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7 - CLET Lab > Orthopedic Diagnosis: Upper Extremities > Flashcards

Orthopedic Diagnosis: Upper Extremities Flashcards

1
Q

Posterior Apprehension Test

A
  • Positive: Patient will have a noticeable look of apprehension or alarm on their face with possible pain
    • Indicates: Chronic posterior dislocation of the glenohumeral joint
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2
Q

Medial Collateral Ligament Test

A
  • Positive: Excessive gapping and pain
    • Indicates: Medial collateral ligament tear and/or instability
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3
Q

Speed Test

A
  • Positive: Pain and/or tenderness in the bicipital groove
    • Indicates: Bicipital tendinitis
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4
Q

Golfer Elbow Test

A
  • Positive: Pain over the medial epicondyle
    • Indicates: Medial epicondylitis
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5
Q

Dawbarn Test

A
  • Positive: Decrease in pain and/or tenderness
    • Indicates: Subacromial bursitis
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6
Q

E.A.S.T.

A
  • Positive: Ischemic pain, heaviness of the arms, or numbness and tingling of the hand
    • Indicates: Thoracic outlet syndrome on the side involved (Evans considers this test to be most accurate for thoracic outlet syndrome evaluation)
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7
Q

L’Hermitte Sign

A
  • Positive: Electric shock-like sensations down the spine and/or through extremities
    • Indicates: Dural irritation, severe spinal cord injury or degeneration
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8
Q

Costoclavicular Maneuver

A
  • Positive: Pain and/or paresthesia, decreased or absent pulse amplitude, pallor
    • Indicates: Compression of the neurovascular bundle between clavicle and 1st rib
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9
Q

Apley Scratch Superior

A
  • Positive: Exacerbation of pain
    • Indicates: Degenerative tendinitis of rotator cuff tendons (usually supraspinatus)
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10
Q

O’Donoghue Maneuver of the Elbow

A
  1. Elbow Flexion
  2. Elbow Extension
  3. Forearm Supination
  4. Forearm Pronation
  5. Positive: Pain during passive range of motion
    • Indicates: Ligamentous sprain (passive range of motion stresses ligaments)
  6. Positive: Pain during resisted range of motion
    • Indicates: Muscle/tendon strain (active range of motion stresses muscles and tendons)
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11
Q

Schepelmann Sign

A
  1. Positive: Pain on the concave side
    • Indicates: Intercostal neuritis
  2. Positive: Pain on the convex side
    • Indicates: Fibrous inflammation of the pleura (or possible intercostal myofascitis)
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12
Q

Reverse Phalen Sign

A
  • Positive: Reproduction of pain and/or paresthesia in the median nerve distribution area (1st, 2nd, 3rd and the lateral ½ of the 4th digit)
    • Indicates: Median neuritis, possibly carpal tunnel syndrome
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13
Q

Impingement Sign

A
  • Positive: Pain in the shoulder
    • Indicates: Overuse injury to the supraspinatus and possibly biceps tendon
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14
Q

Retinacular Test

A
  1. Positive: Flexion of the distal interphanageal joint cannot be achieved
    • Indicates: Joint capsule contracture
  2. Positive: Flexion of the distal interphalangeal joint is achieved
    • Indicates: Tight retinacular ligament
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15
Q

Scalenus Anticus Test

A
  • Positive: Pain and/or paresthesia, decreased or absent pulse amplitude, pallor
    • Indicates: Compression of the neurovascular bundle by scalenus anticus or cervical rib
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16
Q

Eden Test

A
  • Positive: Pain and/or paresthesia, decreased or absent pulse amplitude, pallor
    • Indicates: Compression of the neurovascular bundle between clavicle and 1st rib
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17
Q

Abbott-Saunders Test

A
  • Positive: Palpable and/or audible click
    • Indicates: Subluxation or dislocation of the biceps tendon due to a rupture of the transverse humeral ligament or tendon subluxation beneath the subscapularis muscle belly/tendon
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18
Q

Codman Drop Arm Test

A
  • Positive: Patient will not be able to lower arm slowly or the arm drops suddenly
    • Indicates: Rotator cuff tear, usually supraspinatus
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19
Q

Tinel Elbow Sign

A
  • Positive: Pain and/or tenderness at the site being tapped and paresthesia in the ulnar nerve distribution area (finger 4, 5)
    • Indicates: Neuroma of the ulnar nerve
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20
Q

Elevated Arm Stress Test

A
  • Positive: Ischemic pain, heaviness of the arms, or numbness and tingling of the hand
    • Indicates: Thoracic outlet syndrome on the side involved (Evans considers this test to be most accurate for thoracic outlet syndrome evaluation)
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21
Q

O’Donoghue Manuever of the Cervical Spine

A
  1. Flexion
  2. Extension
  3. Lateral Left Bending
  4. Lateral Right Bending
  5. Left Rotation
  6. Right Rotation
  7. Positive: Pain during passive range of motion
    • Indicates: Ligamentous sprain (passive range of motion stresses ligaments)
  8. Positive: Pain during resisted range of motion
    • Indicates: Muscle/tendon strain (active range of motion stresses muscles and tendons)
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22
Q

Apley Scratch Inferior

A
  • Positive: Exacerbation of pain
    • Indicates: Degenerative tendinitis of rotator cuff tendons (usually supraspinatus)
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23
Q

Mills Maneuver

A
  • Positive: Pain over the lateral epicondyle
    • Indicates: Lateral epicondylitis (tennis elbow)
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24
Q

Beevor Sign

A
  1. Positive: Superior movement of the umbilicus
    • Indicates: Spinal cord lesion at the level of T11-T12 or lower abdominal weakness
  2. Positive: Inferior movement of the umbilicus
    • Indicates: Nerve root involvement T7-T10
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25
Q

Soto-Hall Sign

A
  • Positive: Generalized pain in the cervical region, which may extend down to the level of T2
    • Indicates: Non-specific test for structural integrity of the cervical region
26
Q

Yergason Test

A
  1. Positive: Localized pain and/or tenderness at the bicipital groove
    • Indicates: Bicipital tendinitis
  2. Positive: Audible click or the biceps tendon subluxes or dislocates
    • Indicates: Instability of the biceps tendon possibly associated with a torn transverse humeral ligament
27
Q

Jackson Compression

A
  1. Positive: Exacerbation of localized cervical pain
    • Indicates: Foraminal encroachment without nerve root pressure or facet pathology
  2. Positive: Exacerbation of cervical pain with a radicular component
    • Indicates: Foraminal encroachment with nerve root compression (one would then want to evaluate the myotome, reflex and dermatome of the nerve root involved)
28
Q

Kernig Sign

A
  • Positive: Inability to fully extend the leg and/or pain (usually in the neck region)
    • Indicates: Meningeal irritation/meningitis
29
Q

Lateral Collateral Ligament Test

(Elbow)

A
  • Positive: Excessive gapping and pain
    • Indicates: Lateral collateral ligament tear and/or instability
30
Q

Fromet Paper Sign

A
  • Positive: The patient is seen to flex the thumb thereby recruiting the median nerve to compensate for apparent weakness
    • Indicates: Ulnar nerve paralysis (weakness or palsy of the adductor pollicus muscle)
31
Q

O’Donoghue Maneuver of the Wrist and Hand

A
  1. Wrist Flexion
  2. Wrist Extension
  3. Wrist Ulnar Deviation
  4. Wrist Radial Deviation
  5. Positive: Pain during passive range of motion
    • Indicates: Ligamentous sprain (passive range of motion stresses ligaments)
  6. Positive: Pain during resisted range of motion
    • Indicates: Muscle/tendon strain (active range of motion stresses muscles and tendons)
32
Q

Brudzinski Sign

A
  • Positive: Involuntary knee flexion
    • Indicates: Meningeal irritation or nerve root lesion (classic test for meningitis)
33
Q

Hyperabduction Maneuver

A
  • Positive: Pain and/or paresthesia, decreased or absent pulse amplitude, pallor
    • Indicates: Compression of the axillary artery by pectoralis minor or coracoid process. Thoracic outlet syndrome
34
Q

Adam Positions

A
  1. Positive: A “c” or “s” shaped scoliosis is observed to straighten
    • Indicates: Negative - Evidence of a functional scoliosis, trauma or subluxation
  2. Positive: A “c” or “s” shaped scoliosis does not straighten (look for rib humping, muscular imbalance and asymmetry in hand length)
    • Indicates: Positive - Evidence of a pathologic or structural scoliosis
35
Q

Adduction Stress Test

(Elbow)

A
  • Positive: Excessive gapping and pain
    • Indicates: Lateral collateral ligament tear and/or instability
36
Q

Adam Sign

A
  1. Positive: A “c” or “s” shaped scoliosis is observed to straighten
    • Indicates: Negative - Evidence of a functional scoliosis, trauma or subluxation
  2. Positive: A “c” or “s” shaped scoliosis does not straighten (look for rib humping, muscular imbalance and asymmetry in hand length)
    • Indicates: Positive - Evidence of a pathologic or structural scoliosis
37
Q

Finkelstein Test

A
  • Positive: Pain distal to the radial styloid process
    • Indicates: Stenosing tenosynovitis of the abductor pollicis longus and extensor pollicis brevis tendons (DeQuervain’s Disease)
38
Q

Tinel Wrist Sign

A
  • Positive: Reproduction of pain, tenderness and/or paresthesia in the median nerve distribution area (thumb, 2nd, 3rd and the lateral ½ of the 4th digit)
    • Indicates: Median neuritis, possibly carpal tunnel syndrome
39
Q

Spinal Percussion Test

A
  1. Positive: Local pain
    • Possible fractured vertebrae, ligamentous involvement (spinal pain) and muscular involvement (muscular pain)
  2. Positive: Radiating pain
    • Indicates: Possible disc pathology
40
Q

Valsalva Maneuver

A
  • Positive: Radiating pain from site of the lesion (usually recreating the complaint in the cervical or lumbar areas of the spine
    • Indicates: Space occupying lesion (e.g. disc pathology)
41
Q

Foraminal Compression Test

A
  1. Positive: Exacerbation of localized cervical pain
    • Indicates: Foraminal encroachment or facet pathology without nerve root compression
  2. Positive: Exacerbation of cervical pain with a radicular component
    • Indicates: Foraminal encroachment or facet pathology with nerve root compression
42
Q

Drop Arm Test

A
  • Positive: Patient will not be able to lower arm slowly or arm drops suddenly
    • Indicates: Rotator cuff tear, usually supraspinatus
43
Q

Cervical Distraction Test

A
  1. Positive: Diminished or absence of local cervical pain
    • Indicates: Foraminal encroachment without nerve root compression
  2. Positive: Diminished or absence of radiating pain
    • Indicates: Foraminal encroachment with nerve root compression
  3. Positive: Increase of cervical pain
    • Indicates: Muscular strain, ligamentous sprain, myospasm or facet capsulitis
44
Q

Shoulder Depression Test

A
  1. Positive: Localized pain on the side being tested
    • Indicates: Dural sleeve adhesions, and muscular adhesion/contracture, or spasm, or ligamentous injury
  2. Positive: Radicular pain on either side being tested
    • Radiating pain on the side being tested indicates neurovascular bundle compression, dural sleeve adhesions, or Thoracic Outlet Syndrome
    • Radiating pain on opposite side being tested indicates foraminal encroachment with nerve root compression
45
Q

Scalene Maneuver

A
  • Positive: Pain and/or paresthesia, decreased or absent pulse amplitude, pallor
    • Indicates: Compression of the neurovascular bundle by scalenus anticus or cervical rib
46
Q

Abduction Stress Test

(Elbow)

A
  • Positive: Excessive gapping and pain
    • Indicates: Medial collateral ligament tear and/or instability
47
Q

Swallowing Test

A
  • Positive: Difficulty in swallowing
    • Indicates: Space-occupying lesion at anterior portion of cervical spine. Possibly esophageal or pharyngeal injury, anterior disc defect, muscle spasm or osteophytes etc.
48
Q

Bunnel-Littler Test

A
  1. Positive: Flexion of the proximal interphangeal joint cannot be achieved
    • Indicates: Joint capsule contracture
  2. Positive: Flexion of the proximal interphangeal joint is achieved
    • Indicates: Tight intrinsic muscles
49
Q

Phalen Sign

A
  • Positive: Reproduction of pain and/or paresthesia in the median nerve distribution area (1st, 2nd, 3rd and the lateral ½ of the 4th digit)
    • Indicates: Median neuritis, possibly carpal tunnel syndrome
50
Q

Anterior Apprehension Test

A
  • Positive: Patient will have a noticeable look of apprehension or alarm on their face with possible pain
    • Indicates: Chronic anterior dislocation of the glenohumeral joint
51
Q

Bakody Sign

A
  • Positive: Decrease or absence of radiating pain
    • Indicates: Cervical foraminal compression, nerve root entrapment (usually C5/C6 level because this motion elevates the suprascapular nerve and relieves traction on the upper brachial plexus)
52
Q

O’Donoghue Maneuver of the Shoulder

A
  1. Flexion
  2. Extension
  3. Abduction
  4. Adduction
  5. External Rotation
  6. Internal Rotation
  7. Positive: Pain during passive range of motion
    • Indicates: Ligamentous sprain (passive range of motion stresses ligaments)
  8. Positive: Pain during resisted range of motion
    • Indicates: Muscle/tendon strain (active range of motion stresses muscles and tendons)
53
Q

Roos Test

A
  • Positive: Ischemic pain, heaviness of the arms, or numbness and tingling of the hand
    • Indicates: Thoracic outlet syndrome on the side involved (Evans considers this test to be most accurate for thoracic outlet syndrome evaluation)
54
Q

Mills Test

A
  • Positive: Pain over the lateral epicondyle
    • Indicates: Lateral epicondylitis (tennis elbow)
55
Q

Dugas Test

A
  • Positive: Inability to touch the opposite shoulder and/or inability of the elbow to touch the chest
    • Indicates: Acute dislocation of the glenohumeral joint
56
Q

Cozen Test

A
  • Positive: Pain over the lateral epicondyle
    • Indicates: Lateral epicondylitis (tennis elbow)
57
Q

Adson Test

A
  • Positive: Pain and/or paresthesia, decreased or absent pulse amplitude, pallor
    • Indicates: Compression of the neurovascular bundle by scalenus anticus or cervical rib
58
Q

Maximal Cervical Compression

A
  • Positive: Pain on the concave side
    • Indicates: Foraminal encroachment with or without nerve root compression (based on presence or absence of radicular component)
59
Q

Halstead Maneuver

A
  • Positive: Pain and/or paresthesia, decreased or absent pulse amplitude, pallor
    • Indicates: Compression of the neurovascular bundle by scalenus anticus or cervical rib
60
Q

Apley Test

A
  • Positive: Exacerbation of pain
    • Indicates: Degenerative tendinitis of rotator cuff tendons (usually supraspinatus)
61
Q

Allen Test

A
  • Positive: A delay of more than 10 seconds (Evans says 5 seconds) in returning a reddish color to the hand
    • Indicates: Radial or ulnar artery insufficiency. The artery held (occluded) by the examiner is not the artery being tested
62
Q

Prayer Sign

A
  • Positive: Reproduction of pain and/or paresthesia in the median nerve distribution area (1st, 2nd, 3rd and the lateral ½ of the 4th digit)
    • Indicates: Median neuritis, possibly carpal tunnel syndrome

7 - CLET Lab (28 decks)

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