Orthopedic Tests NMS I Flashcards
Rust’s Sign
grasps head with both hands
Sprain, RA, FX, Sever subluxation
Libman’s Sign
apply pressure to mastoid increase pressure til it hurts
pain tolerance
Bakody Sign
place hand on head with elbow at level of ear>reduced pain
traction on Brachial Plexus
Reverse Bakody Sign
pt. place hand on head>increase pain
TOS
Bikeles sign
Pt. abducts straight arm to 90º
Brachial Plexus Tension test
Pt. Hands behind head. Dr. Pulls back.
Dejerin’s Triad
coughing, sneezing, straining cause radicular Sx
Swallowing Test
pt. swallows>pain
Valsalva’s Maneuver
pt. breath in and bear down>dizzy
Barre Lieou
pt. seated shake head back and forth as fast as can>vertigo, dizziness, nystagmus, nausea, visual disturbances
Vertebrobasilar Artery Fxnal maneuver
pt. seated, Dr. auscultates (bell + diaphragm) carotid and subclavian bilat. Then plapates. Pt. Rotates and hyperextends counts backwards from 20>vertigo, dizziness, visual stuff, nausea
Dekleyn’s Test
pt. lying supine. Dr. rotates and hyperextends to one side. count back from 20>vertigo, dizziness, visual stuff, nausea
Distraction test
pull up on back of pt. head hold 30-60 sec
Foramina Compression Test
pt. rotates head side to side. Dr. pushes down on neutral head, then rotate head with pushing down
Jackson Compression test
pt. rotates head, then lateral bend. Dr. pushes on neutral head, then lateral flexed head 30-60 sec
Maximum Cervical Compression Test
pt. looks over shoulder
Spurling’s
pt. rotates, laterally bends. Dr. pushes on neutral head, then laterally flexes and extends head as far as tolerated while pushing down 30-60s. Head neutral give it a bop>pain, paresthesia
Lhermitte’s
pt. drops chin to chest Dr. then passively flexes>electric shock down spine
O’Donoghue $
cervical active ROM, passive ROM, resisted ROM
Kernig
flex hip and knee to 90º then extend leg>pain, flexion of opposite hip
Brudzinski
pt. supine flex head to xiphoid>pain, hip and knee flexion
Shoulder Depression Test
Dr. Push on head and shoulder opposite directions>radicular Sx
Soto-Hall
Dr. places hand on sternum of pt. then flexes pt’s head to chest>pain
Allen’s Test
pt. rests forearms palms up, pump fist and hold. Dr. occludes Radial and Ulnar art. Open hand and release on side. Repeat with other side>greater than 5 sec filling time
Adson’s Test
dr. palpates radial pulse then slightly ABduct ext. rotates arm. Pt. looks to same side extends neck and holds deep breath for 10s>paresthesia, decrease in amplitude
Modified Adson’s
same as adsons but pt. rotates head away from side being tested>paresthesia, decrease in amplitude
Halstead
palpate Radial pulse, dr. pulls down on affected arm pt. hyperextends neck, no change pt. rotates head to opposite side>paresthesia, decr. amplitude
Allen’s MANEUVER
find pulse, pt in bicep flex position, rotate head away check pulse>absent pulse
Roo’s Test
Hands up pump fist for 3 minutes>paresthesia
Wright’s Test
aka hyperabduction test
feel pulse from lap to hail position>compare side to side for diminished pulse at what º
Edens
feel pulse on lap palms up, pt. then pulls shoulders down, and back, hold breath for 10s>radicular pain, paresthesia
Apley’s scratch test
pt. touches superior angle of opposite scap, then inf. angle of opposite scap>pain
Apprehension Test
dr. abducts and externally rotates pt. shoulder>pt. shows apprehension or alarm and resists motion.
Drop Arm Test
Passively abduct arm, dr. then drops arm>pt. unable to return arm slowly to side
Dawbarn
Deep palpation of shoulder gets a tender area, dr. abducts arm while keeping pressure on that spot>painful spot moves
Dugas Test
pt. grabs opposite shoulder then touches chest with elbow>cant do it
Impingement Sign
Dr. moves pt’s arm through full flexion>pain
Speed’s Test
Dr. resists flexion of shoulder>pain
Supraspinatus Press test
Dr. resists abduction of shoulder at 90º. Shoulder is then angled 30º forward thumb down and dr. resists abduction>weakness pain
Yergason’s
Pt. flexes elbow while seated, dr. resists supination of the hand>pain, pop over transverse humeral
Load and Shift Test
Dr. stabilizes scapula, pushes humerus into glenoid, pushes forward, backward and pulls down>sulcus
Lift Off Test
pt. puts back of hand in small of back push backwards>can’t do it
O’Brien’s
Pt. Flex straight arm to 90º adducts 10-30º full supination, resistance. repeat in pronation>pain
Elbow Flexion test
hold elbow in flexion for 5 min>paresthesia
Tinels test at Elbow
tap groove btwn olecranon and lat. epicondyle repeat on med. epicondyle side>hypersensitivity
Cozen’s Test
Pt. Clenches fist dorsiflexes it. Dr. stabilizes forearm and tests resistance>pain to lateral epicondyle
Golfer’s Elbow
Pt. flexes fist. Dr. stabilizes forearm and tests resistance>pain to medial epicondyle
Lift Test
Support forearm and lift 20lb sandbag with wrist fully supinated, then pronated>pain to lat. or med. epicondyle
Ligamentous instability test
Stabilize elbow and wrist apply adduction forces and abduction force to elbow>laxity, mobility, pain
Mill’s Test
pt. flexes forearm, wrist, fingers then pronates and extends forearm>pain to lateral epicondyle
Tinel’s Sign
Tap carpal tunnel>tingling to median nv. distribution
Phalen’s Test
Dr. flexes wrists and pushes them together 1 min
Froments
Pt. grasps piece of paper between flat of thumb and forefinger, Dr. pulls it away>do pinch move
Pinch Grip
Pinch tips of index finger and thumb>uses flats of fingers and thumb
Bunnell Littler Test
MCP joint extended dr. moves PIP joint into flexion>cannot flex
Finkelstein’s Test
Pt. makes a thumb tucked fist. Dr. Stabilizes forearm and ulnar deviates wrist>pain
Mannkopf Sign
Dr. establishes pulse rate, applies pressure/pain to painful area>pulse increase 10 bpm
