ORTHOS- UE Flashcards
Underberg’s
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
formaminal compression
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
Extension compression
doc: exert downward force, and then extend head back
(+) local, radicular pn
= local: sp/ st, facet sx
= radicular: disc herniation, IVF
Maximal foraminal compression
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
Jackson’s compression
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
Shoulder depression:
(+) 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
how long is ROOS tested for
3 min’s
Adson’s test
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
wright’s test indication
TOS: pectoralis minor s
halstead maneuver indication
TOS: cervical rib, hypertonic scalenes
Costoclavicular maneuver indication
(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
Eden’s test
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)
Soto hall indication
sp/ st
subluxation
bacterial meningitis
mutiple sclerosis
L’Hermitte’s sign
shock like pn down the spine
= meningitis, cervical myelopathy, Multiple sclerosis
O’Donoghue maneuver
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
sharp pusher
thumb on C2 SP and preform resisted cervical flexion
(+) clunk
= Alar/ transverse ligamentough instability
Transverse lig stress test
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
Alar lig stress test
doc: grasp leg with one hand, pinch C2 SP –> shear side to side
(+) pn, excessive motion
= alar lig rupture/ sp/ tear
Schepelmann’s test
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
Lewin Supine
pt lies supine, doc stabilizes calfs, pt does a sit up
(+) cant complete task, pn
= AS, fused thoracic vertebrae, weak abs
Apley’s scratch
= impingement of supraspinatus tendon btw the humerus and scap
up= external rotators ( teres minor, infraspinatus) down= internal rotators (supraspinatus, subscapularis, and teres major)
Forced cross flexion
horizontal to 90 degrees–> adducts across (stabilize the body)
doc: palpate the AC joint
(+) reproduce the pn at the AC jt
= jt dysfunction
Neer’s impingement
PASSIVELY flex arm up to 180 degrees (thumb facing down) (+) pn, jt crepitus = impingement sx of rotator cuff tendon * supraspinatus * bicep long head * bursitis
Supraspinatus/ empty can/ jobes
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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
