Orthopedics

Question 1

Describe Painful Arc (General)

Answer 1

Standing with Full Abduction
Positive sign = Pain
Tissues = GH Joint (45-120) & AC Joint (170-180)

Question 2

Describe Apleys Scratch Test (General)

Answer 2

Standing Reach behind back to touch Scap

Positive test = Pain

Question 3

Describe Crank (ant Apprehension) (Stability/Instability)

Answer 3

Passive Lateral Rotation
Positive test = Resistance, Facial Expression
Tissues = GH Dislocation

Question 4

Describe Stress Test (Posterior Apprehension) (Stability/Instability)

Answer 4

• Supine position, arm in front, Elbow 90*, pronation, medial rotation and push elbow into table
• Positive test = pain
• Posterior Capsule

Question 5

Describe Anterior Drawer (Stability/Instability)

Answer 5

• Supine, 90* abduction, 60* lateral rotation. Hand is placed beneath GH joint, distract Humerus , pull shoulder up
• Pain , excessive motion
• Anterior Capsule

Question 6

Describe Dugas Test (Stability/Instability)

Answer 6

• Arm in front, touch shoulder, drop elbow to chest
• Positive test = Pain
• Tissues = GH dislocation

Question 7

Describe AC Shear Test (Stability/Instability)

Answer 7

• One hand on the posterior surface of scapula to stabilize, other hand on clavicle- then push together
• Positive Sign = Pain/abnormal end feel
• AC Dislocation

Question 8

Describe Roos (Neurological)

Answer 8

• Goal post hands, open and close for 3 minutes
• Positive sign = Tingling/Numbness/Pain
• Tissues = Brachial Plexus

Question 9

Describe Adsons (Neurological)

Answer 9

• Full extension, feel pulse, turn head towards arm
• Positive sign = Reduced Pulse/Tingling/Numbness/Pain
• Tissues = Brachial Plexus

Question 10

Describe Halstead (Neurological)

Answer 10

• Full extension, feel pulse, turn head away
• Positive sign = Reduced Pulse /Tingling/Numbness/Pain
• Tissues = Brachial Plexus

Question 11

Describe Costoclavicular -Edens - Military Brace (Neurological)

Answer 11

• Arm into extension, feel pulse, downward distraction
• Positive sign = Reduced Pulse/Tingling/Numbness/Pain
• Tissues = Brachial Plexus

Question 12

Describe Alen’s Maneuver (Neurological)

Answer 12

• Elbow 90*, Feel pulse, Look opposite side
• Positive sign = Reduced Pulse /Tingling/Numbness/Pain
• Tissues = Brachial Plexus

Question 13

Describe Wrights (Neurological)

Answer 13

• Full Abduction, Lateral Rotation, Feel pulse
• Positive sign = Reduced Pulse/Tingling/Numbness/Pain
• Tissues = Brachial Plexus

Question 14

Describe Speeds Test (Musculotendinous)

Answer 14

• Shoulder Flexion. RMT Push hand down in supination and pronation
• Positive Test = Pain
• Tendons = Biceps Long Head

Question 15

Describe Yergason’s (MusculoTendinous)

Answer 15

• Lateral rotation, Supination with active resistance, hand on intertubercular groove
• Positive test = Bicep Tendon shift / Pain
• Tendons = Ligament holding biceps long head

Question 16

Describe Empty Can (Supraspinatus) (Musculotendinous)

Answer 16

• Abduction, push arm down in full abduction and 30-45 * with pronation
• Positive Test = Pain
• Tendon = Supraspinatus tendon, due to strain microtear

Question 17

Drop Arm - (Codman) (Musculotendinous)

Answer 17

• Standing Abduction, Let arm go, observe drop
• Positive Test = Pain
• Tendons = Supraspinatus tendon impingement, due to tear - severe sprain

Question 18

Hawkins - Kennedy (MusculoTendinous)

Answer 18

• Arm in flexion, Elbow 90*, support elbow, RMT Medially rotates at the arm
• Positive Test = Pain
• Tendons = Supraspinatus Tendon impingement

Question 19

Neer’s Impingement (MusculoTendinous)

Answer 19

• Full abduction, Medial Rotation
• Positive Sign = Pain
• Tendons = Supraspinatus Tendon Impingement

Question 20

Describe Valgus Stress Test

Answer 20

• Seated: Stabilize wrist, elbow 70°, apply pressure from lateral to medial
• Positive: Laxicity, based on end-feel, pain in medial epicondyle area
• Ulnar Collateral Ligament

Question 21

Describe Varus Test

Answer 21

• Seated: Stabilize wrist, elbow 70°, apply pressure from medial to lateral
• Positive Test: Laxicity, based on end-feel, pain in lateral epicondyle area
• Radial Collateral Ligament

Question 22

Describe Tinels Test

Answer 22

• Tap Distal to Cubital Fossa
• Numbness, tingling through medial 1.5 digits, dorsal & palmar
• Ulnar nerve

Question 23

Pronator Teres Stress Test (Active Resisted Pronation)

Answer 23

• (hand shake)
  Hand in slight pronation, support elbow, try to bring into supination, client resists
• Positive Test: Pain, tingling where median nerve innervates
• Median Nerve

Question 24

Cozen’s Test (Active)

Answer 24

• Start with fist in neutral, 1.pronate 2.radial deviation 3.extension
• Pain in lateral Epicondyle
• May indicate Lateral Epicondylitis , Tennis Elbow

Question 25

Mill's Test (passive)

Answer 25

- Elbow flexed, pronated, flex wrist… therapist bring elbow into extension - Pain in lateral epicondyle - Lateral epicondylitis / Tennis Elbow

Question 26

Lateral Epicondylitis Method 3 (Active Resisted)

Answer 26

- Therapist resists extension of 3rd digit at the proximal phalange - Pain in lateral Epicondyle - Lateral epicondylitis

Question 27

Medial Epicondylitis Method 1 (Active Resisted)

Answer 27

- Elbow flexed, palm up, active resist wrist flexion, resistance on hand - Pain in medial epicondyle - Indicate Medial Epicondylitis Golfers elbow

Question 28

Medial Epicondylitis Method 2 (Passive)

Answer 28

- Elbow flexed, supinated, extend the wrist and the therapist brings the elbow in to extension. - Pain medial Epicondyle - May indicate medial epicondylitis

Question 29

Describe the Supination lift Test

Answer 29

- Elbow’s flexed to 90, supinated. Use elbows and tell client to push my elbows up w/o wrist flexion - Pain or clicking - TFCC (Triangular Fibrocartilaginous complex - possible Tear )

Question 30

Describe the Scaphoid Stress test

Answer 30

- Press on scaphoid and ask them to radially deviate, palm up and open - No Restrictions in deviation/popping - Dislocation of scaphoid

Question 31

Describe Murphy's Test (Lunate)

Answer 31

- Hands in fist, pronated. Observe knuckles - 3rd metacarpal in being pulled back toward wrist - Dislocation of lunate

Question 32

Describe Phalen's Test

Answer 32

- Position dorsum of hands together, practitioner brings hands downward - Pain, tingling where median nerve innervates - Median nerve, compression

Question 33

Describe Tinel's Test (At wrist)

Answer 33

- Tap lateral to palmaris longus tendon - Pain, tingling where median nerve innervates, in carpal tunnel - Median Nerve

Question 34

Describe Prayer's Test

Answer 34

- Position palms together, practitioner brings hands upward - Pain, tingling where median nerve innervates, in carpal tunnel - Median nerve, stretching

Question 35

Describe Finkelstein Test

Answer 35

- Thumb in fist, practitioner brings client into ulnar deviation - pain in radial side - Extensor pollicis brevis and abductor pollicis longus

Question 36

Describe Bunnel-Littler's Test

Answer 36

- Extend metacarpophalangeal (2-5) , flex PIP and DIP - Resistance, can’t get into flexion - Flexor Tendons

Question 37

Describes Allens Test

Answer 37

- Arm 90 degrees, open & close hand, then hold a fist. Practitioner compresses radial and ulnar nerve, client opens hand. Releases one nerve. Close hand and repeat - Lack of blood flow back into hand upon release of the nerve, takes more than 10 secs

Question 38

Describe the Three Knuckle Test

Answer 38

- Ask patient to open the jaw and insert as many fingers (Proximal Interphalangeal joints) into mouth - Positive Sign = Patient can only get 1 or 2 knuckles

Question 39

Chvostek Test

Answer 39

- Tap Parotid Gland (Cheeks) overlying the masseter muscle - Positive Sign = if fascial muscle twitch - Determines pathology of CN (vii) facial nerve)

Question 40

DTR for TMJ

Answer 40

- Examiners thumb is place on the chin of patient with patient mouth is relaxed. Patient closes eyes while the thumbnail is tapped. - Assesses cranial Nerve V (Trigeminal)