Orthopedic exams Flashcards
Bakody’s test
* AKA :
* Test :
* Positive :
* Indicative :
- AKA : shoulder abduction test
- Test : seated , patient activeley places affected arm’s palm on top of head, elbow should be at the level of the head
- Positive : relief of pain
- Indicative : IVF enroachment
Foramina compression test
* AKA :
* Test :
* Positive :
* Indicative :
* Management :
- AKA : compression test / rotation
- Test : seated , patient rotate side to side, doctor puts donward pressure
- Positive : radicular pain, localized pain
- Indicative : nerve root compression, facet symdrome, Space occupying lesion ( disc lesion, IVE enroachment, tumor, inflammation , chiro subluxation )
- Management : adjust, traction, extension exercise, mckenzy, myofascial release, monitor neuro every visit
Jackson’s compression
* AKA :
* Test :
* Positive :
* Indicative :
* Management :
- AKA : lateral compression test
- Test : seated, lateral flex head both sides, doctor does downward pressure.
- Positive : radicular pain, localized pain
- Positive : radicular pain, localized pain
- Indicative : nerve root compression, facet symdrome, Space occupying lesion ( disc lesion, IVE enroachment, tumor, inflammation , chiro subluxation )
- Management : adjust, traction, extension exercise, mckenzy, myofascial release, monitor neuro every visit
maximum cervical compression test
- Test :
- Positive :
- Indicative :
- Management :
- Test : seated, patient rotate+ lateral flex + hyper extend on both sides, no compression is done activty.
- Positive : radicular pain, localized pain
- Indicative : nerve root compression, facet symdrome, Space occupying lesion ( disc lesion, IVE enroachment, tumor, inflammation , chiro subluxation )
- Management : adjust, traction, extension exercise, mckenzy, myofascial release, monitor neuro every visit
Distraction test
- Test :
- Positive :
- Indicative :
- Test : seated , doctor does upward pressure and left pt head up.
- Positive : decreased pain / increased pain
- Indicative : nerve root compression / sprain strain
- Management : adjust, traction, extension exercise, mckenzy, myofascial release, monitor neuro every visit
Shoulder depression
* Test :
* Positive :
* Indicative :
- Test : seated, doctor depress the shoulder + lateral flex the head away from the shoulder
- Positive : pain
- Indicative : nerve root adhesion
- Management : adjust, traction, extension exercise, mckenzy, myofascial release, monitor neuro every visit
Spurling test
- Test :
- Positive :
- Indicative :
- Management :
- Test : patient does maximum compression test, doctor ADDs pressure downward.
- Positive : pain in the neck shoulder arm
- Indicative : space occupying lesion ( disc lesion, IVE enroachment, tumor, inflammation , chiro subluxation )
- Management : adjust, traction, extension exercise, mckenzy, myofascial release, monitor neuro every visit
Soto hall
- Test :
- Positive :
- indicative :
- Management :
- Test : pt supine, doctor places hand on sternum, doctor flex pt head to sternum
- Positive : localized pain
- indicative : fracture ( anterior pain) , ligament dmg ( posterior pain)
- Management : adjust, traction, extension exercise, mckenzy, myofascial release, monitor neuro every visit
Valsalva maneuver
- Test :
- Positive :
- indicative :
- Management :
- Test : doctor ask patient to take a deep breath and hold it while bearing down
- Positive : radicular pain
- indicative : space occupying lesion ( disc lesion, IVF enroachment, tumor, inflammation, subluxation chiro)
- Management :
Naffzinger’s test
* AKA :
* Test :
* Positive :
* indicative :
* Management :
- AKA :
- Test : patient erect while doctor holds digital pressure bilaterally pver the jugular veins. or puts a blood pressure cuff around the patients neck and pumps to 40 mmhg. hold 30 seconds if no pain patient is instructed to cough,
- Positive : pain
- indicative : space occupying lesion ( disc lesion, iVF enroachment, inflammation, tumor, chiro subluxation)
- Management :
Allens test
- Test :
- Positive :
- indicative :
- Management :
- Test : seated , elbow flexed, forearm supinate, patient pump hand, doctor will put pressure and close the radial and ulnar arter. when patient slowly open hands, doctor will open one atery and record filling time. repeat for other artery.
- Positive : delay more than 10 seconds for blood to return to hand
- indicative : occlusion of corresponding artery
- Management : adjust, myofascial release, stretch pecs and suboccipital, strengthe n deep cervical flexots and rhonboids
Adson’s test
* AKA :
* Test :
* Positive :
* indicative :
* Management :
- AKA : sclanus anticus test
- Test : seated , doctor slightly abduct, extend and externally rotate arm. doctor checks radial pulse. patient rotate head towards side being tested and extend the end. patient take deep breaths
- Positive : alteration in amplitute of radial pulse
- indicative : cervical rib, subclavian artery, sclanus anticus syndrome
- Management : adjust, myofascial release, correct for upper cross, stretch pecs and suboccipitals, stregnthen deep cervical flexors and rhomboids
: add stretch anterior scalene
modified adson’s test
* AKA :
* Test :
* Positive :
* indicative :
* Management :
- AKA : sclanus medius test
- Test : if adson is negative patient will look opossite side.
- Positive : alteration in amplitude of the radial pulse
- indicative : subclavian artery, sclanus medius syndrom
- Management : adjust, myofascial release, correct for upper cross, stretch pecs and suboccipital, strengthen deep cervical flexors and rhomboids add middle scalene stretch
Costoclavicular maneuver
* AKA :
* Test :
* Positive :
* indicative :
* Management :
- AKA : eden’s test
- Test : doctor check radial pulse when patient shoulder is down and back. patient flexes chin to chest
- Positive : alteration in amplitutde of radial pulse
- indicative : compression between first rib and clavicl
- Management : adjust 1st rib , myofascial release, stretch pec, suboccipitals, strengthen rhomboid, deep cervical flexors. correct for upper cross
Wright’s test
* AKA :
* Test :
* Positive :
* indicative :
* Management :
- AKA : hyperabduction test
- Test : seated, dr palpate radial puylse, arm is abducted up to 180 degrees, note the angle at which radial pulse disappear.
- Positive : pulse lost more than 10* difference
- indicative : pectoralis minor syndrome, axillary artery
- Management : adjust, myoffascial relase, stretch suboccipitals, pec muscles, strengthen deep cervical flexors, rhomboids, correct for upper cross syndrome
Reverrse bakody meneuver
- Test :
- Positive :
- Test : seated ,patient places pal on top of head
- Positive : increase pain,
Halstead’s test
* Test :
* Positive :
* indicative :
* Management :
- Test : seated, extend head back. abduct arm downward . take pulse.
- Positive : alteration in amplitude of radial pulse
- indicative : cervical rib
- Management : do not adjust if congenital, refer to ortho for surgery
Bikele’s sign
* Test :
* Positive :
* indicative :
* Management :
- Test : abduct shoulder 90* elbow flexed to 90 * and extend shpoulder , extend elbow
- Positive : resisntance , increased radicular pain
- indicative : TOS, brachial plexus neuritis, meningeal irritation
- Management : adjust, myofascial release, stretch for upper cross, stretch suboccipital, pecs, strengthen rhomboid , deep cervical flexor muscles
Roo’s test
* Test :
* Positive :
* indicative :
* Management :
- Test : seated, both arns 90, abducts, and externally rotae , patient repeat opens and close fisrt 5 minutes
- Positive : reproduction of symtoms or unusualy discomfort
- indicative : TOS
- Management : adjust, myofascial relase, stretch for upper cross stretch suboccipital, pecs ,strengthen deep cervical flexors, rhomboids
rotator cuff tear/tendonitis
* of 4 tendons, which is most frequently torn?
* diagnosis ?
* treatment?
- supraspinatus
- MRI
- codman’s exercise
rotatior cuff muscles
* what are they?
* movement, nerve, insertion
- Supraspinatus=abudction=suprascapular n.=greater tublercle
- infraspinatus = external rot = suprascapular n.= greater tubercle
- teres minor = external rot = axillary n. = greater tubercle
- subscapularis = internal rot = subscapular n. = lesser tubercle
Scapular motion : elevation
trap + levator scap
Scapular motion : retraction
rhomboid major + minor
Scapular motion : protraction
SA
apley’s test
* AKA :
* Test :
* Positive :
* indicative :
* Management :
- AKA : apley scratch test
- Test : seated, patient put hand behind , superior angle of scapula. then inferior angle of scapula
- Positive : pain or decreased rom
- indicative : degenerative tendonitis or rotator cuff
- Management : codman exercise
codman drop arm
- Test :
- Positive :
- indicative :
- Management :
- Test : doctor bring arm 90* then suddenly release to lose support
- Positive : instability to maintain arm position
- indicative : supraspinatus tear
- Management : ortho referral
Apprehention test
- Test :
- Positive :
- indicative :
- Test : doctor abducts and slowly externally rotate the affected shoujlder
- Positive : sign of spprehention or alarm
- indicative : chronic shoulder disloaction
Dugas test
- Test :
- Positive :
- indicative :
- management :
- Test : patient places hand of affected shoulder to opossite shoulder and attempts to touch the chest with elbow
- Positive : unable to perform
- indicative : acute shoulder dislocation
- management : ER
Dawbarn’s test
* Test :
* Positive :
* indicative :
- Test : deep palpation by doctor over the subacromial bursa elicits pain. without moving fingers the arm is passively abducted
- Positive : reduction of pain
- indicative : subacromial bursa
Yergason’s test
* Test :
* Positive :
* indicative :
- Test : patient flexes elbow, to 90 while seated. doctor palpates bicipital tendon and resist the patients attempt to actively supinate hand and flex elbow
- Positive : audible click or snap in the bicipital tendon
- indicative : bicipital tendon instability
lateral epicondylitis
* AKA :
* detail
* management
- AKA : radio humeral bursitis, tennis elbow
- affects the extensor carpi brevis
- pain with extension of wrist and prination of elbow
- management : massage, ultrasound under water, counterforce brace, adjust
Medial epicondilitis
* AKA:
* detail
* management
- AKA: little leaguer’s elbow, golfer’s elbow
- affects the flexor carpi ulnaris
- pain with flexion of wrist at medial portion of elbow
- management : adjust, massage, ultrasound under water , counterforce brace
cozen’s test
* Test :
* Positive :
* indicative :
* Management :
- Test : elbow flexed 90* , forearm pronated , fist dorsiflexed , doctor stabilize elbow and resit the patient dorsiflexion
- Positive : pain in lateral elbow
- indicative : lateral epicondiltis
- Management : adjust,massage,ultrasound under water, counterforce brace
reverse cozen’s
* Test :
* Positive :
* indicative :
* Management :
- Test : seated w/ arm close to body, patient makes a fist and flexes with supination. doctor resist flexion of wrist while supporting elbow
- Positive : pain in medial elbow
- indicative : medial epicondilitis
- Management : adjust, massage, ultrasound under water, counterforce brace
Mill’s
* Test :
* Positive :
* indicative :
* Management :
- Test : extend forarem, make a fist, flex the wrist, maximally pronate the forearm,
- Positive : pain in lateral elbow
- indicative : lateral epicondilitis
- Management : adjust, massage, ultrasound under water, counterforce brace.
Tinel’s sign
* Test :
* Positive :
* indicative :
- Test : percuss over the flexor retinaculum of the wrist and the tunnel of guyon
- Positive : tingling into lateral 3 finger / medial 2 finger
- indicative : carpal tunnel syndrome / ulnar nerve entrapment
Phalen’s
* Test :
* Positive :
* indicative :
* Management :
- Test : patient flexes wrist maximally, hold position for up to 60 seconds by , patient looks like he is praying in reverse
- Positive : tingling into the 1st 3 digits of hand
- indicative : carpal tunnel syndrome
- Management :
Froment’s paper sign
* Test :
* Positive :
* indicative :
* Management :
- Test : piece of paper between thumb and index, dr try to remove paper.
- Positive : unable to keep paper between
- indicative : ulnar nerve palsy
- Management :
Fingklestein’s test
* Test :
* Positive :
* indicative :
* Management :
- Test : make fist w/ thumb inside. then fist is ulnar deviated.
: checks extensor pollicis brevis and abductor pollicis longus - Positive : pain over the anatomical snuff box
- indicative : dequervain’s disease AKA stenosing tenosynovitis
Straight leg raise
* Test :
* Positive :
* indicative :
* Management :
- Test : supine, legs extended, dr put one hand under the heel and on knee and slowly lifht leg
- Positive : pain down the affected side
- indicative : sciatica, disc, lumbar lesion
- Management : adjust, traction, extension exercise, mckenzy, myofascial release, montior neuro exam
Bragards
* Test :
* Positive :
* indicative :
* Management :
- Test : after SLR, leg is lowered to point where its comfort, feet is dorsiflexed
- Positive : oain in affected leg
- indicative : sciatica
- Management : adjust, traction, extension exercise, mckenzy, myofascial release, montior neuro exam
Sicards
* Test :
* Positive :
* indicative :
* Management :
- Test : perform SLR then drop 5 degrees, the dorsiflex big toe
- Positive : pain in affected area
- indicative : sciatica
- Management : adjust, traction, extension exercise, mckenzy, myofascial release, montior neuro exam
Turyn’s sign
* Test :
* Positive :
* indicative :
* Management :
- Test : supine, dorsiflex big toe
- Positive : pain in affcted leg
- indicative : sciatica
- Management : adjust, traction, extension exercise, mckenzy, myofascial release, montior neuro exam
Well leg raise
* Test :
* Positive :
* indicative :
* Management :
- Test : SLR + dorsiflexion of foot on unaffected side of the SLR,
- Positive : pain down syptomatic side
- indicative : medial disc lesion
- Management : adjust, traction, extension exercise, mckenzy, myofascial release, montior neuro exam
Millgram’s
* Test :
* Positive :
* indicative :
* Management :
- Test : supine, and legs extended, patient ask to elevate legs 6 incues off the table and hold as long as possible,
- Positive : pain
- indicative : space occupying lesion
- Management : adjust, traction, extension exercise, mckenzy, myofascial release, montior neuro exam
Goldthwaits
* Test :
* Positive :
* indicative :
* Management :
- Test : supine with affected leg raised slowly while hand under lumbosacral portion of the spine
- Positive : pain
- indicative : 0-30 SI, 30-60 lumbosacral , or contralateral SI joint
- Management : adjust, traction, extension exercise, mckenzy, myofascial release, montior neuro exam