
Q
Valsalva’s sign
A
A - Seated, take a deep breath, hold, bear down
Postive - Radicular pain
Indicates - SOL
2
Q
Naffziger’s
A
P - Seated, digitally compress both internal jugular veins
3
Q
Milgram’s
A
A - Supine, raise and hold legs 3” off the table (may help patient raise legs)
4
Q
Dejerine’s Triad
A
Patient has pain when coughing, sneezing, or during a bowel movement
5
Q
Swallowing
A
A - Seated, instruct patient to swallow (esp. esophageal lesion)
6
Q
Rust’s sign
A
A - Look to see if patient holds their head (ADI instability) - ask to change positions and observe
7
Q
Foraminal Compression Test
A
P - Seated, direct compression (head rotated to each side with pressure)
Positive = radicular pain
Indication - Nerve Root Compression
8
Q
Jackson’s Compression Test
A
P - Seated, laterally flex and compress on each side
Postive - Radicular pain
Indicates - Nerve Root Compression
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
10
Q
Spurling’s
A
P - Seated, fist strike after “Maximal position” (Disc and IVF encroachment)
11
Q
Bakody’s
A
A - Seated, hand on head (+ sign = decreased pain) (Nerve root syndrome)
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
13
Q
Distraction Test
A
P - Seated, lift head avoiding face and TMJ
Positive - Decreased pain = Nerve Root Compression; Increased pain - sprain / strain
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
15
Q
Lhermitte’s
A
A - Seated, neck flexion (Cord degeneration, MS = electric-like sensations)
16
Q
Sternal compression
A
P - Supine, cross arms on chest and apply pressure on sternum (Rib or thorax lesion)
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
18
Q
Libman’s
A
P2 - Seated, pressure on mastoid - assessment patient pain threshold
19
Q
Brudzinski’s
A
P - Supine, flex neck (+ sign = knees buckle)
20
Q
Kernig’s
A
P - Supine, hip and knees flexed, extend knee (+ sign = knee kicks)
21
Q
VBAI (Maigne’s)
A
A2 - Seated, rotate and extend (auscultate carotids if stethoscope present)
22
Q
DeKleyn’s
A
P2 - Supine Maigne’s - supported rotation and extension (head on table)
23
Q
Hallpike’s
A
P2 - Supine, extend head off table, add rotation and lat. flexion, then unsupported ext.
24
Q
Dizziness Test
A
A2 - Seated, Patient rotates head, Patient rotates body as Dr. holds head neutral
25
Mittlemeyer's
A - standing, march in place eyes opened and then closed (+ sign = rotate to side of lesion)
26
Barany-Nylen
A2 - Seated, turn head, lay supine with head off table (+ nystagmus fatigues) (BPV)
27
Barany-Caloric
P2 - Seated with head extended, irrigate ear with cold and then warm water
28
Hall Pike Caloric
P2 - Supine Barrany-Caloric
29
Allen's Test
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)
30
Buerger's
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)
31
Barre-Lieou's
A2 - Seated, maximally rotate head from side to side several times (VBAI)
32
Homan's
Supine, leg in 90/90 position, squeeze calf and dorsiflex foot.
Positive is Deep Pain
Indicating Deep Vein Thrombosis
33
Claudication
A - Standing, marching in place, when pain occurs bend forward (relief = neurogenic)
34
Perthes' (Tourniquet)
A - Standing with tourniquet around thigh, exercise
35
Bicycle / Stoop
A - Cardiovascular exercise (bicycling) "upright" until claudication, then stooped forward (+ relief of pain) (Neurogenic claudication, DJD, canal stenosis)
36
Adson's
A - Seated, rotate towards involved side and extend (Scalenus Anticus, cervical rib)
37
Modified Adson's
A - Seated, rotate away from involved side and extend (Scalenus medius, cervical rib)
38
Halstead's
A - Seated, extend head and traction arm down
39
Eden's
A - Seated, shoulders down and back, break frontal plane (costoclavicular)
40
Wright's
P2W - Seated, hyperabduct each arm (pect. minor)
41
Allen's maneuver
A/P - Seated, flex elbow 90 degrees, extend arm horizontal, externally rotate arm, patient rotates head
42
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Roos maneuver
AKA EAST (Elevated Arm Stress Test)
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A2W - seated, "hostage position" pump hands
43
Reverse Bakody
A - Seated, hand on head (+ increase in pain)
44
Apley's scratch test
A2W - Seated, touch ipsilateral scapula behind head from superior and inferior
45
Mazion Shoulder Rock
A - Seated, touch opposite shoulder and bring elbow up and down
46
Dugas test
A - seated, touch opposite shoulder and bring elbow down (dislocation)
47
Apprehension Test
P - Seated with arm in hostage position, stress humerus anterior (dislocation)
48
Calloway's
P2 - Seated, measure vertical shoulder circumferences (+ increased girth) (dislocation)
49
Dawbarn's
P - Seated, press on bursa while abducting arm (+ is decrease in pain) (subacromial bursitis)
50
Abbot Saunders
P - Seated, Dr passively abducts arm, ext rot then lowers arm
51
Yergason's
AR - Seated, resist patient elbow flexion and supination (bicipital tendon instability)
52
Speeds
AR - Seated with arm extended, resist patient shoulder flexion (bicipital tendonitis)
53
Impingement
P - Seated, fully flex patient's arm (biceps or supraspinatus tendonitis)
54
Supraspinatus arc
AR - Standing, resist patient arm abduction throughout entire 180 degrees
(+ pain at 10-20 and 90-110 = supraspinatus) (20-90 = deltoid)
55
Supraspinatus press aka empty can
AR2 - Seated, thumb down
1. patient arm 90 degrees abduction, resist abduction
2. angle arms forward 30 degrees, resist abduction
56
Codman's
A/P - Standing abduct past 90 degrees (rotator cuff)
57
Cozen's
AR - Seated, resist patient wrist extension (lat. epicondylitis)
58
Mill's
P - Seated, pronated and flex wrist (lat. epicondylitis)
59
Reverse Cozen's
AR - Seated, resist patient wrist flexion (medial epicondylitis)
60
Tinel's tap for elbow
P2 - Seated, tap btn. olecranon and medial epicondyle (ulnar n.)
61
Tinel's tap for wrist
P2 - Seated, tap over flexor retinaculum (median n.)
62
Phalen's aka wrist flexion
A - Seated, dorsum of hands together, flexing wrists (carpal tunnel)
63
Reverse phalen's
A - Seated, palms of hands together, extending wrists (prayer sign) (carpal tunnel)
64
Pinch
A2 - Seated, bring index and thumb tips together (median n)
65
Froment's paper sign
A - Seated, pull paper from btn. patient's index and thumb (ulnar n)
66
Finkelstein's
A - Seated, thumb in palm, make fist, ulnar deviate (DeQuervain's)
67
Bunnel-Littler's (PIP)
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
Retinaculum (DIP)
Same as bunnel littler, except using the PIP to test DIP flexion
69
Bracelet test
Seated, grasp and compress patient's distal radius and ulna (RA, ganglion cyst, carpal tunnel)
70
Finsterer's
Seated, pronated fist, strike base of 3rd metacarpal (Kiencock's disease)
71
Wrinkle Shrivel
Seated, place hand in tepid water for 5 minutes (+ no pad wrinkle) (Denervation)
72
Adam's
Standing, examine spine as patient flexes with their shoes off.
Improvement = functional scoliosis
No improvement = strutcural scoliosis
73
Adam's positions
Standing, kneeling, sitting
74
Rib Compression
Seated, from behind, squeeze the patient's forearms on side
75
Schelpelmann's
Seated or standing, have the patient laterally flex, clasping hands over head
Ipsilateral pain = intercostal neuritis
Contralateral pain = pleurisy / myofasciitis
76
Forestier's bowstring
A2 - Standing, feel paraspinals, as patient laterally flexes (+ ipsilateral contraction)
77
Chest expansion
A - Seated erect or standing, tape measure at T4 lvl, patient expires, then inspires
(+ less than 2" male or 1.5 for female)
78
Lewin supine
A - supine, stabilize legs as patient attempts a sit-up (+ inability)
79
Amoss' sign
A - supine or side lying, patient rises to a sitting position (+ if action causes localized thoracic pain)
80
Minor's sign
A - Patient pushes off uninvolved side leg or chair arm when getting up (sciatica)
81
SLR (Lasegue's)
P1 - Supine, flex hip on involved side (+ radiculopathy)
82
Seated Lasegue's
P1 - Seated, extend knee on involved side (+ radiculopathy)
83
Lasegue's differential sign
P1 - Supine, SLR until radiculopathy pain elicited, Dr. then flexes knee (relieves pain = rules out hip involvement)
84
Braggard's
P1 - Supine, SLR, lower foot 5 degrees, then dorsiflex (+ radiculopathy)
85
Sicard's
P1 - Supine, SLR, lower foot 5 degrees, then extend big toe (+ radiculopathy)
86
Turyn's
P1 - Supine, extend big toe (+ radiculopathy)
87
WLR
P1 - Supine, lift uninvolved side (+ radiculopathy affected side) (medial disc)
88
Fajersztajn's
P1 - Supine, WLR, lower foot 5 degrees, dorsiflex foot (+ radiculopathy affected side) (medial disc)
89
Lindner's
P - Supine, flex upper trunk into a C (+ radiculopathy) (lateral disc)
90
Bowstring's AKA Cram test and Popliteal pressure sign
Supine, SLR, relax knee, apply popliteal pressure (+ radiculopathy)
91
Kemp's
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
Bonnet's
P1 - Supine, SLR with hip adduction and internal rotation (+ sciatica) (piriformis)
93
SOTO
P1 - Supine, SLR with hip abduction and external rotation (relieves piriformis)
94
Bechterew's
A2 - Seated, with hands on their lap, extend one knee, then other knee, then both (+ sciatica/hamstrings) (disc)
95
Prone Lumbar Hyperextension test
A2 - Prone, Dr. stabilizes ankles and patient attempts to extend torso off the table (pain = lumbar sprain/strain)
96
Reversal Sign
A - standing, bend forward (+ pain when getting up), chronic facet syndrome
97
Femoral Nerve Traction Test
P2 - Side lying, Dr. grasps affected leg and extends hip while knee is bent
98
Stork test
A2 - standing on one leg, patient leans back (+ pain = pars instability)
99
Tripod sign
A2 - seated, observed during Bechterew's (tight hamstrings)
100
Beery's sign AKA Chair sign
A - Sitting relieves discomfort
101
Neri Bowing AKA Bowing, Curtsy, Buckle
A2 - standing, trunk flexion without / with knee flexion
102
Lewin Standing
A/P2W - Standing, pull each knee into extension, then both, while stabilizing pelvis
103
Anterior innominate AKA Advancement, Mazion's Pelvic Maneuver
A2 - Standing, advance uninvolved leg and flex trunk
104
Supported Adam's Belt
A - Standing, flex trunk without / with support (pain better = SI; worse = lumbar)
105
Goldthwait's
P - Supine, flex hip while palpating low back
106
Gaenslen's
P - Supine, knee to chest, involved side hip ext. off edge of table (Best SI test)
107
Lewin=Gaenslen's
P - Side-lying Gaenslen's, stabilize pelvis and extend hip (SI)
108
Iliac Compression
P - Side-lying, press down on SI
109
Hibb's
P - Prone, flex knee and internally rotate hip (SI, may suggest hip)
110
Double leg raiser
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
SI resisted abduction
A - Side-lying, abduct and extend affected leg; Dr. exerts downward force (pain = SI)
112
Piedallu AKA Seated Flexion Sign
A - Seated, on flat surface; Palpate PSIS, patient flexes, low side becomes high (SI)
113
Erichsen's
P - Prone, squeeze SI joints together bilaterally (SI)
114
Squish AKA Distraction, Gapping
P - Supine, hands on ASIS, facing feet, push downward at 45 degree angle (SI)
115
Yeoman's
P - Prone, flex knee and Extend hip with SI stabilization (SI)
116
Nachlas'
P - Prone, flex knee and bring heel to buttock with SI stabilization (SI, L/S, femoral nerve stretch)
117
Ely's sign
P - Prone, flex knee and Bring heel to buttock (no stabilization) (+ buttock hunch) (psoas contacture)
118
Ely's test
P - Prone, flex knee and bring heel to contralateral buttock (no stabilization) (general low back)
119
Trendelenburg's
A - Standing, raise uninvolved foot off the floor (+ glueus drop) (gluteus medius)
120
Ludloff's
A - Seated, raise inovled thigh off table (lesser trochanteric fracture)
121
Noble's
P - Supine with hip and knee flexed, press lateral femoral condyle with thumb while extending knee to 30 degrees (iliotibial band friction syndrome)
122
Ober's
P - Side-lying, abduct and extend hip and release (TFL contacture)
123
Gauvain's
P - side-lying, extend and continually rotate hip, feeling abdominals (TB of the hip)
124
Anvil
P - Supine, leg straight and strike heel (Hip)
125
Thomas
A - Supine, uninvolved knee to chest (+ involved side raises) (Hip flexor contracture)
126
Patrick Fabere
P - Supine, rest heel on opposite knee (aka sign of 4) (Hip)
127
Laguerre's
(P - Supine, "fabere in the air" (hip)
128
Apparent functional leg length
P2 - Supine, compare measurement from umbilicus to each medial malleolus
129
Actual structural leg length
P2 - Supine, compare measurement from ASIS to each ipsilateral lateral malleolus
130
Allis
P2 - Supine with knees flexed and feet together, compare femur and tibia lengths
131
Tinel's tap for knee
P2 - Seated or supine, tap over lateral fib head (common peroneal nerve)
132
Drawer's test for knee
P2 - Supine with knees flexed
Anterior: P-A pull (ACL)
Posterior: A-P push (PCL)
133
Slocum's
P2 - Anterior drawer with rotation (ACL and MCL / LCL) (rotary instability)
134
Lachman's
P2 - Supine, knee slightly flexed, stabilize femur and P-A pull on leg (best ACL test)
135
Fouchet's (Grind)
P2 - Supine, compress patella, if no pain, rub sideways (Perkin's sign) (CMP)
136
Clarke's (Comp)
(AR) - supine, traction patella inferior and patient contracts quadriceps
137
Ballotment
P - Supine, compress patella, release (+ rebound) (major effusion)
138
Patellar tap
P - supine, milk down to superior pole and press patella (+ feel) (minor effusion)
139
McMurray's
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
Apley's
P2W - Prone with knee flexed, compression: press down with rotation (twice) (Menisci)
Distraction: pull up with rotations (twice) (collateral ligaments)
141
Fairbanks AKA Patella Apprehension AKA Knee Apprehension
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
Ext. Post. Sag Sign
P - Supine, doc lifts both legs by heels off table, comparing knee sag (PCL)
143
Sag Sign
P - Supine, patient bends knees, doc observes (PCL)
144
Godfrey Sag Sign
P - Supine, patient bends knees, doc lifts ankles off table (PCL)
145
Ankle draw
P2W - Supine with foot off table.
Anterior = Stabilize tibia, pull calcaneus (ant. talofib lig)
Posterior = Stabilize foot dorsum, pull tibia (post. talofib lig)
146
Thompson's AKA Simmond's
P - Prone with knee flexed, squeeze calf (+ lack of plantar flexion) (Achilles rupture)
147
Morton's AKA Squeeze Test
P - Supine, squeeze metatarsals (+ pain indicates Morton's neuroma)
148
Hoover's
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
Burn's bench
Malingering Test
| A - kneeling on table, bend forward (+refusal) (for LBP)
150
Magnuson's
Malingering Test
| A - Ask patient to locate pain, distract, ask again (+ change in location)
151
Mannkopf's
Malingering Test
| P - Monitor pulse and press into painful site (+ no increase in pulse)
