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
Lindner’s
* Test :
* Positive :
* indicative :
* Management :
- Test : head passivly flexed to chest
- Positive : pain in lumbar radiate to sciatic
- indicative : root sciatic
- Management : adjust, traction, extension exercise, mckenzy, myofascial release, montior neuro exam
Bowstring’s
* Test :
* Positive :
* indicative :
* Management :
- Test : after SLR locate pain, pt flex knee slightly and put on dr shoulder, then digital pressure on popliteal fossa then in popliteal fossa.
- Positive : paion in lumbar region or radiculopathy
- indicative : sciatic
- Management : adjust, traction, extension exercise, mckenzy, myofascial release, montior neuro exam
Bonnet’s
* Test :
* Positive :
* indicative :
* Management :
- Test : supine, dr on side being tested, internally rotate leg adduct leg and perform slr
- Positive : radicular pain to limb
- indicative : piriformis syndrome
- Management : adjust, traction, extension exercise, mckenzy, myofascial release, montior neuro exam
Belt’s test
* AKA:
* Test :
* Positive :
* indicative :
* Management :
- AKA : supported adam test
- Test : patient bend forward without support on pelvis, then patient bend foward w/ support
- Positive : when pain with support meaning lumbar problem
: no pain w/ support meaning pelvis issue - indicative :
- Management : adjust, traction, extension exercise, mckenzy, myofascial release, montior neuro exam
Kemp’s test
* Test :
* Positive :
* indicative :
* Management :
- Test : seated/standing, rotate the trunk and circumducts toward affected side and away from affected side
- Positive : sciatic pain down involved side
- indicative : posteromedial disc = + kemp away from pain
postero lateral disc= + kemp into pain - Management : adjust, traction, extension exercise, mckenzy, myofascial release, montior neuro exam
Neri’s bowing
* Test :
* Positive :
* indicative :
* Management :
- Test : bending forward from the wasit, the knees flex on side of involvement
- Positive : knee buckling
- indicative : tight hamstrings
- Management : adjust, traction, extension exercise, mckenzy, myofascial release, montior neuro exam
Becterew’s sitting test
* Test :
* Positive :
* indicative :
* Management :
- Test : seated, extend each leg one at a time, dr put hand on side being tested to resist hip flexion. patient try to extend both leg together w/ both thighs being stabilize by doc
- Positive : pain or leaning back
- indicative : disc, posteromedial disc if pain when good leg is raised
- Management : adjust, traction, extension exercise, mckenzy, myofascial release, montior neuro exam
Minor sign
* Test :
* Positive :
* indicative :
* Management :
- Test : patient rise from seated
- Positive : patient support body with uninvolved side balancing good side
- indicative : sciatica
- Management : adjust, traction, extension exercise, mckenzy, myofascial release, montior neuro exam
Ely’s test
- Test : prone, heel is approxcated to buttock after flexion of knee. approximated to oposite buttock and hyperextended
- Positive : radicular pain
- indicative : lumbar nerve root adhesions
- Management : adjust, traction, extension exercise, mckenzy, myofascial release, montior neuro exam
Nachlas test
- Test : leg flxed to 90* heel is approximated to same button and stabilize the side being tested
- Positive : pain in Lumbosacral joint
- indicative : lumbosacral lesion
- Management : adjust, traction, extension exercise, mckenzy, myofascial release, montior neuro exam
Gaenslen’s test
* Test :
* Positive :
* indicative :
* Management :
- Test : supine, involve side near the edge of table, opossite knee and thigh are fully flexed and fixed against the abdomen. the involve leg is extended off the table down by dr. and put downward pressure against clased knee and knee of exteneded
- Positive : SI joint pain
- indicative : si joint lesion
- Management : adjust, traction, extension exercise, mckenzy, myofascial release, montior neuro exam
Hip abduction stress test
* Test :
* Positive :
* indicative :
* Management :
- Test : laying on non affected side. patient abduct leg then dr put downard pressure proximal to knee
- Positive : pain in PSIS
- indicative : si joint problem, gluteus medius weakness
- Management : adjust, traction, extension exercise, mckenzy, myofascial release, montior neuro exam
Lewin gaenslen’s test
* Test :
* Positive :
* indicative :
* Management :
- Test : patient lies on unafceted side and pulls lower knee to chest, dr stand behind pt stabilize pelvis and hyperextend the top thigh
- Positive : pain on si
- indicative : si joint lesion
- Management : adjust, traction, extension exercise, mckenzy, myofascial release, montior neuro exam
Illiac compression test
* Test :
* Positive :
* indicative :
* Management :
- Test : patient laies on uninvolved side. dr hands are placed over the upper part of illiac crest and dr exercrts downward pressure
- Positive : pain on si
- indicative : si joint lesion
- Management : adjust, traction, extension exercise, mckenzy, myofascial release, montior neuro exam
Hibb’s test
* Test :
* Positive :
* indicative :
* Management :
- Test : dr, stabilize pelvics m other hand grasp ankle of opossite leg where dr is standing . flex leg to 90* and push the leg laterally away producting internal rotation of hip
- Positive : pain on SI
- indicative : si joint lesion
- Management : adjust, traction, extension exercise, mckenzy, myofascial release, montior neuro exam
Yeoman’s test
* Test :
* Positive :
* indicative :
* Management :
- Test : dr stabilize si joint testing with other hand. dr flexes leg of affcted side and hyperextend the thigh by lifting knee off the table
- Positive : pain si
- indicative : si joint lesion
- Management : adjust, traction, extension exercise, mckenzy, myofascial release, montior neuro exam
Patrick test
* AKA :
* Test :
* Positive :
* indicative :
* Management :
- AKA : fabere
- Test : supine, thigh flexed, de kwatro
- Positive : pain in hip
- indicative : hip lesion
- Management : adjust, traction, extension exercise, mckenzy, myofascial release, montior neuro exam
Laguerre’s test
* Test :
* Positive :
* indicative :
* Management :
- Test : supine, dr flexes abduect and laterally rotate hip, dr applies pressure over the opposite ASIS iwth one hand and with other hand presses down on knee ( dr uses his arm sa de kwatro )
- Positive : pain in hip
- indicative : hip joint lesion
- Management : adjust, traction, extension exercise, mckenzy, myofascial release, montior neuro exam
Thomas test
* Test :
* Positive :
* indicative :
* Management :
- Test : supine, thigh is flexed knee bent to abdomen
- Positive : opposite thigh/knee rises off table
- indicative : hip flexion contracture
- Management : adjust, traction, extension exercise, mckenzy, myofascial release, montior neuro exam
Allis test
* Test :
* Positive :
* indicative :
* Management :
- Test : supine, patient flex both legs 90* , dr compares heigh of knees
- Positive : significant different
- indicative : posteior displacement of femoral head or femur shorntening
- Management : adjust, traction, extension exercise, mckenzy, myofascial release, montior neuro exam
ortolani
* Test :
* Positive :
* indicative :
* Management :
- Test : infant supine , legs are abducted and eternally rotated
- Positive : palpable or audible click
- indicative : congenical hip dislocation
- Management : adjust, traction, extension exercise, mckenzy, myofascial release, montior neuro exam
barlow test
* Test :
* Positive :
* indicative :
* Management :
- Test : infant on hip adduction, gentle posterior pressure is placed on each hip one at a time
- Positive : deep spound think as ball subluxates out of socky
- indicative : congenital hip dysplasia
- Management : adjust, traction, extension exercise, mckenzy, myofascial release, montior neuro exam
Ober’s test
* Test :
* Positive :
* indicative :
* Management :
- Test : patient on side, involve side up. dr behind pt, superior hand on hip, and inferior hand abduct leg and extend . then dr allow leg to drop into adduction
- Positive : knee stay elevated
- indicative : tesnor fascia lata contracture
- Management : adjust, traction, extension exercise, mckenzy, myofascial release, montior neuro exam
Trendelenburg test
* Test :
* Positive :
* indicative :
* Management :
- Test : patient standing, raisis one foot and then other, dr observe buttocks
- Positive : buttock on foot that is elevated drops
- indicative : hip abductor weakness on stance leg side
- Management : adjust, traction, extension exercise, mckenzy, myofascial release, montior neuro exam
Ligament tear
* how soon symptom happen?
- swelling and pain occur immediately following injury
minescal tear
* how soon symptom happen?
- swelling occur 12-24 hour post injury, unable to lock out
chondromalacia patella
* AKA :
* detail :
* symptom :
* causes what :
* test :
- AKA : patellofemoral tracking disorder, runner knee
- detail : patell is pulled laeterally by vastus lateralis
- symptom : walking downstairs is most proactive
- causes what : retropatellar djd,
- test : clark’s fouchet’s
Osgood schlatter
- avn of tibal tuberosity in atheletes doing repetitive knee extension
osteochondritis dessicans
- avn knee locks out on extension , test : wilson sign
Housemaid’s knee
- prepatellar bursitis after reptititve pressure on knees
- jumper’s knee
- patellar tendonitis
TFL syndrome
- lateral knee pain caused from shorterned tfl, seen in runners and made wworse by walking or running down hill or up downstairs.
abduction stress test
* AKA :
* test :
* Positive :
* indicate :
- AKA : valgus stress test
- test : supine, valgus stress while abducting foot in full extension at 30 flexion
- Positive : medial collateral ligament involvement
- indicate : pain increased
Adduction stress test
* AKA :
* test :
* Positive :
* indicate :
- AKA : varus stress test
- test : supine, dr puts varus pressure on knees, adducting foot in full extension at 30 flexion
- Positive : pain or increased laxity
- indicate : lateral collacteral ligament involvement
apley’s distraction test (collateral lig)
* test :
* Positive :
* indicate :
- test : prone , knee flexed 90. dr anchors thigh of pt and grasps proximal to foot and applies upward pressire and rotates leg internally and extenally. heel point towards side being tested
- Positive : pain
- indicate : collateral ligament tear
drawer test
* test :
* Positive :
* indicate :
- test : supine, knee 90* , hip 45 * dr stabilize foot on table, tibia is drawn forward and back.
- Positive : pain or joint laxity
- indicate : anterior pulling = acl
: posterior pushing PCL
Slocum’s test
* test :
* Positive :
* indicate :
- test : supine, knee 90 * , foot is put internal / external rotation. dr stabilize sits on foot and grasp leg and thumbs palpating he knee joint. dr pulls tibia applying p-a stress in knee
- Positive : pain or joint laxtiy
- indicate : acl or mcl ( external
: lcl ( internal)
lachman’s
* test :
* Positive :
* indicate :
- test : supine, knee flexed 30* , dr, stabilize femur with one hand and pulls tibia forward with other hand
- Positive : soft end feel
- indicate : acl instability
posterior sag sign
* test :
* Positive :
* indicate :
- test : patient supine with knees flex 90* hips flexed 45 * dr compares the prominence of the tibial tubersotiy. ( side view look ) look like depression on tibia down
- Positive : tibia drops back sags on femur
- indicate : pcl tear
McMurraty sign
* test :
* Positive :
* indicate :
- test : supine, dr flex to 90* leg and thigh. dr places one hand on knee and other frasp the patient heel . dr extenrall rotate leg and then slowly extend knee then doctor internally rotate leg and bring it tinto extension with valgus stress test
- Positive : painful click or snap heard
- indicate : internal rotation checks lateral meniscus and external rotations checks medial meniscus
apley’s comrpession test
* test :
* Positive :
* indicate :
- test : prone, knee flex to 90* dr achonrs the thigh and pt grasps proxical foot and applies downard pressure and rotates leg internally and externally. heel points towards side being tested
- Positive : pain in knee
- indicate : meniscal tear ( medial or latera)
bounce home test
* test :
* Positive :
* indicate :
- test : patient supine, knee flex completely, knee is then droped into extension
- Positive : incomplete extension
- indicate : torn meniscus
apprehension test ( patella )
* test :
* Positive :
* indicate :
- test : supine, dr displaces the patella medial to lateral
- Positive : patella feels it wil dislocation and patient will contract quadriceps or look for apprehension
- indicate : chronic patellar dislocation
clarke’s grinding test
* AKA:
* test :
* Positive :
* indicate :
- AKA : patellar grinding test
- test : patient supine w/ knee extended, dr applies s-i pressure on the superior pole of patella and ask patient to contract quidriceps
- Positive : retropatellar pain or insability to sustain the contraction
- indicate : chondromalacia patella
Wilson’s test
* test :
* Positive :
* indicate :
- test : seated in patient actively extend and flexed the knee with the tibial internally rotated, when 30 degree reached the pain increase and is relieved bty externally rotating the tiba
- Positive : pain decrease
- indicate : osteochondritis dessicans
dreyer’s test
* test :
* Positive :
* indicate :
- test : supine, patient raise their extended leg and unable to do so. dr applies pressure on quad muscle and patient can lift leg
- Positive : patient only lift leg w/ pressure on quads
- indicate : fractured patella
noble compression test
* test :
* Positive :
* indicate :
- test : supine, leg in 90 /90 . dr applies pressure on lateral femoral condyle while extending knee
- Positive : pain over area of pressure
- indicate : TFL syndrome
Pes planus
* detail
* management
- detail : flat foot, talar head displaces medially and plantarward
- management : exercise and orthotics
talipes equinovarus
* detail :
* management :
- detail : m/c birth defect where heel is elevated and foot is turned inward. also called clubfoot at birth
- management :
pes cavus
- detail : very high arch on toes in flexion, prone to march fracture
- management : orthotics stretch out
morton neuroma
tumor on the nerve most commonly found between 3 and 4 metatarsal heads
metatarsal stress fracture
march fracture
plantar fascitis
heel spur pain when walkingi n morning, improves as the day progress
tarsal tunnel syndrome
- pain and burning on sole of foot ( medial plantar nerve)
achiles tendon rupture
( thomspons aka dimmon’s trauma
sprain/strain grading : grade 1
- no ligament tear, slight swelling and decrease rom
sprain/strain grading : grade 2
Incomplete or partial ruptre
lots of swelling brusing and almost no rom
sprain/strain grading grade 3
- complete tear, surgical case, refer to ortho
anterior foot drawer test
* test :
* positive :
* indicates :
- test : supine, doctor places hand around anterior aspect of lower tibia while grasping calcaneous in palm of the other hand and pulls calcaneus forward
- positive : talus slides forward
- indicates : anterior talofibular lig instability
medial / lateral stability test
* test :
* positive :
* indicates :
- test : seated or supine, dr grasps the patients foot and passively inverts and everts it
- positive : exessive gapping
- indicates : inversion = anterior talofibular or calcanofibuer
lig tear
eversion = deltoid lig tear
thompson’s test
* AKA :
* test :
* positive :
* indicates :
- AKA : simmond’s test
- test : prone, feet hang off table , dr flexes knee to 90 and squeeze calf
- positive : no plantar flexion of foot
- indicates : achilles tendon rupture
burn’s bench test
* test :
* positive :
* indicates :
- test : patient instructed to knee on a table , 18 incues from floor bend forward at trunk and touch floor doctor holds ankle
- positive : patient refuses to perform
- indicates :
hoover sign
* test :
* positive :
* indicates :
- test : supine, dr places one hand under each heel and ask patient ot left affected limb
- positive : dr doesnt feel the unaffected side pressing downward
- indicates :
lasegues sitting
* test :
* positive :
* indicates :
- test : patient sitting upright on edge of table or which w/ no back rest. examier faces the patient and usually under the guise of checking circulation extends the patients legs and below the knee one at a time so the limb isparallel to floor
- positive : no pain when there had been a slr
- indicates :
magnusson’s
- test : ask patient point site of pain on the back and examiner marks it w/ skin pencil and ask again patient point again
- positive : patient does not point on same spot
- indicates :
mannkoph’s
- test : doctor takes resing pulse rate. dr then applies pressure over painful area and takes pulse rate again
- positive : increase 10 beats per minute
- indicates : not a malinger
Chest expansion test
* test :
* positive :
* indicates :
- test : use tape masure, patient exhale complete and measere, patient inhales deep and measure
- positive :
- indicates : AS
forester’s bowstring sign
- test : patient bend side to side
- positive : muscle tightnening on concave
- indicates : AS
lewin supine
supine
dr support leg on table and pateint ask to sit up without usping hands
unable to perform
AS
amoss sign
- test : patient asked to go from side laying postion to seatedpostion
- positive : localaised pain on thoracolumbar pain or lack of rom
- indicates : AS / ivd syndrome, severe strainsprain