Ortho Tests Flashcards
1
Q
What is the Ober test used for?
A
Dx tightness of IT band
2
Q
What does the pt do during the Ober test?
A
Pt lies on uneffected side w/ bottom leg flexed & in line w/ shoulder & pelvis
3
Q
What does the doc do during the Ober test?
A
Doc stabilizs iliac crest & lifts top leg which is flexed @ knee & extended @ hip. Doc slowly lowers leg.
4
Q
What is a + Ober test?
A
If pt cant adduct leg past neutral.
(IT band is too tight)
5
Q
What is the Piriformis test used for?
A
Look for tightness in the muscle or sciatic n. pain
6
Q
What does the pt do during the piriformis test?
A
Pt lies on uneffected side w/ hip @ 60° F & knee F
7
Q
What does the doc do during the piriformis test?
A
Stabilize pelvis, apply downward traction on knee & internally rotate leg
8
Q
What is + Piriformis test?
A
Pain shoots down posterior thigh
9
Q
What is Thomas test used for?
A
To rule out a hip flexion contracture
10
Q
What does the pt do during the Thomas test?
A
Pt lies supine w/ one leg bent & the other extended
11
Q
What is a + Thomas test?
A
- Contralateral hip flexes w/o knee extension→ tight iliopsoas
- Hip abducts during test→ tight tensor fascia lata (IT band)
- Knee extension occurs→ tigh rectus femoris
12
Q
What is the Hip Scouring test used for?
A
- Hip labrum
- Capsulitis
- Osteochondral defects
- Acetabular defects
- Osteoarthritis
- Avascular necrosis
- Femoral acetabular impingment syndrome
13
Q
What does the pt do during the Hip Scouring test?
A
Pt lies supine w/ affected leg F
14
Q
What does the doc do during the Hip Scouring test?
A
Doc F & ADDucts hip while applying a downward force. Then, externally/internally R knee
15
Q
What is a + Hip Scouring test?
A
Pain or pt is apprehensive
16
Q
What is Patrick’s test used for?
A
Assessment for gross hip motion. Differentiate b/w hip joint pathology & SI SD
(Pain is either deep in the hip joint or toward the back)
17
Q
What does FABRE stand for?
A
- Flexion
- ABDuction
- External Rotation
- Extension
18
Q
How is Patella Femoral Grinding Test done?
A
- Pt supine w/ knee extended
- Doc pushes patella caudad in trochlear groove & holds it
- Pt contracts quads against doc
19
Q
What indicates a + Patella Femoral Grinding test?
A
Crepitus or pain→ roughness of articulating surfaces
20
Q
What is Nobles test?
A
Repetitive F/E of knee while palpating lateral epicondyle
21
Q
What indicates a + Nobles test?
A
Pt complains of pain over lateral epicondyle @ 30° F
22
Q
What is Knee Effusion Test (Bounce-Home test) used for?
A
Degenerative Joint dz (osteoarthritis)
23
Q
How is Knee Effusion Test perfomed?
A
- Pt is supine w/ knee semi-flexed
- Pt’s heel is supported in one hand & the calf is supported w/ the other
- The hand under the calf is carefully removed & the knee allowed to extend fully
24
Q
What indicates a + Knee Effusion Test?
A
Failure to extend knee fully→ Inc joint fluid
25
What is Apley's test used for?
Evaluate pt for problems w/ the meniscus in the knee
26
What does the pt do during Apley's test?
Pt lies prone w/ affected knee F to 90
27
What does the doc do during the Apley's test?
Doc compresses tibia into the knee joint & externally rotates the leg
28
What indicates a + Apley's test?
If the maneuver produces pain
29
What is the McMurray test used for?
Evaluating tears in the meniscus
30
How is the McMurray test perfomed for medial meniscus?
* Knee completely **Flexed** while the foot is held by the sole w/ the other hand.
* Doc places one hand on the **lateral side** of the knee to stabilize the joint and provide a **valgus stress** in order to identify a **valgus deformity**.
* The other hand **externally R leg **while extending the knee
31
How is the McMurray test performed for the lateral menisucs?
Knee stabilized in a fully **Flexed** position and the leg **internally rotated** as the leg is extended
32
What indicates a + McMurray test?
Pain, palpable or audible "click"
33
What is the Lachman test used for?
Test for ACL injury
34
How is the Lachman test performed?
* The knee is flexed at 30 degrees
* Doc pulls on the tibia to assess the amount of anterior motion of the tibia in comparison to the femur
35
What indicates a + Lachman test?
An ACL-deficient knee will demonstrate increased forward translation of the tibia at the conclusion of the movement or "soft/mushy" endpoint
36
What is the Anterior Drawer test used for?
Test for ACL laxity
37
What does the pt do during the Anterior Drawer test?
Pt lies supine w/ hips F to 45° & Knee to 90°
38
What does the doc do during the Anterior Drawer test?
* Thumbs grasp tibia below the knee along the patellar tendon
* Fingers grasp the hamstrings to ensure they are relaxed
* The tibia is then drawn forward anteriorly
39
What indicates a + Anterior Drawer test?
Inc anterior tibial translation, compared to other limb, or lack of fim end point
40
What is the Posterior Drawer test used for?
Assess PCL laxity
41
How is the posterior drawer test performed?
Same as the anterior drawer test except the tibia is translated posteriorly
42
What indicates a + Posterior drawer test?
If the tibia translates posterior further than the other limb or if there is a lack of a firm end point
43
What is the Varus stress test used for?
Assess LCL
44
What does the pt do during the Varus stress test?
Pt lies supine w/ affected leg extended of the table w/ knee F 20
45
What does the doc do during the Varus Stress test?
The doc stabilizes the pt's ankle while applying a varus stress (medial to lateral pressure) @ the knee
46
What indicates a + Varus stress test?
Laxity or pt discomfort
47
What is the Valgus Stress test used for?
Assess MCL
48
Wat does the pt do during the Valgus stress test?
Pt lies supine w/ affected leg extended off the table & knee F 20
49
What does the doc do during Valgus stress test?
Stabilize ankle while applying a Valgus stress (lateral to medial pressure) @ knee
50
What indicates a + Valgus stress test?
Pt discomfort or laxity
51
What is Pivot test used for?
Assess ACL injury
52
How is Pivot test performed?
Flex knee with internal rotation and then flex knee while applying a valgus force to the proximal tibia
53
What indicates a + Pivot test?
Clunk/give is felt during knee flexion
54
What is the Posterior Sag test used for?
Tests for rotary instability posteriorly and/or torn PCL
55
How is the Posterior Sag test performed?
Pt lies supine w/ hip & knee are Flexed to 90°while the doc supports the leg under the lower calf or heel in the air.
56
What indicates a + Posterior Sag test?
Posterior sag of the tibia caused by gravitational pull
57
What is the Thessaly test used for?
Test for meniscal injury
58
How is the Thessaly test performed?
* Pt stands flat footed on one leg while doc provides hands for balance.
* Pt then flexes the knee to 20° & rotates the femur on the tibia medially & laterally three times while maintaining the 20° flexion.
* Pt tests first the good leg & then the injured leg
59
What indicates a + Thessaly test?
Pt experiences medial or lateral joint line discomfort. The patient may also have a sense of locking or catching in the knee.
60
What is the Talar Tilt test used for?
Asses an ankle sprain
61
What does the pt do during a Talar Tilt test?
Pt sits w/ leg off the table
62
What does the doc do during a Talar Tilt test?
Doc stabilizes ankle w/ one hand & holds calcaneous into platar flexion w/ the other. Doc induces inversion & eversion of the foot
63
What indicates a + Talar Tilt test?
* Translation into Inversion--tear of calcaneofibular ligament
* Translation into Eversion--tear of Deltoid ligament
64
What is the Squeeze test used for?
Assess high ankle sprain or syndesmosis
65
How is the Squeeze test perfomed?
The pt dorsiflexes foot w/ leg off the table as the doc squeezes the tibia & fibula @ midshaft
66
What indicates a + Squeeze test?
Weak plantar flexion or pain
67
What is the Thompson test used for?
Assess Achilles tendon rupture
68
How is the Thompson test performed?
Pt lies prone as the doc squeezes the gastrosoleus complex
69
What indicates a + Thompson test?
Pt can't plantar flex
70
What is the Cross Arm test used for?
* AC joint
* Acromion process
* Proximal end of clavicle
* Ligamentous structures of the AC joint
71
How is the Cross arm test performed?
Doc passively moves the humerus across the chest by F to 90° & horizontally ADDucting the shoulder
72
What indicates a + Cross arm test?
Pain, crepitus, or separation at the acromioclavicular joint
73
What is the shoulder Apprehension test used for?
Test for Shoulder instability
74
What does the pt do during should Aprehension test?
Pt lies on the table supine w/ the shoulder abducted 90° & max ER
75
What does the doc do during the shoulder Apprehension test?
Doc supports the humerus w/ one hand while applying overpressure to ER
76
What indicates a + shoulder Apprehension test?
Pt reacting to the movement by preventing further rotation or appearing apprehensive
77
What is the Jobes Relocation test used for?
Asses anterior shoulder stability
78
How is Jobes Relocation test performed?
* Perform after positive apprehension test
* Apply posterior force over humeral head during ER
79
What indicates a + Jobes Relocation test?
Inc ER tolerance before apprehension/sx
80
What is the Hawkins test used for?
Asses shoulder instability
81
How is the Hawkin's test perfomed?
Pt sits w/ arm F to 90° & elbow F to 90
Doc stabilizes elbow & IR arm
82
Wha indicates a + Hawkins test?
Pain located to the sub-acromial space
83
What is Neer SIGN used for?
Assess shoulder impingement
84
How is Neer SIGN performed?
Starting w/ arm extended at side, the doc IR pts arm & passively moves the arm through fowarrd F
## Footnote
85
What indicates a + Neer SIGN?
Pain located to the sub-acromial space or anterior edge of acromion
86
What is Neer TEST used for?
Shoulder impingement
87
How is Neer TEST performed?
Inject lidocine subacromial after Neer SIGN & get dramatic inc in strenght/ROM
88
What is the Empy Can test used for?
Asses ingegrity of Supraspinatus tendon
89
How is the Empty Can test performed?
Pt tested at 90° elevation in the scapula plane & full IR
Pt resists downward pressure exerted by doc at patients elbow or wrist
90
What indicates a + Empty can test?
Pain located to subacromial region &/or weakness
91
What is Yergason's test used for?
Biceps tendonitis
92
How is Yergason's test performed?
Doctor stabilizes elbow & wrist
## Footnote
Pt attempts ER (supination) & extension against resistance
93
What indicates a + Yergason's test?
Pain & poppping located to bicipital groove area
94
What is Speeds test used for?
Biceps tendonitis
95
How is Speeds Test Performed?
Pt's elbow is extended, forearm supinated & the humerus elevated to 60°
Doc resists humeral forward flexion
96
What indicates a + Speeds test?
Pain located to bicipital groove
Weakness w/o pain= rupture
97
What muscles is tested w/ Lift off sign or Belly press?
Subscapularis
98
What is the Phalen maneuver used for?
Test for Carpal Tunnel Syndrome
99
How is Phalen maneuver perfomed?
Pt holds wrist in complete & forced flexion for 30–60 seconds
100
What indicates a + Phalen maneuver?
Burning, tingling or numb sensation over the thumb, index, middle and ring finger
101
How is Tinels sign performed?
Doc taps b/n the olecranon & the medial epicondyle (ulnar groove), attempting to elicit a tingling sensation down the forearm of the ulnar nerve distribution
102
What is Spurlings test used for?
Checks for disc &/or neural impingement issues
103
How is Spurling's test performed?
Doc extends the pt’s neck & rotates/SBs it to one side with axial compression (caudad)on the pt’s head
104
What indicates a + Spurlings test?
Pain elicited down the ipsilateral arm from the neck
105
What is Adson's test used for?
Evaluates vascular compromise originating in the neck area
(either scalene muscle compression or a cervical rib).
106
How is Adson's test performed?
* Doc palpates the radial pulse on the affected arm with the arm at pt’s side.
* As pulse is monitored, doc moves pt’s arm into 90° of ABD & ER
* Pt takes a deep breath & turns head toward the raised arm
107
What indicates a + Adson's test?
Marked diminution/loss of pulse
| (subclavian a. compression)
108
What is Cozen's sign used for?
Assess lateral epicondylitis
109
How is Cozen's sign performed?
* Pt sits w/ elbow F to 90°
* Doctor stabilizes the elbow
* Pt makes a fist, pronate & extend the wrist
* Doc applies a resistive force to the extending wrist
110
What indicates a + Cozen's test?
Pain at the lateral epicondyle
111
What cervical roots are tested w/ Biceps reflex?
**C5** & C6
112
What cervical roots are tested w/ Brachioradialis?
C5, **C6**, C7
113
What cervical roots are tested w/ Triceps reflex?
C6 & **C7**
114
How is the motor neuro testing for the bicep performed?
* Pts elbow F to 90° & forearm is placed in supination
* Doc places one hand under elbow for stabilization and the other hand at the distal forearm to resist movement
* Instruct the patient to flex the forearm.
115
How is motor neuro testing for brachioradial performed?
* Pt’s elbow is F to 90° & forearm is placed in neutral w/ the palm facing medially
* Doc places one hand under elbow for stabilization & the other hand at the distal forearm
* Pt flexes forearm
116
How is motor neuro testing for the triceps performed?
* Pt’s arm is ABD to 90° & elbow is F to 90°
* Doc places one hand under the elbow joint for stabilization & the other hand at the distal forearm to resist the movement
* Pt extends forearm
117
What is Finkelstein's test used for?
Dx DeQuervain's tenosynovitis in people who have wrist pain
118
How is Finkelstein's test performed?
Doc grasps the thumb & the hand is ulnar deviated sharply
119
What indicates a + Finkelstein test?
If sharp pain occurs along the distal radius
120
What is the Ankle Drawer test used for?
Test integrity of the anterior & posterior talofibular ligaments
121
How is the Ankle Drawer test performed?
**For Anterior**:
Pt supine, stabilize distal tibia, grasp posterior heel, pull anterior with posterior tibial counterforce
**For posterior**:
switch hands and force
122
What indicates a + Ankle Drawer test?
Laxity in either direction
123
What is the Drop Arm test used for?
Asses Rotator Cuff pathology
124
How is the Drop Arm Test performed?
Doc abducts an staight arm to the pt side & drops it instructing the pt to lower their arm down slowly
125
What indicates a + drop arm test?
Pt can't lower their arm down slowly & their arm drops to their side
Rotator cuff tear
126
How is AC shear test performed?
Interlock fingers with hand on distal clavicle & spine of scapula
127
What indicates a + AC shear test?
Pain in A-C joint when hands squeezed together
128
What is the Sulcus sign used for?
Inferior Instability of shoulder
129
How is the sulcus sign performed?
Arm relaxed in neutral position, pull downward at elbow
130
What indicates a + Sulcus sign?
Sulcus at infra-acromial area
131
What is O'brien's test used for?
SLAP lesion (Superior Labrum Antero-Posterior)
Labral/AC pathology
132
How is O'Brien's test performed?
Arm flexed to 90°, elbow extended, adduct 10-15°, resist downward force
133
What indicates a + O'Brien's test?
AC pain or internal pain/click
134
What is Crank test used for?
Glenoid labrum injury
135
How is Crank test performed?
Abduct arm to 160°, pt is supine or upright, elbow secured with one hand axial load at shoulder with other
136
What indicates a + Crank test?
Audible/painful catch/grind is noted
137
What is the Allen's test used for?
Test for radial & ulnar artery insufficency
138
How is the Allen's test performed?
Pt rapidly open and close fist then hold it closed
Occlude ulnar and radial artery
Open fist and release one artery--look for pink - repeat for opposite artery
139
What indicates a + Allen's test?
Poor return of color
