Orthopedic Tests Flashcards
What is the procedure for Hoffman’s test?
Bend middle finger at distal joint, then quickly let go
What is expected for Hoffman’s test?
no reax
What is a positive sign for Hoffman’s test?
flexion of fingers
What is the significance of a positive Hoffman’s test?
lesion to corticospinal tract C5 level or above
What is the procedure for a Tromner test?
Patient hand relaxed with fingers hanging down, tap up on the middle finger to quickly extend the digit
What is expected for a Tromner test?
no reax
What is a positive sign for a Tromner test?
flexion of fingers
What is the significance of a positive Tromner test?
lesion to corticospinal tract C5 level or above
What is the procedure for a Kernig test?
Patient supine, flex one leg at the knee and hip, then extend leg while hip flexed
What is expected for a Kernig test?
no pain
What is a positive for a Kernig test?
guarding, compensation, very acute pain
What is the procedure for a Brudzinsi test?
Patient supine, passively flex head at neck to sternum (or max range of motion if lesser)
What is expected for a Brudzinsi test?
no pain
What is a positive for a Brudzinsi test?
Guarding, knee flexion to reduce traction on cord very acute
What is the significance for a positive Kernig or Brudzinsi test?
meningitis
What is the procedure for a Soto-Hall test?
Patient supine, patient places one hand over the other on sternum, doctor places one hand over patient’s hands, compress the chest, passively flex neck (or max range of motion if lesser)
What is expected for a Soto-Hall test?
no pain
What is a positive Soto-Hall test?
Guarding, knee flexion to reduce traction on cord, very acute pain
What is the significance of a positive Soto-Hall test?
meningitis
What is the procedure for O’Donahue’s test?
Active ROM of neck, Passive ROM, Active resisted ROM-Flexion, extension, lateral bend, rotation
What is expected for O’Donahue’s test?
no pain
What is a positive O’Donahue test?
Pain, radiation (have them point to it and describe)
What is the procedure for a Foraminal Compression test?
Patient seated, compress spine when neutral and during rotation
What is expected for a Foraminal Compression test?
no pain
What is a positive sign for a Foraminal Compression test?
Pain, radiation (have them point to it and describe)
What is the significance of a positive O’Donahue test?
IVF encroachment
What is the significance for a positive Foraminal Compression test?
IVF encroachment
What is the procedure for Jackson’s test?
Patient seated, patient laterally bends neck, doctor compresses spine
What is expected for Jackson’s test?
no pain
What is a positive sign for Jackson’s test?
Pain, radiation (have them point to it and describe)
What is the significance of a positive Jackson’s test?
IVF encroachment
What is the procedure for Maximum Cervical Compression test?
Patient seated, patient rotates neck, then extends neck while rotated, doctor compresses spine (not too heavy)
What is expected for a Maximum Cervical Compression test?
no pain
What is a positive for Maximum Cervical Compression test?
Pain, radiation (have them point to it and describe)
What is the significance for a positive Maximum Cervical Compression test?
IVF encroachment
What is the procedure for Spurling’s test?
Patient seated, place one hand on top of head, strike the back of placed hand with other hand
What is expected for Spurling’s test?
no pain
What is a positive sign for Spurling’s test?
pain, radiation (have them point to it and describe)
What is the significance of a positive Spurling’s test?
IVF encroachment
What is the procedure for a Distraction test?
Patient supine, hook occiput with one hand, support mandible with other, traction neck
What is expected for a Distraction test?
no pain
What is a positive sign for Distraction test?
Reduction of symptoms (impingement relieved by traction)
What is the significance for a Distraction test?
IVF encroachment
What is a reverse positive sign for a Distraction test?
increase in pain
What does a reverse positive sign for a Distraction test signify?
sprain/strain of cervical spine
What is the procedure for Rust sign test?
X ray patients before any other tests?
What is expected w/ Rust sign?
healthy people don’t do this
What is a positive Rust sign?
patient spontaneously grasps neck or head w/ both signs
What is the significance of a positive Rust sign?
sever atlantoaxial instability
What is the procedure for Libman’s test?
Apply gradually increasing pressure to mastoid until patient states it’s uncomfortable
What is expected for Libman’s test?
pain
What is a positive sign for Libman’s test?
no pain
What is the significance of a positive Libman’s test?
determines the pain threshold of patient
What is the procedure for Lhermitte’s sign?
Patient seated, passive flexion of head to sternum
What is expected for Lhermitte’s sign?
no pain
What is a positive sign for Lhermitte’s sign?
sharp pain down spine into the upper or lower limbs
What is the significance for a positive Lhermitte’s sign?
Myelopathy of the cervical spine (from stenosis, tumor, disc herniation)
What is the procedure for Bakody’s Sign?
Patient places hand on top of head
What is expected for Bakody’s sign?
no change in pain
What is a positive Bakody’s sign?
decrease in radiating pain in arm
What is the significance of a positive Bakody’s sign?
nerve root encroachment
What is a positive REVERSE Bakody sign?
pain is exacerbated
What is the significance of a positive REVERSE Bakody sign?
TOS
What is the procedure for Bikele sign?
Abduct the shoulder 90 degrees then extend elbow
What is expected for Bikele’s sign?
no pain
What is a positive Bikele’s sign?
radicular pain
What is the significance for a Bikele’s sign?
Irritation to brachial plexus
What is the procedure for Brachial plexus tension test?
Abduct both shoulders 90 degrees, place hands behind head, pull elbows back. Additional stress-flex neck
What is expected for brachial plexus tension test?
no pain
What is a positive Brachial plexus tension test?
radicular pain
What is the significance of a positive brachial plexus tension test?
inflammation to brachial plexus
What is the procedure for a Shoulder depression test?
Depress patient shoulder, and laterally bend neck away from depressed shoulder
What is expected for a Shoulder depression test?
no pain
What is a positive sign for a Shoulder depression test?
pain
What is the significance for a positive shoulder depression test?
Adhesion of dural sleeve, spinal nerve roots, or adjacent structures of the joint capsule of shoulder
What is the procedure for an Upper limb tension test?
Patient supine, doctor-depress scapula, abduct shoulder, forearm supination with wrist and finger extension, shoulder external rotation, elbow extension, contralateral then ipsilateral cervical lateral flexion
What is expected for an Upper limb tension test?
no pain
What is a positive sign for an Upper limb tension test?
Increase in pain with contralateral bend, decrease in pain with ipsilateral bending.
What is the significance of a positive Upper limb tension test?
cervical radiculopathy