OSCE 2- tests (3) Flashcards
allen’s test procedure
patient is in a seated position with forearms resting on thighs, palms up. patient opens and closes the hands 5 times and maintaining a tight fist after 5. doctor occludes radial and ulnar artery just proximal to the wrist, patient opens up hand, then doctor lets one artery go at a time. watch color come back to hands
allen’s test purpose
test patency of the upper extremity arterial system
function of allen’s test
occlude vascular flow to the hand in order to observe the filling time required by each vessel
findings of allen’s test
delayed color return indicates partial blockage
no color return= complete blockage of artery
adson’s test procedure
patient seated
doctor palpates radial pulse. maintain palpation while slightly abducting and externally rotating the patient’s arm
patient rotates head to side being tested
extend the neck as far as possible
take a deep breath and hold for 10 seconds
purpose of adson’s test
test for neurovascular compression of subclavian artery and/or brachial plexus
function of adson’s test
hypertrophy of scalenus anticus or a cervical rib
findings of adson’s test
positive if there is paresthesia or a decrease in amplitude of the radial pulse
modified adson’s test
doctor palpates the radial pulse, doctor slightly abducts and externally rotates patient’s arm
patient turns head away from tested area, extend back and hold breath for 10 seconds
purpose of modified adson’s
test for neurovascular compression of subclavian artery or brachial plexus
function of modified adson’s
test for hypertrophy of scalenus medius or cervical rib
findings of modified adson’s
positive if there is paresthesia or a decrease in amplitude of the radial pulse
halstead’s test procedure
patient seated, arms at side doctor palpates radial pulse
maintain palpation while pulling downward on affe ted arm while patient hyperextends the neck
hold breath for 10 seconds
purpose of halstead’s test
neurovascular compression of subclavian artery and brachial plexus
function of halstead’s test
scalenus medius muscle hypertrophy or cervical rib
findings of halstead’s test
positive if paresthesia or decrease in amplitude of radial pulse
allen’s maneuver procedure
doctor abducts shoulder 90 degrees and flexes patient’s elbow for 90 degrees then shoulder is externally rotated
palpate radial pulse
clinical indication of allen’s maneuver
disappearance of pulse indicates a positive test result for TOS
roo’s test/hands up test/hostage test procedure
patient’s arms are elevated 90 degrees and elbows are flexes 90 degrees, shoulders externally rotated
patient closes fists for 3 minutes
roo’s test/hands up test/hostage test
stresses TOS
findings of roo’s/hands up/hostage test
tingling or paresthesia in forearm and hand
wright’s test/hyperabduction test procedure
patient seated with arms at side. doctor stands to side or behind favoring the side being tested. doctor palpates radial pulse, arm is abducted 180 degrees passively, note how long it takes for radial pulse to disappear. do both sides
function of wright’s test/hyperabduction test
compresses axillary artery under pectoralis muscle
findings of wright’s/hyperabduction test
if one arm’s pulse goes away faster than the other, then it is positive
costoclavicular/eden’s test procedure
patient in seated position with arms resting on thighs and palms facing up
palpate radial pulse, patient actively draws shoulders down and back, chin to ches and hold breath for 10 seconds
purpose of costoclavicular/eden’s test
narrow space bewteen the clavicae and the first rib, thus compressing the neurovascular tissues of the sublclavian artery, vein and brachial plexus
function of costoclavicular/eden’s test
narrowing could be caused by... poor posture cervical rib bone tumor poorly united fracture of the clavicle
findings of costoclavicular/eden’s test
positive= cessation or dampening of radial pulse ischemic color changes paresthesia radicular pain in upper limb
