ORTHOS- UE

Question 1

Underberg’s

Answer 1

pt: standing with eyes closed, arms forward, march in place and then put one leg up

(+) equilibrium loss, drifting/ pronating arms, vertigo
= vertebral, carotid or basilar art. –> compression or stenosis

Question 2

formaminal compression

Answer 2

doc: exert downward force when looking head and rotated to ea. side

(+) local pn, radicular pn
= local: sp/st, facet sx
= radicular: cervical herniation, IVF encroachment

Question 3

Extension compression

Answer 3

doc: exert downward force, and then extend head back
(+) local, radicular pn
= local: sp/ st, facet sx
= radicular: disc herniation, IVF

Question 4

Maximal foraminal compression

Answer 4

pt: seated, extend and rotate, hold for 15 - 40 seconds

(+) local pn, radicular, pn on opp. side
= local: foraminal encroachment without N involvement, facet sx
= radicular: foraminal encroachment with N involvment
= opp. side: sp/ st

Question 5

Jackson’s compression

Answer 5

doc: exert downward force, and then do the same for lateral flexion
(+) local pn, radicular pn
= local: sp/ st, subluxation , facet sx
= radicular: disc herniation, IVF encroachment

Question 6

Shoulder depression:

Answer 6

(+) pn, numbness, or tingling . local pn or relief of pn
= tingling: side of lateral flexion –> cervical radiculopathy: herniated disc, IVF encroachment
= tingling: opp side of lateral flexion–> brachial plexus neuroapthy

Question 7

how long is ROOS tested for

Answer 7

3 min’s

Question 8

Adson’s test

Answer 8

take pulse with pt looking towards, and then with pt looking way

decreases tooking towards: anterior scalene
decreases tooking away: middle scalenes

others: pan coast tumor, apical lung carcinoma

Question 9

wright’s test indication

Answer 9

TOS: pectoralis minor s

Question 10

halstead maneuver indication

Answer 10

TOS: cervical rib, hypertonic scalenes

Question 11

Costoclavicular maneuver indication

Answer 11

(no traction, just have pt roll shoulders back and look down)

TOS: costoclavicular sx–> reduced space btw rib 1 and clavicle
compresses: axillary art, V or brachial plex

Others:
hypertrophic clavicle, 1st rib sublux, spastic subclavius M

Question 12

Eden’s test

Answer 12

pt: rolls shoulders back and look down
doc: traction down

TOS: costoclavicular sx–> compressing axilllary art and brachial plex

(same as the costoclavicular sx, but with the traction down)

Question 13

Soto hall indication

Answer 13

sp/ st
subluxation
bacterial meningitis
mutiple sclerosis

Question 14

L’Hermitte’s sign

Answer 14

shock like pn down the spine

= meningitis, cervical myelopathy, Multiple sclerosis

Question 15

O’Donoghue maneuver

Answer 15

passive and then resistive ROM in all C/S directions

passive pn: sprain of the alar, transverse, supraspinous, interspinous, ligamentum flavor, capsule, inter transverse, longitudinal lig

Active: M st

Question 16

sharp pusher

Answer 16

thumb on C2 SP and preform resisted cervical flexion

(+) clunk
= Alar/ transverse ligamentough instability

Question 17

Transverse lig stress test

Answer 17

pt is supine.
doc: fingers btw occiput and C1 at posterior arch. push PA and hold for 10 seconds

(+) pn, excessive translation –> nystagmus, dizziness, vertigo (bc of SC compression)
= transverse lig rupture/ sp/ tear

Question 18

Alar lig stress test

Answer 18

doc: grasp leg with one hand, pinch C2 SP –> shear side to side

(+) pn, excessive motion
= alar lig rupture/ sp/ tear

Question 19

Schepelmann’s test

Answer 19

pt: seated and laterally flexes

(+): pn on side of lateral bending, pn on opp. side of lat bending

= side of lat bending: intercostal neuritis
= pn on opp side: fubrous inflammation of pleura or intercostal sp

Forestier bowstring sign: taught ribbon paraspinals
= AS, acute paraspinal M strain

Question 20

Lewin Supine

Answer 20

pt lies supine, doc stabilizes calfs, pt does a sit up

(+) cant complete task, pn
= AS, fused thoracic vertebrae, weak abs

Question 21

Apley’s scratch

Answer 21

= impingement of supraspinatus tendon btw the humerus and scap

up= external rotators ( teres minor, infraspinatus)
down= internal rotators (supraspinatus, subscapularis, and teres major)

Question 22

Forced cross flexion

Answer 22

horizontal to 90 degrees–> adducts across (stabilize the body)
doc: palpate the AC joint

(+) reproduce the pn at the AC jt
= jt dysfunction

Question 23

Neer’s impingement

Answer 23

PASSIVELY flex arm up to 180 degrees (thumb facing down) 
(+) pn, jt crepitus
= impingement sx of rotator cuff tendon 
* supraspinatus 
* bicep long head 
* bursitis

Question 24

Supraspinatus/ empty can/ jobes

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Answer 24

put arm into scaption –> press arm down aginst resistance
put arm into scaption with IR (thumb down) –> press arm down

(+) cant hold for 5 sec, pn over insertion
= supraspinatus tear/ sp