Physical Exam Flashcards
What to always conduct in an exam?
- observe \+ colour \+ deformity \+ postural aligments - AROM, PROM, RROM - Inspect and palpate
Beighton Scoring system?
- test for hypermobility
- thumb to back of hand
- increased elbow extension
- increased pinky extension
- increased knee extension
- hand flat on floor with straight knees
Tests for TMJ dysfucntion?
- knuckle test
- auscultation
- mandible deviation, to the side of lesion
Cervical Radiculopathy Tests?
- Kemps
- maximal foraminal compression
- spurlings
- jacksons
- compression distraction
- shoulder depression
- tinels tap
- doorbell sign
- bakody’s sign
- shoulder abduction relief sign
- Soto Hall
- dermatomes, myotomes DTRs
Cervical Instability Test?
- alar ligament stress test, lateral flex + rotation, should feel the sp move to the opposite direction
- sharp purser test/ transverse ligament test
- atlantoaxial lateral shear test
- sagital shear test
TOS tests?
- Roo’s (EAST)
- Adson’s
- Halstead’s
- Costoclavicular
- Wright’s Test
General Thoracic pain?
- costovertebral expansion
- rib motion
- breathing assessment
- diaphragm inspection/palpation
Function vs structural scoliosis?
- Adam’s forward bend test
Subacromial Impingement Tests?
- Hawkin’s Kennedy
- Neer’s Impingment
- posterior lateral impingement test
Rotator cuff?
Supraspin
- drop arm
- empty can/jobes
Infraspin/teres minor
- infraspinatus test
- external rotation lag
- hornblowers test/ patte’s
Subscapularis
- internal rotation lag sign
- bear hug
- belly press
Bicep Tendonitis/SLAP lesion Tests?
- Speeds
- yergasons
- biceps load 2 test
Labral tear tests?
- O’Briens
- Crank Test
- anterior apprehension test
- dynamic labral shear
- biceps load II
- Speed’s Test
- Yergason’s Test
Shoulder Instability Tests?
- sulcus sign
- anterior draw/posterior draw
- load and shift
- posterior apprehension
- anterior apprehension/crank/ relocation/release
Lateral Epicondylopahty Tests?
- Cozen’s
- Mills
- Middle finger sign
- varus stress test
Medial Epicondylitis Tests?
- medial epicondylopahty test
- valgus stress test
- moving valgus stress test
- valgus extension overhead test
Pronator teres syndrome nerve entrapement?
- pronator teres syndrome test
- OK sign for AIN
- tinels tap
Cubital tunnel Syndrome?
- elbow flexion test (trapped ulnar nerve)
- froments sign
- Tinels tap
Radial Head pain(posteriolateral instability) tests?
- posterolateral pivot shift
OCD of the radial head tests?
- radiocapitellar test
De Queroins synovitis?
- finkelstein
- flexor pollicis brevis
TFCC injury?
- fovea sign
- TFCC load test
Carpal tunnel syndrome?
- phalen’s
- reverse phalen’s
- carpal compression
- tinels tap at the carpal tunnel
- allen’s test
Carpal intability (dislocation)?
- lunotriquetral ballottement
- dorsal capitate displacement test
- watson scaphoid shift
Flexor digitorum profundus injury?
- FDP test, flex DIPs
- sweater finger sign/jersey test
Flexor digitorum superficialis injury?
- FDS test, flex PIPs, dips extended
Lumbar Disc Tests?
- Valsava
- compression distraction
- slump/bechterew’s sitting test
- SLR/Lasgue’s
- bragard’s
- bonnet’s (piriformis test)
- bowstring test
- well leg raise
Lumbar Facet Tests?
- kemps
Lumbar Spondy/Instability Tests?
- single leg stork extension
- prone segmental instability
- pheasant’s test/prone knee bend
- anterior instability test
- posterior instability test
- palpable step-defect
Neurogenic Claudication (stenosis) tests?
- Provocation stoop test
- buergers
- distal pulses
- treadmill test
- bicycle von der wall test
- shopping cart sign
Lumbar versus SI pathology?
- adam’s supported belt test
Glue med weakness?
- trendelemburg sign
SIJ motion?
- gillette’s test
- piedallu’s test
- SIJ gapping tet
- approximation test
- thigh thrust
- yeomans
- gaenslen’s
- Hibb’s test/ prone gap test, knee flex and hip int rot while pal ipsi SI
Hip Labral Tears?
- FABER
- FADIR
- scouring
- anterior posterior labral tear
- sign of buttock
TFL HT?
- ober’s test
- noble’s compression test
Rectus femoris tightness?
- Ely’s test
Psoas HT?
- Thomas Test
Hip #?
- fulcrum test
- log roll
Leg length?
- craig’s
- weber-barstow
Knee Meniscus injury?
- thessaly
- bounce home
- mcmurray’s
- modified mcmurrays
- appley’s
ACL tear?
- anterior draw
- slocom
- lachman
- varus/valgus stress test
- lateral pivot shift test/ external rotation recuvatum
Patellar dislocation?
- patellar aprehension test/fairbanks apprehension test
- patellar glide test
Patellofemoral pain syndrome?
- clarks test
- weak VMO
- pain can be felt in all parts of the knee
- ascending descending stairs
- sitting with bend knee
kneeling squatting
Patellar tendonitis tests?
- jumping
- inferior pole of the patella
- must ultrasound to confirm
Chondromalacia patella Tests?
- clarks
- wipe test
- posterior patella degen
- effusion
- crepitus
OCD of knee?
- wilson’s test, extend internally rotated knee until pain
Medialpatellar plica?
- medialpatellar plica test, medial glid fo the patella
- hugston plica test, knee flexed to 30 + medialpatellar test
- plica stutter test
Anterior Talofibular ligament or calcaneofibular ligament sprain?
- anterior draw mor ATFL
- talar tilt inversion more CTFL
Posterior talofibular ligament sprain?
- posterior drawer
Deltoid ligament (tibionaviicular, tibiocalcaneal) sprain?
- talar tilt eversion
High ankle sprain?
- squeeze test
- kleiger test
Peroneal tendon dislocation?
- windlass test, dorsiflexion of the toes
Achillies Rupture?
- thompson test
Tarsal Tunnel Tests?
- tinel’s tap medial malleolous
Morton’s neuroma test?
- squeeze test
- mortons neuroma test
- commonly inbetween the 3rd and 4th digit
DVT Tests?
- Homan’s sign
- Buerger’s sign
Medial longitudinal arch injury predisposition test?
- navicular drop test
- could cause
+ shin splints
+ plantar fascitis
+ PFPS
Facet Mediated pain protocol?
- 4 tests increase the diagnostic ability
- palpation for segmental tenderness
- manual joint plapation (motion palp)
- kemps (extension and passive rotation test)
- supine passive flexion rotation test
Radiculopathy protocol?
- < 60 deg cervical rotation toward the affected side
- positive median NTT
- positive cervical distraction
- positive spurlings
Myelopathy Protocol?
- gait deviation
- hoffman’s test
- inverted supinator sign (finger flexion or elbow extension w/ brachioradialis tapped)
- babinski test
- > 45
Lower Limb Myotomes?
- L1/2: hip flexion
- L2/3: hip adduction
- L3: kne extension
- L4: foot inversion
- L4/L5: hip abuction, dorsiflexion
- L5: big toe extenion
- L5/S1: knee flexion, hip extnesion
- S1: plantar flexion, eversion
- S2: Toe flexion
Upper limb Myotoms?
- C1/2: neck flexion
- C2/3: neck lateral flexion
- C4: shoulder shrug
- C5: shoulder abduction
- C6: elbow flexion, wrist extension
- C7: elbow extension, wrist flexion, finger extension
- C8/T1: finger abduction, finger adduction, finger flexion
Lower limb DTR?
- patellar: L4
- Achilies: S1
Upper limb DTR?
- brachial: C5
- brachioradialis: C6
- Triceps: C7
Optic nerve testing?
- opthalmoscopy
- pupillary light reflex
- visual accuity
- visual fields
Occulomotor testing?
- H-movement
- X-movement
- smooth pursuit
- sacades
- convergence
Trochlear testing?
- can patient move eye in and down
Trigeminal nerve Testing?
- facial sensation
- chewing muscles
- jaw jerk reflex
Abducens testing?
- H movement
- x movement
- saccades
- optokinetic nystagmus
- oculocephalic testing
Facial Nerve testing?
- facial expression
- taste tests (anterior 2/3 of tongue)
- corneal reflex
Vestibulocochlear nerve testing?
- general hearing
- webers and Rinnes
- otoscopy
- dix hall pike
- fukuda step test
Glossopharyngeal nerve testing?
- palate movement ipsilateral to lesion
- reflex
- posterior 1/3 of tongue
Vagus nerve testing?
- voice
- articulation
- aphasia
- gag reflex
Accessory nerve testing?
- SCM MT
- trap MT
Hypoglossal nerve testing?
- atophy of tongue
- ipsilateral deviation of the tongue if LMNL
Sensory cortex testing?
- sterognosis
- graphesthesia
- two point discrim
- point localisation
Cranial reflex arcs?
- pupillary light reflex, CN2 and 3
- occulocephalic reflex CN 3, 4, 6 and 8
- corneal reflex, 5 and 7
- jaw jerk reflex 5 and 7
- gag reflex 9 and 10 uvula deviates contra to lesion
Cerebellar exam?
- Drift
+ eyes closed, arms horizontal, palms up, feet apart, shake no for 60s
+ arm move up and pronate = cerebellar disease - scanning speach
- nystagmus
- finger nose agnosisa
- dysdiadochokinesia
- heel to shin test
- hypotonia
cerebellar ataxia: wide based staggering gait
What does rigid muscle tone mean?
- basal ganglia lesion
+ constant throughout ROM
+ lead pipe rigidity
+ cog wheel
What does spastic muscle tone mean?
- UMNL
- clasp knife
- stiff and quick release
What does Beevor’s sign mean?
- dorsal myelopathy @ T10
- umbilicus drifting toward weak side on contraction
L’Hermitte’s test?
- seated neck flexion = electric shooting pain from neck to the back
- MS screening tool or meningeal irritation
What does pin prick test?
- lateral spinothalamic lesion, pain and temperature
What does light touch test?
- posterior columns, proprioception
Testing for dorsal column medial leminescus pathoway?
- joint position sense
- passive movement recognition
- vibration sense
What is a spastic gait?
- decoricate arm
- circumducting leg
- UMNL (pyramidal loss)
What is a spastic diplegic gait?
- scissoring legs
- flexed internally rotated hips
- hyperlordosis
What is a Trendelemberg gait?
- single hip dip
What is a parkinsonian gait?
- difficulty starting stopping
- short fesinating steps
- stooped
- little arm movement
- basal ganglia lesion
What is an apraxic gait?
can’t walk, but can describe how
- cortical lesion
What is a magnetic gait?
- shuffling gait glued to the floor
- frontal lobe lesion
What is a marche a petit pas?
- b/l cortex lesion
Tests for Truncal Vestibulocerebellum lesion?
- vertigo
- nystagmus
- nausea
- broad base drunk gait
- can’t perform romberg
Tests for appendicular Spinocerevellum or cerebrocerebellum lesion?
- intentional tremour
- dysdidokinesia
- precision finger tap
- finger nose-finger agnosia
- heel shin overshot
Tests for Tabetic gracilis DCML or peripheral neuropathy lesion?
- high step and foot slap
- joint position sense
- rombergs
Tests for Vertiginous vesibular pathway lesion?
- druken gait
- vertigo
- nystagmus
What does the rebound tenderness test test for?
- periotonitis
What could you have with + Rheumatoid factor?
- sarcoidosis
- Sjoren’s syndrome
- SLE
- RA
What can you have with + HLA - B27?
- psoriatic arthritis
- ankylosing spondylitis
- inflammatory bowel disease
- reactive arthritis
What is present in Multiple Myeloma?
- bence jones proteins
What is wassermans test for?
- syhilis
What is downey cell?
- infectious mono
- epstein bar
What is paul bunnet test for?
- infectious mono
- epstein barr
