Orthopedic Testing Flashcards
What is the patient position for maximal cervical compression test?
seated
What test is this?
-instruct patient to rotate their head and then extend their neck
-ask if theres pain
maximal cervical compression test
What are the positive signs for a maximal cervical compression test? What does this indicate?
local or radicular pain
indications:
1) facet capsulitis (local)
2) foraminal encroachment (local or radiating)
3) cervical radiculopathy (nerve root compression)
4) sprain or strain on the contralateral side
What is another name for foraminal compression test?
cervical compression test
What is the patient position for foraminal compression test?
seated
What test is this?
-with pt head in neutral, exert downward pressure on their head and neck
-ask if theres pain
-have pt rotate head to opposite side of complaint and exert pressure on their head
-ask if theres pain
-repeat with affected side
foraminal compression test
note: when the neck is rotated and downward pressure is applied, the IVF closes. If you suspect nerve root involvement, evaluate neurological level
What are the positive signs for a foraminal compression test? What does this indicate?
local or radicular pain
indications:
1) facet capsulitis (local)
2) foraminal encroachment (local or radiating)
3) cervical radiculopathy (nerve root compression)
What is the patient position for a distraction test?
seated
What test is this?
-grasp beneath the mastoid processes and exert upward pressure on pt head, removing the weight of their head from neck
-hold this position for 30-60 seconds
distraction test
note: pulling the head upward stretches the cervical muscles, ligaments, and opens IVF, disc spaces and decreases pressure on facet joint capsules
What are the positive signs for a distraction test? What does this indicate?
decreased pain indicates facet capsulitis (local), foraminal encroachment, or nerve root compression
increased pain indicates sprain, strain, or spasm
What is the patient position for jackson’s compression test?
seated
What test is this?
-laterally flex pt head and extert downward pressure on their head
-ask if theres any pain
-repeat on affected side
jackson’s compression test
What are the positive signs for a jackson’s compression test? What does this indicate?
local or radicular pain
indications:
1) facet capsulitis (local)
2) foraminal encroachment (local or radiating)
3) cervical radiculopathy (nerve root compression)
4) sprain/strain on contralateral side
What is the most invasive cervical ortho test?
spurlings test
What is the patient position for spurlings test?
seated
What test is this?
-apply downward pressure on patients head and then rotate head with downward pressure, laterally flex, and extend
-ask if theres any pain
-repeat on affected side
spurlings test
What are the positive signs for a spurlings test? What does this indicate?
local or radicular pain
indications:
1) facet capsulitis (local)
2) foraminal encroachment (local or radiating)
3) cervical radiculopathy (nerve root compression)
4) sprain/strain on contralateral side
What is the patient position for O’Donoghue’s maneuver?
seated
What test is this?
-put cervical spine (or other spine) through resisted ROM and then passive ROM
-flexion and extension
-rotation
-lateral flexion
O’Donoghue’s maneuver
What is the positive for O’Donoghue’s maneuver? What does this indicate?
local pain
indications:
-pain during resisted ROM= muscle strain
-pain during passive ROM= ligament sprain
-can be a combo of muscle and ligament
What ligaments are being tested with O’Donoghue’s maneuver when done on cervical spine?
-alar
-transverse
-supraspinous
-interspinous
-ligamentum flavum
-articular capsule
-intertransverse
-PLL
-ALL
What is the patient position for dejerine’s triad?
seated
What test is this?
-ask pt if they have pain coughing, sneezing, bearing down during bowel movement
dejerine’s triad
What test do you do if pt says yes to at least one dejerine’s triad questions?
valsalva’s maneuver
What test is this?
-ask patient to sit up straight, take a deep breath, and bear down like they’re having a bowel movement or blowing up a baloon
-ask if theres any pain
valsalva’s maneuver
What are the positives for valsalva’s maneuver? What does this indicate?
local or radicular pain in any part of spine, but lumbars is most common
indication: increased intrathecal pressure due to SOL
1) disc defect/herniation
2) spondylolisthesis
3) osteophyte
4) fracture
5) tumor
“DSOFT”
What is the patient position for Lhermitte’s sign?
seated
What are the positive signs for Lhermitte’s sign? What does this indicate?
sharp, electric, tingling, or radiating pain down spine and into the upper and/or lower extremities
indication: cervical myelopathy/spinal cord stenosis/dural irritation
-narrowing of cervical spinal canal due to
1) osteophytes
2) central disc herniation
3) tumor
4) meningitis
5) MS
What is the patient position for soto-hall test?
supine
What test is this?
-one hand on sternum to stabilize and ensure that no flexion takes place in the thoracic or lumbar spine
-other hand passively flexes head to chest
soto-hall test
***this isolates the cervical spine in flexion
What are the positive signs for soto-hall test? What does this indicate?
local or radicular pain
indications:
1) ligament sprain or muscle strain/spasm (local)
2) osseous pathology or fracture (local)
3) cervical disc herniation or disc defect (radiating)
4) meningitis (radiating)
What is the patient position for spinal percussion test?
seated
What test is this?
-with patient sitting and head slightly flexed forward, tap on the SP’s of each cervical vertebrae and the paraspinal musculature with a reflex hammer
-this can also be done on thoracics and lumbars
spinal percussion test
What are the positive signs for spinal percussion test? What does this indicate?
local or radicular pain
indications:
1) fractured vertebra with no neurological involvement (local)
2) fractured vertebra with neurological involvement or a disc lesion (radiating)
3) ligament sprain or muscle strain (local)
What is another name for bakody sign?
shoulder abduction test
What is the patient position for bakody sign?
seated
What test is this?
-patient actively moves their arm and places hand on the top of their head
bakody sign and reverse bakody sign (same test, different indicators)
note: placing the hand on head elevates the suprascapular nerve and lower trunk of brachial plexus
What is the positive sign for bakody’s sign? What does this indicate?
decreased pain
indications:
1) nerve root compression
2) herniated disc
What is the patient position for shoulder depression test?
seated
What test is this?
-doctor pushes down on the shoulder while laterally flexing the head to opposite side
-repeat on affected side
shoulder depression test
What are the positive signs of shoulder depression test? What does this indicate?
local pain on the side being tested indicates shortening of the muscles, muscular adhesions, muscular spasms, or ligamentous injury
local pain on the opposite side being tested may indicate formainal encroachment, facet syndrome, or disc defect
radicular pain may indicate compression of the neurovascular bundle (brachial plexus) and cause a burner/stinger, dural sleeve adhesion, or TOS
What is the patient position for bikele’s sign?
seated
What test is this?
-patient raises their arm sideways up to 90 degrees with the elbow fully flexed
-then the arm is extended at the shoulder joint, followed by the extension of the elbow joint (ask patient to reach behind them)
bikele’s sign
What are the positive signs of bikele’s sign? What does this indicate?
radicular pain or other neurological symptom felt on extending the shoulder and elbow joint
indications:
1) brachial plexus neuritis
2) nerve root irritation
3) meningitis (radicular pain bilaterally)
What is the patient position for brachial plexus stretch test?
seated
What test is this?
-instruct the patient to laterally flex their head on one side and extend the shoulder and arm behind them on the opposite side
-repeat with affected side
brachial plexus stretch test
What are the positive signs of brachial plexus stretch test? What does this indicate?
radicular pain and or paresthesia may indicate a nerve root problem or damage to brachial plexus
local cervical pain on the side of lateral flexion may indicate facet joint problem
What is the patient position for brachial plexus tension test?
seated
What test is this?
-ask patient to bring their arms back behind their head and interlace fingers
-doctor pulls back on the patients elbows
-ask if theres any pain
brachial plexus tension test
note: abduction and external rotation of the shoulder with elbow flexion provides maximum stretch to the brachial plexus and C8/T1 nerve roots
What are the positive signs of brachial plexus tension test? What does this indicate?
radicular pain and or paresthesia indicates brachial plexus irritation or nerve root irritation
What is the patient position for adson’s test?
seated
What test is this?
-doctor slightly abducts and extends pt’s arm while taking radial pulse
-patient actively rotates head to face the test shoulder and then extend head
-patient is instructed to take a deep breath and hold it
-doctor monitors for disappearance of pulse and or pain
-patient is instructed to breathe and then turn head back to neutral
-if there is no positive sign yet then have pt turn head to opposite side and monitor pulse/pain
adson’s test (and the last bullet point is modified adson’s test)
What are the positive signs of adson’s test? What does this indicate?
decrease in strength of disappearance of radial pulse= compression of vascular bundle (subclavian a.)
paresthesia and or radiculopathy= compression of brachial plexus
indication= anterior scalene syndrome
A modified adson’s positive test indicates what?
middle scalene syndrome
What is the patient position for allen’s test?
seated
What test is this?
-patient flexes elbow and supinates hand
-doctor occludes radial and ulnar arteries distally
-patient is instructed to open and close fist repeatedly to express remaining blood
-patient opens hand
-hand should be blanched
-doctor lowers hand and releases ONE artery and observe refill time
-repeat with other artery and arm
allen’s test
What is a positive for allen’s test? What does this indicate?
skin of hand remains blanched longer than 5 sec
indication= arterial occlusion/compromise
What is another name for costoclavicular maneuver?
eden’s test
What is the patient position for costoclavicular maneuver?
seated
What test is this?
-doctor palpates radial pulse bilaterally while pulling patients shoulders down and into extension
-patient flexes chin to chest
costoclavicular maneuver
What are the positive signs for costoclavicular maneuver? What does this indicate?
paresthesia and or radiculopathy, or decrease in strength/disappearance in radial pulse indicates costoclavicular syndrome
What is the patient position for halstead maneuver?
seated
What test is this?
-doctor tractions pt’s arm inferiorly while taking radial pulse
-patient extends neck
-doctor monitors for change in pulse or pain
-if negative, patient extends neck and rotates head away from side being tested
-repeat with other arm
halstead maneuver
What are the positive signs for halstead maneuver? What does this indicate?
paresthesia and or radiculopathy, or decrease in strength/disappearance in radial pulse indicates TOS
What is the patient position for reverse bakody maneuver?
seated
What is the positive sign for reverse bakody maneuver? What does this indicate?
increased pain indicates radiculopathy or encroachment, aka TOS
What is another name for Roos test?
elevated arm stress test (EAST)
What is the patient position for roos test?
seated
What test is this?
-patient bends elbows 90 degrees, abducts and externally rotates shoulders
-patient opens and closes hands for 3 min
-think chicken dance
roos test
What are the positive signs for roos test? What does this indicate?
paresthesia and or radiculopathy or inability to maintain chicken dance
indication= TOS
What is another name for wright’s test?
hyper abduction maneuver
What test is this?
-doctor monitors radial pulse while passively abducting arm 180 degrees, pausing at small increments to monitor pulse
-doctor notes the angle at which radial pulse diminishes or disappears (if it does)
-repeat on other arm
wright’s test
What is the patient position for wright’s test?
seated
What are the positive signs of wright’s test? What does this indicate?
paresthesia and or radiculopathy or decreased strength or disappearance of radial pulse indicates pec minor syndrome
note: if pulse disappears bilaterally at same angle then this is a NEGATIVE
What test is this?
1) pt actively extends one leg at a time, unaffected first
2) doctor resists attempts at hip flexion with downward pressure on thigh
3) pt attempts to extend both legs at same time
bechterew’s sitting test
What are the positive signs for bechterew’s sitting test? What does this indicate?
increase in LBP or radicular pain, or if patient has to lean back when both legs are elevated= FLIP sign
indications:
1) sciatica
2) disc lesion
3) adhesions
4) spasm
What is another name for bechterew’s sitting test?
SLR in seated position
What is the patient position for well leg raising test+ straight leg raising test?
supine
What test is this?
-passive test
-each leg tested separately
-unaffected leg is tested 1st (WLR)
-affected leg is lifted 2nd (SLR)
-patient lies supine with legs extended and relaxed
-doctor places one hand under the pt’s ankle and the other hand just above the knee
-keeping the leg straight, the doctor passively and gently raises the pt’s legs as if stretching hamstring to the point of pain or 90 degrees, whichever one comes first
well leg raising test+ straight leg raising test
What is the positive sign for well leg raising test+ straight leg raising test? What does this indicate?
radicular pain down affected leg
indications:
1) lumbosacral or SI involvement
2) disc lesion
3) spondylolisthesis
4) adhesions
5) IVF occlusion
6) SOL (DSOFT)
What is the patient position for bragard’s sign?
supine
What test is this?
-perform WLR/SLR
-after a positive SLR, lower the leg below the point of pain and sharply dorsiflex the foot
bragard’s sign
What is the positive sign for bragard’s sign? What does this indicate?
radicular pain down the affected leg
indications:
1) sciatic neuritis
2) spinal cord tumor
3) IVD lesion
4) nerve irritation
What is the patient position for sicard’s test?
supine
What test is this?
-perform WLR/SLR
-after positive SLR, lower the leg below point of pain and sharply dorsiflex the big toe
sicard’s test
What is a positive sign for sicard’s test? What does this indicate?
radicular pain down the affected leg indicates sciatic radiculopathy from disc lesion
What is the patient position for turyn’s test?
supine
What test is this?
-perform WLR/SLR
-after a positive SLR, lower the leg to the table and sharply dorsiflex the big toe
turyn’s test
What is a positive sign of turyn’s test? What does this indicate?
radicular pain down the affected leg indicates sciatic radiculopathy from disc lesion
What is the patient position for bonnet’s sign?
supine
What test is this?
-perform WLR/SLR
-after a positive SLR, lower the leg below the point of pain and internally rotate and adduct
bonnet’s sign
What are the positive signs of bonnet’s sign? What does this indicate?
sciatic pain locally in butt or radiating down leg indicates piriformis syndrome
What is the patient position for bowstring sign?
supine
What test is this?
-perform WLR/SLR
-after a positive SLR, rest pt’s flexed knee on doctor’s shoulder
-doctor applies pressure to the posterolateral thigh in the popliteal fossa
bowstring sign
What are the positive signs of bowstring sign? What does this indicate?
LBP or lumbar radiculopathy indicates
1) sciatica
2) lumbar nerve compression
3) piriformis syndrome
4) disc herniation
What is the patient position for Kemp’s test?
standing or seated
What test is this?
-patient crosses arms against chest
-doctor stabilizes contralateral SI joint, while passively moving patient through lateral flexion, extension, and rotation to opposite side of stabilization
Kemp’s test
What are the positive signs of kemp’s test? What does this indicate?
increased radicular pain in low back, thigh, and or leg
indications:
1) nerve root compression (radicular)
2) facet syndrome (local pain, this is not a positive finding)
What is the patient position for the belt test?
standing
What test is this?
-pt has pain in the low back when flexed at waist to touch toes (unsupported adams test)
-doctor stabilizes patient’s sacrum with doctor’s hip and patient flexes forward again (supported adams test)
belt test
What is the positive sign for belt test? What does this indicate?
decreased pain with stabilization indicates SI lesion or lumbar lesion
What is the patient position for goldwaith’s sign?
supine
What test is this?
-doctor places one hand under pt’s low back and performs WLR/SLR using the other hand
goldwaith’s sign
What are the positive signs for goldwaith’s sign? What does this indicate?
pain before lumbar spine moves indicates SI lesion
pain after lumbar spine moves= lumbosacral lesion, arthritis, or sprain
0-30 degrees= SI joint
30-60 degrees= lumbosacral
60-90= opposite SI or upper lumbars
What is the patient position for double leg raise test?
supine
What test is this?
-perform WLR/SLR
-then raise both legs at same time noting the degree or angle or leg elevation pain
double leg raise test
What is the positive sign of double leg raise test? What does this indicate?
radicular pain when both legs are lifted indicates central disc defect/herniation
What is the patient position for milgram’s test?
supine
What test is this?
-with both legs straight, patient actively lifts both legs simultaneously 2-6” off table and holds this position for 30 seconds or as long as possible
-if they can’t then ask why? pain? strength?
milgram’s test
What are the positive signs for milgram’s test? What does this indicate?
LBP, unable to hold legs, or pain in affected leg
indication= SOL
note: if they cant do it bc of strength then focus on core strength
What is the patient position for leg lowering test?
supine
What test is this?
-doctor raises pt’s leg to 90 degrees
-pt actively lowers legs to table without bending legs
leg lowering test
What are the positive signs of leg lowering test? What does this indicate?
legs drop or pain indicates lumbosacral involvement or disc lesions
What test is this?
-patient is asked to walk 7 steps on their heels and then 7 steps on their tippy toes
-doctor must walk with patient in case they stumble
heel toe walk
What are the positive signs of heel toe walk? What does this indicate?
unable to walk on heels= L5 lesion
unable to walk on tippy toes= S1 lesion
What is the patient position for lindner’s sign?
supine, seated, or standing
What test is this?
-doctor does passive flexion of patient’s head to chest
lindner’s sign, brudzinski’s sign, and Lhermitte’s sign (same test, different indicators)
What are the positive signs of lindner’s sign? What does this indicate?
pain in lumbar spine and sciatics= nerve root compression
What is the patient position for femoral nerve traction test?
side lying
What test is this?
-doctor stabilizes top ilium and grabs ankle of top leg while extending hip about 15 degrees
-if no pain, flex knee and hip is hyperextended further
femoral nerve traction test
What is the positive sign of femoral nerve traction test? What does this indicate?
pain radiates down the anterior thigh indicates inflammation of L2-L4 nerve root irritation
What is the patient position for ely’s sign/test?
prone
What test is this?
1) flexion of pt’s knee causes hips to rise or pop up from table
2) pt’s leg is bent 90 degrees and then heel is brought toward the opposite butt, hyperextending the butt and thigh with NO stabilization
1 is ely’s sign
2 is ely’s test
What are the positive signs of ely’s SIGN? What does this indicate?
hip flexes and or one side of butt comes off table indicates tight rectus femoris or iliopsoas muscle
What are the positive signs of ely’s TEST? What does this indicate?
pain in anterior thigh indicates lumbar nerve root irritation or adhesion
What is the patient position for nachlas test?
prone
What test is this?
-dr stabilizes ipsilateral SI
-pt’s leg is bent 90 degrees and then the heel is brought toward the ipsilateral butt
nachlas test
“gonna nack your ass”
What are the positive signs of nachlas test? What does this indicate?
pain in SI or lumbosacral area, or thigh indicates SI or lumbosacral disorder
What test is this?
-doctor stabilizes lumbar region with one hand and hyperextends the leg with the other hand
prone hyperextension test
What is the positive sign of prone hyperextension test? What does this indicate?
radicular pain in anterior thigh indicates inflammation of L3/L4 nerve root
What is another name for stork standing test?
one leg standing lumbar extension test
What test is this?
-place patient in the standing position with their hands on hips
-ask pt to stand on one leg (the other is propped against the weight bearing leg) and extend backward
stork standing test
What is the positive sign for stork standing test? What does this indicate?
LBP during extension indicates spondylolysis or spondylolisthesis
What is the patient position for yeoman’s test?
prone
What test is this?
-doctor flexes pt leg 90 degrees and then slides hand under quad, resting the pt’s ankle on doctors shoulder
-doctor stabilizes SI joint on ipsilateral side with the other hand
-doctor picks up pt leg and hyperextends the low back
yeoman’s test
“yeoman, pick up my knee”
What is a positive sign for yeoman’s test? What does this indicate?
localized SI pain indicates SI lesion
What is the patient position for hibb’s test?
prone
What test is this?
-doctor stabilizes pelvis on near side by placing one hand on dorsum of iliac bone
-other hand is on patient’s ankle of opposite leg, with knee flexed to 90 degrees
-from this position, leg is pushed laterally to cause internal rotation of femur head
hibb’s test
note: the side you are pushing the leg out is the side you are testing
What is a positive sign of hibb’s test? What does this indicate?
pelvic pain (hip or SI) indicates hip or SI lesion
What is another name for hip abduction test?
SI resisted abduction test
What is the patient position for hip abduction and adduction test?
side lying
What test is this?
-patient abducts leg that is up and doctor offers resistance
-do the same with adduction
-repeat with other leg
hip abduction and adduction test
What is the positive sign for hip abduction and adduction test? What does this indicate?
pain in SI, butt, or lateral thigh indicates SI sprain on ipsilateral side
What is the patient position for iliac compression test?
side lying
What test is this?
-with involved side up, doctor places hand over iliac crest and gives steady pressure down into patient, pushing patient into table
iliac compression test
What is a positive sign for iliac compression test? What does this indicate?
pain in ipsilateral SI indicates SI lesion or sprain of posterior SI ligaments
What is the patient position for Lewin-Gaenslen’s test?
side lying
What test is this?
-patient hugs the knee of bottom leg up to their chest
-doctor stands behind patient and stabilizes pt at the hip, holds the top leg and slowly hyperextends back
Lewin-Gaenslen’s test
note: top leg is the testing leg
What is the positive sign for Lewin-Gaenslen’s test? What does this indicate?
pain in ipsilateral SI indicates SI lesion
What is the patient position for gaenslen’s test?
supine
What test is this?
-patient scoots toward side of the table that the doctor is standing on and then pt hugs the knee of their inner leg up to their chest
-the doctor moves the straight leg off the table into hyperextension
gaenslen’s test
What is positive sign with gaenslen’s test? What does this indicate?
pain in SI of leg off table indicates SI lesion
What test is contraindicated in older patients?
gaenslen’s test
What is the patient position for allis’ sign?
supine
What test is this?
-patient flexes both knees and places feet flat on exam table
-doctor observes the height of both knees from bottom, sides, and top
allis’ sign
What is the positive sign of allis’ sign? What does this indicate?
one knee is lower indicates possible hip dislocation on lower side or there is a tibial or femur length discrepancy
What is the patient position for anvil’s test?
supine
What test is this?
-pt’s legs are extended, bottom of calcaneus is struck with doctors hand
anvil’s test
What are the positive signs of anvil’s test? What does this indicate?
local pain in thigh indicates hip or femur fx
local pain in lower leg indicates tibial or fibula fx
local pain in calcaneus indicates calcaneal fx
What is the patient position for thomas test?
supine
What test is this?
-pt has feet hanging off table, edge of table should be about mid calf
-pt flexes one knee to chest while seated and then lays back while still holding knee
thomas test
What is the positive sign for thomas test? What does this indicate?
opposite thigh or knee rises off of table indicates hip flexor contracture (shortened iliopsoas and or rectus femoris)
What is the patient position for Patrick’s test?
supine
What test is this?
1) pt’s hip and knee are flexed by doctor to 90 degrees and then pushed straight down
2) no pain, then doctor abducts and externally rotates pt knee into a figure 4
3) if still no pain, then pressure is applies to the ipsilateral knee and contralateral hip
Patrick’s test
FABERE
F= flexion
AB= abduction
E= extension
R= rotation
E= extension
What is the positive sign of Patrick’s test? What does this indicate?
pain in hip indicates hip lesion or pathology of femur head
What is the patient position for Laguerre’s test?
supine
What test is this?
-doctor flexes, abducts, and laterally rotates patient’s hip
-pressure is applied at end ROM
-doctor stabilizes opposite side by applying pressure over ASIS
Laguerre’s test
“Patrick’s test in the air”
What is a positive sign of Laguerre’s test? What does this indicate?
Hip or SI joint pain indicates hip or SI lesion or osteitis condensans illi
What is the patient position for ober’s test?
side lying
What test is this?
-patient lies on their side
-doctor places hand on pt pelvis to stabilize and hold ankle of the top leg with other hand
-knee is flexed to 90 degrees while hip is slightly abducted and extended
-leg is then allowed to drop into adduction
ober’s test
“if leg hangs ober the table, its a tight IT or TFL”
What is the positive sign of ober’s test? What does this indicate?
pain or presence of ITB/TFL contracture (leg remained abducted)
What is the patient position for trendelenburg’s test?
standing
What test is this?
-doctor stands behind patient at a wall
-patient is instructed to stand on involved leg while lifting uninvolved foot off of ground
trendelenburg’s test
What is a positive sign of trendelenburg’s test? What does this indicate?
unsupported hip drops below supported hip indicates insufficiency of the hip abductor system due to weak contralateral gluteus medius and minimus (standing on R leg tests R glute)
What is the patient position for Brudzinski’s sign?
supine
What are the positive signs of Brudzinski’s sign? What does this indicate?
uni or bilateral buckling of knee, often accompanied with flexion of hip indicates meningitis or meningeal irritation
What is the patient position for Kernig’s sign?
supine
What test is this?
-doctor flexes the knees to 90 degrees on table and then attempts to completely extend one leg
Kernig’s sign
What is a positive sign of Kernig’s sign? What does this indicate?
pain during extension, with resistance to extension and kicking motion indicates meningitis or meningeal irritation
“kernig’s kicks”
What is the patient position for adam’s position?
standing
What test is this?
-performed barefoot
1) doctor stands behind pt and inspects/ palpates the entire length of the spine looking for scoliosis, hyperkyphosis, or kyphoscoliosis
2) instruct pt to flex forward at the hips with arms hanging forward to floor with hands together and inspect/palpate again
3) doctor then stands in front of patient to evaluate spine
adam’s position
What are the positive signs of adam’s position? What does this indicate?
1) scoliosis
2) hyperkyphosis
3) kyphoscoliosis
indications:
-if deformity is present with pt standing but reduces or disappears upon forward flexion, this indicates functional scoliosis
-if deformity remains the same, this indicates structural scoliosis
What are the 2 meningeal irritation tests?
1) brudzinski’s sign
2) kernig’s sign
If deformity is present with adam’s position with pt standing but reduces or disappears upon forward flexion, this indicates ________________. If deformity remains the same, this indicates ____________________
functional scoliosis, structural scoliosis
What is the patient position for Forrestier’s bowstring sign?
standing
What test is this?
-patient stands with hands to their sides while the doctor notes any loss of symmetry of the spinal musculature and notes the posture
-patient laterally flexes to one side and then the other
Forrestier’s bowstring sign
What are the positive signs of Forrestier’s bowstring sign? What does this indicate?
muscles tighten on the ipsilateral/concave side and contracture of the paraspinal musculature indicates AS (bilateral also indicates AS)
What test is this?
-with patient’s legs held by doctor, the patient is asked to sit up without using hands
lewin supine test
What is the positive sign of lewin supine test? What does this indicate?
unable to sit up indicates AS, lumbar arthritis (DJD)
What is the patient position for schepelman’s sign?
standing or seated
What test is this?
-pt holds both arms over head and bend laterally to each side
schepelman’s sign
“every day im schepelmans”
What are the positive signs of schepelman’s sign? What does this indicate?
pain on concave side (squishing things down) indicates intercostal neuritis
pain on convex side (stretching it out) indicates intercostal myofascitis or pleurisy
What is the patient position for sternal compression test?
supine
What test is this?
-doctor exerts downward pressure over sternum
sternal compression test
What is the positive sign of sternal compression test? What does this indicate?
localized pain at lateral border of ribs indicates rib fracture or costochondritis
What are the 5 prone ortho tests?
1) elys sign/test
2) nachlas test
3) yeoman’s test
4) hibbs test
5) prone hyperextension test
What are the 5 side lying ortho tests?
1) hip abduction/hip adduction test
2) iliac compression test
3) ober’s test
4) femoral nerve traction test
5) Lewin-Gaenslen test
