Orthopedic Exams Flashcards
Kernig’s sign
Supine, passively flex hip and Knee to 90-90, then extend leg
Pain with fever - meningitis
Brudzinski’s sign
Supine, passively flex neck
Pain with fever - meningitis
Soto-Hall test
Supine, knife edge against sternum (immobilize T&L), active then passively flex neck
Fracture suspected
Lalsalva’s maneuver
Seated, ask PM to bear down “heavy squat”
SOL, tumor, IVD, lesion, hemangioma
Dejerine’s sign
Gathered from history
Cough, sneeze, strain cause aggravation of symptoms
Herniated disc, tumor, spinal compression fracture
Distraction test
Supine or seated, traction neck 30-60 seconds
Increase pain: muscle spasm
Decrease pain: IVF encroachment, facet capsulitis
Foraminal compression test
Seated, check ROM, compress neck in neutral and rotated position
Local pain: foraminal encroachment
Radiating pain: pressure on nerve root
Jackson compression test
Seated, check ROM, compress neck in neutral and lateral flexion position
Same side pain: facet or nerve root involvement
Opposite side pain: muscle strain
Maximum cervical compression test
Seated, actively extend, rotate, and lateral bend neck to max
Same side pain: facet or nerve root involvement
Opposite side pain: muscle strain
Spurring’s test
Seated, check ROM, compress in neutral and Lat. flex neck, then downward blow to top of head in neutral position
IVF encroachment and nerve root involvement
Bakody’s test
Seated, place back of hand on top of head w/ elbow above ear
Decreased pain
Decreased traction on lower brachial plexus
Reverse Bakody’s sign
Increases pain
TOS, inter-scalene compression
Bikele’s sign
Seated, actively aBduct shoulder to 90, then go into full extension
Increase radicular pain
Traction brachial plexus and nerve roots
Brachial plexus tension test
Seated, hands behind head, doc pulls elbows back
Traction brachial plexus and nerve roots
Increase radicular pain
Allen’s test
Seated, palms up on lap, squeeze hands 5x, occlude arteries, open hand, release one artery, check hand color
Radial artery runs - brachioradialis and flexor Capri radialis
Ulnar artery runs - flexor carpi ulnaris
Halstead test
Seated, palpate pulse, aBduct and externally rotate arm, actively extend neck as far as possible, doc tractions arm, rotate head to opposite side, hold breath 10 seconds
Neurovascular compression of: subclavian artery and brachial plexus
MIDDLE scalene hypertrophy or cervical rib
Allen’s maneuver
Seated, find pulse, shoulder and elbow 90-90, turn head away
TOS
Wright’s test
Seated, find pulse, passively bring arm to 180, compare sides
Axillary artery under pectoralis minor
Roo’s test
Seated, “hands up”, 90-90 arms, hold for 1-3 minutes
TOS, increased tingling or parathesias
Costoclavicular (Eden’s) test
Seated, find pulse, patient draws back and down shoulders and chin to chest, hold breath for 10 seconds
Narrow space b/w clavicle and 1st rib
Compress subclavian artery and brachial plexus
Lhermitte’s
Seated, passively flex neck
Traction of spine
MS, myelopathy, stenosis, spondylosis, protruding disc, n. root compression
