Prac Viva Revision Flashcards

1
Q

Explain the Concave/Convex Rule

A

When a concave bone moves within a convex socket, the movement moves as you’d expect.
For example, Shoulder Flexion moves AP

When a convex bone moves on a concave surface, the movement moves in the opposite direction to what you’d expect.
For example, Hip Flexion = Femur Head PA

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2
Q

Trendelenburg Special Hip Test
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?

A

Process = pt. standing on one leg for ~15-30s. Examiner checks ASIS levels are equal.

Findings = Glute Medius and Minimus

Positive = hip with leg in the air drops due to adductor weakness

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3
Q

Thomas Test - Hip
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?

A

Process = pt. perched on edge of the plinth. pt. hold one leg to their chest, slowly lying down.

Findings = Iliopsoas + Rectus Femoris

Positive = extended leg cannot reach the plinth + if moving laterally, tight TFL and ITB

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4
Q

Quadrant Scour Test - Hip - NON-IRRITABLE
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?
> Sn and Sp?

A

Process = pt supine. Therapist bring hip to ~90 degrees flexion. From there, therapist glides/scours into adduction, IR, and compression of the joint.

Findings = this tests intra-articular joint pathology/restriction

Positive = onset/reproduction of pain

Sn = 50, Sp = 29

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5
Q

Ober’s Test - Hip
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?

A

Process = pt. side lying. Therapist supports top leg in flexion. Therapist then extends and abduct’s top leg. The test is excited by slowly bringing the leg into adduction

Findings = TFL + ITB tightness

Positive = top leg cannot get parallel with plinth OR if lateral knee pain occurs

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6
Q

FADIR Test - Hip
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?
> Sn and Sp?

A

Process = pt. in supine. flex knee to 90, adduct, and IR.

Findings = this tests for mechanical anterior impingement intra-articular labarum tear

Positive = reproduction/onset of groin pain

Sn = 99, Sp = 5

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7
Q

Adductor Squeeze Test - Hip
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?
> Sn and Sp?

A

Process = pt. supine, knees flexed with feet flat on plinth. therapist places hand between pt. knees and instructs pt. to squeeze knees together.

Findings = tests for adductor tendinopathy + osteitis pubis

Positive = reproduction of groin pain

Sn = 43, Sp = 91

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8
Q

Anterior-Posterior (AP) Glide - Hip
> Describe how to execute the test for all grades
> What movement does AP Glide assist with?

A

Process =
Grade 1 and 2 - pt. in supine. Therapist places thumbs on greater trochanter
Grade 3 and 4 - pt. supine. Therapist uses heel of hand

Useful for increasing Hip Flexion ROM

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9
Q

Posterior-Anterior (PA) Glide - Hip
> Describe how to execute the test for all grades
> What movement does PA Glide assist with?

A

Process =
Grade 1 and 2 - pt. prone. Therapist places thumbs on greater trochanter
Grade 3 and 4 - pt. prone. Therapist uses heel of hand

Useful for increasing Hip Extension ROM

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10
Q

Lateral transverse Hip Glide
> Describe how to execute the test for all grades
> What movement does Lateral Transverse Glide assist with?

A

Process =
Grade 1 and 2 - pt. supine. Therapist uses hands to laterally move femur
Grade 3 and 4 - pt. supine. Therapist uses belt around mid femur whilst hip in 90 flexion

Useful for increasing flexion and IR due to capsular tightness

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11
Q

Caudad Hip Glide - Hip
> Describe how to execute the test for all grades
> What does a Caudad Glide assist with?

A

Process =
For all grades - pt. supine with hip at 90 flexion. Pull leg towards feet/end of the bed

Useful for pain relief in intra-articular pathologies

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12
Q

Talar Tilt Test - Ankle
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?
> Sn and Sp?

A

Process = pt. seated on edge of plinth. One hand stabilises distal tib/fib and the other rotates foot into inversion and eversion

Findings = Inversion tests ATFL and CFL. Eversion tests deltoid ligament

Positive = excessive translation movement

Sn = 58-80, Sp = 88

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13
Q

Anterior Drawer Test - Ankle
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?
> Sn and Sp?

A

Process = pt. sits on edge of plinth. Distal tib/fib stabilised with one hand, the other pulls calcareous forwards

Findings = Tests ATFL and CFL

Positive = excessive translation OR altered end feel, pain onset, or clunk

Sn = 58-80, Sp = 74-79

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14
Q

Squeeze Test - Lower Leg
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?
> Sn and Sp?

A

Process = pt. supine on bed. Therapist bends knee into flexion and squeezes mid tib and fib together. Repeats distally.

Findings = Tests for Syndesmosis, Tib/Fib ligaments & Interosseous membrane/ligament
+
Common w/ #

Positive = reproduction of pain

Sn = 30-100, Sp = 14-93

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15
Q

Thompsons Test - Lower Leg
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?
> Sn and Sp?

A

Process = pt. prone w/ ankle hanging off plinth. Therapist squeezes gastrocnemius and observes for PF

Findings = Tests achilles tendon integrity

Positive Test = no PF –> indicating toren tendon

Sn = 96, Sp = 93

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16
Q

Inferior Tibia Fibula Joint Accessory Move.

Explain how to execute the following:
AP
PA
Compression
Distraction

A

AP and PA
- pt. supine/prone with knee flexion 90
- stabilise tibia and move fibular by pushing in opposite direction
- Supine = AP VS Prone = PA

Compression
- squeeze malleolus together

Distraction
- passive dorsiflexion

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17
Q

Talocrural Joint Accessory Movement

Explain how to execute the following:
AP
PA
Compression
Distraction

A

AP (for DF) and PA (PF)
- pt. supine w/ ankle off end of plinth
- stabilise tip/fib and move talus in desired direction

Compression
- pt. prone w/ knee flexed to 90
- compress ankle pushing weight down into the leg

Distraction
- pt. prone w/ knee flexed to 90
- pull talus upwards

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18
Q

Subtalar Joint Accessory Movement

Explain how to execute the following:
Medial/Lateral Glide
Compression
Distraction

A

Medial/Lateral Glide
- pt. prone w/ knee flexed to 90
- stabilise talus and move calcaneus
(medial glide = assists with eversion, vice versa)

Compression
- push ankle into closed packed position

Distraction
- pt. supine w/ ankle off plinth
- stabilise talus + pull calcaneus

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19
Q

Transverse Tarsal Joint Accessory Movement
(between talus and navicular and cuboid and cuneiform)

Explain how to execute the following:
AP/PA
Medial/Lateral

A

AP and PA + Medial and Lateral
- pt. seated supine with ankle off plinth
- stabilise talus and move cuneiforms + cuboid

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20
Q

Intra-Articular Effusion Budge Sign/Sweep

A
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21
Q

MCL + LCL Stress Test
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?
> Sn and Sp?

A

Process = pt. supine. Therapist flexes knee to 30 with pt. foot tucked under armpit. Application of valgus/varus force via just rotating body

Findings = test for any laxity in MCL or LCL

Positive = laxity or excessive movement

Sn = 91, Sp = 49

22
Q

Lachman’s Test
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?
> Sn and Sp?

A

Process = pt. supine. Therapist places pt. distal femur on top of therapist knee. One hand stabilises distal femur, the other under proximal tibia. Therapist passively translates tibia anteriorly

Findings = Tests for torn/damaged ACL

Positive = excessive anterior translation with soft end feel

Sn = 81, Sp = 81

23
Q

Pivot Shift Test - Knee
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?

A

Process = pt. supine with knee in full extension. IR tibia with valgus force

Findings = Tests ACL laxity/damage

Positive = clunk + sublaxation

24
Q

Anterior Drawer Test - Knee
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?
> Sn and Sp?

A

Process = pt. supine with knee flexed to 90. Therapist sits on foot with hands wrapped around calf with thumbs of anterior joint line. Draw tibia forward

Findings = Tests for ACL laxity/damage

Positive = anterior displacement exceeding 5mm with soft end feel

Sn = 38, Sp = 81

25
Q

Posterior Drawer Test - Knee
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?

A

Reverse Anterior Drawer Test Process and Positive Test

Findings = Tests PCL laxity/damage

26
Q

Apleys Grind Test - Knee
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?

A

Process = pt. prone with knee flexed to 90. Therapist can place knee on distal femur for stabilisation. Place downward pressure on tibia and rotate leg IR and ER

Findings = Tests for meniscal damage. IR = Lateral Meniscus, ER = Medial Meniscus

Positive = pain or clicking on IR or ER indicating meniscal tear

27
Q

Posterior Sag Test - Knee
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?
> Sn and Sp?

A

Process = pt. supine. Therapist flexes knee + hip to 90 flexion. Place pt. foot on a stool at the end of the plinth. Observe position of the patella and the tibial tubercle from lateral view.

Findings = Test PCL intergerity

Positive = tibia will be posteriorly displaced

Sn = 46-100, Sp = 100

28
Q

McMurray’s - Knee
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?
> Sn and Sp?

A

ALMOST FULL ROM FLEXION MUST BE PRESENT
Process = pt. supine with knee fully flexed. Therapist palpates joint line. Medial Meniscus = lower leg is ER + extend flexed knee. Lateral Meniscus = lower leg is IR + extend the flexed knee.

Findings = Tests meniscal integrity

Positive = reproduction of pain and a palpable/audible click

Sn = 61, Sp = 84

29
Q

Thessaly Test - Knee
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?
> Sn and Sp?

A

Process = pt. standing SL holding onto therapist hands. pt. flexes to 5 + fully rotates body 3x each direction. Repeat at 20 flexion.

Findings = Tests meniscal integrity

Positive = pain @ joint line OR locking/catching feeling in knee

Sn = 75, Sp = 87

30
Q

Patellar Apprehension Test
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?
> Sn and Sp?

A

Process = pt. supine with knee @ 30 flexion. Therapist applies pressure to medial patella. Therapist observes mobility of patella.

Findings = Test for subluxation/instability

Positive = pain, apprehension, resistance of further movement via quad activation, excessive movement

Sn = 15, Sp = 89

31
Q

Tibiofemoral Joint Accessory Movements

Explain how to execute the following:
AP/PA
Caudad

A

AP
- pt. supine with 90 knee flexion
- one hand stabilise over femur
- other hand applies force to proximal tibia, directly down into bed

PA
- pt. supine with 90 knee flexion
- both hand around back of proximal tibia with thumbs over anterior tibial tuberosity
- apply force towards therapist body

Caudad
- pt. supine with towel under knee (loosed-packed position)
- both hands over tibial tuberosity + pull in caudal direction

32
Q

Superior Tibiofibular Accessory Movements

Explain how to execute the following:
AP/PA
Caudad/Cephalad

A

AP/PA
- pt. supine (AP) or prone (PA)
- use both thumbs to apply pressure onto fibula head in desired direction

Caudad/Cephalad (direction of fibula)
- pt. prone with 90 knee flexion
- Inversion = Caudad
- Eversion = Cephalad

33
Q

Gerber’s Test - Shoulder
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?
> Sn and Sp?

A

Process = pt. places hand behind back. pt. pushes hand away from body with therapist applying an opposing force.

Findings = Test for subscapularis weakness

Positive = Inability/Lack of Movement

Sn = 50, Sp = 88

34
Q

Full Can Test - Shoulder
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?
> Sn and Sp?

A

Process = lift arm to 90 flexion with thumb facing up. Therapist places pressure on pt. arm while pt. resists the force

Findings = Tests for Supraspinatus Tendinopathy

Positive = Pain + lower strength level compared to stronger side

Sn = 55-89, Sp = 54-82

35
Q

Jobe’s (empty can) Test = Shoulder
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?

A

Process = lift arm to 90 flexion with thumb facing down. Therapist places pressure on pt. arm while pt. resists the force

Findings = Tests for subacromial impingement

Positive = pain

36
Q

Hawkins-Kennedy - Shoulder
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?
> Sn and Sp?

A

Process = pt. flexes shoulder to 90 + therapist passively IR arm

Findings = Tests for subacromial impingement - this position brings the supraspinatus tendon against the anterior portion of the coracoacromial ligament

Positive = pain production

Sn = 63-74, Sp = 40-89

37
Q

Neer’s Test - Shoulder
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?
> Sn and Sp?

A

Process = therapist stabilises scapula and passively flexes pt. arm in IR (thumbs facing down (180))

Findings = Tests subacromial impingement

Positive = pain reproduction

Sn = 54-81, Sp = 10-95

38
Q

Which 5 Positive Shoulder Tests indicate subacromial impingement?
What happens if 3+ of these test are positive?

A

The 5 Tests:
- Jobe’s
- Hawkins-Kennedy
- Neer’s
- Painful Arc
- Resisted ER

If 3+ results positive there is a 75% Sn and 74% Sp for Subacromial Impingement

39
Q

Inferior Drawer Test - Shoulder
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?
> Sn and Sp?

A

Process = pt. sitting on edge of plinth with elbow flexed to 90. Therapist palpates shoulder joint + pulls arm inferiorly

Findings = Test for multi-directional instability

Positive = step deformity + clear gap b/w HOH and Shoulder Joint

Sn = 28-82, Sp = 86-97

40
Q

Apprehension and Relocation Test
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?

A

Process:
Apprehension = pt. lying supine with arm abducted to 90 + elbow flexed. Therapist passively ER’s until the onset of symptoms.
Relocation = Once at the point of symptoms, therapist applies AP translation on HOH

Findings = Tests instability of anterior aspect of jt.

Positive:
- Apprehension = onset of symptoms
- Relocation = easing of symptoms when HOH posteriorly translated + onset of symptoms when post. trans. released

41
Q

Speed Test - Shoulder
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?
> Sn and Sp?

A

Process = pt. flexes shoulder to 90 with ER + supination. Therapist places downward pressure on wrist of pt. as they resist the downward pressure

Findings = Tests bicipital tendinopathy (Long Head Bicep) and superior labral pathology (SLAP lesion)

Positive = reproduction of pain in bicipital groove

SLAP Lesion Indication: Sn = 20, Sp = 78

42
Q

Yergason’s Test - Shoulder
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?
> Sn and Sp?

A

Process = pt. elbow flexed to 90 with forearm pronated + elbow by side. Therapist holds pt. wrist and resists pt. supination

Findings = Tests bicipital tendinopathy (Long Head Bicep) and superior labral pathology (SLAP lesion)

Positive = pain\

SLAP Lesion Indication: Sn = 12, Sp = 95

43
Q

O’Briens Active Compression Test - Shoulder
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?
> Sn and Sp?

A

Process = pt. flexes shoulder to 90 + 10-20 horizontal adduction. Therapist places downward pressure on pt. wrist in both an IR and ER position whilst pt. resists pressure

Findings = Tests for SLAP lesion and AC joint injury

Positive = more clicking/pain in IR than ER - potentially SLAP lesion
Note: deep pain –> SLAP VS shoulder tip –> ACJ

SLAP Lesion Indication: Sn = 67, Sp = 37

44
Q

Glenohumeral Joint Accessory Movements

Explain how to execute the following:
AP/PA
Caudad
Lateral Glide

A

AP/PA
- can be performed in neutral or abduction
- pt. supine
- AP glide use heel of hand AND PA use thumbs
- have arm supported by towel

Caudad
- pt. arm by side with elbow flexed at 90
- therapist applies pressure towards pt. feet

Lateral Glide
- pt. supine with arm by side
- therapist hands up shaft of humerus and pulls laterally

45
Q

Locking Passive Physiological Test - Shoulder
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?

A

ONLY USE FOR NON-IRRITABLE PRESENTATIONS
Process:
- pt. supine
- therapist places one arm under the scapula with finds over trapezius
- other hand holds pt. in elbow flexion (90) and passively abducts

Findings = Tests intra-articular joint pathologies

Positive = there should be painless and full ROM

46
Q

Quadrant Passive Physiological Test - Shoulder
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?

A

Process:
- start in locked position
- therapist relaxes pressure whilst maintain abduction allowing movement into frontal plane
- continue to abduct and ER through 30 degree arc laterally –> fully elevated position

Findings = Tests intra-articular joint pathologies

Positive = there should be painless and full ROM

47
Q

Acromial clavicular Joint Accessory Movement

Explain how to execute the following:
AP/PA
Caudad/Cephalad

A

AP/PA
- pt. supine
- therapist uses thumbs for AP/PA pressure

Caudad/Cephalad
- pt. supine
- therapist uses thumbs for both directions

48
Q

Sternoclavicular Joint Accessory Movement

Explain how to execute the following:
AP
Caudad/Cephalad

A

REMEMBER THIS JOINT SHOULD NOT MOVE EXCESSIVELY

AP
- pt. supine
- therapist applies pressure over joint with thumbs

Caudad/Cephalad
- pt. supine
- therapist applies pressure in desired direction with thumbs

49
Q

Tinel’s Test - Ulnar Nerve
> Describe how to execute the test
> What does the test identify?
> False Positive %?

A

Process = pt. supine with arm above head and elbow flexed. Therapist taps ulnar nerve 4-6 times

Findings = Tests ulnar nerve sensitivity and integrity

False + % = 6-45%

50
Q

Collateral Ligaments Stress Test - Elbow
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?

A

Process = pt. in supine with 20 elbow F and forearm supinated. Therapist then applies a valgus or varus force to the elbow.

Findings = Assess Collateral Ligaments Integrity

Positive = altered end-feel + pain reproduction

51
Q

Moving Stress Test - Elbow
> Describe how to execute the test
> What does the test identify?
> What does a positive test appear like?

A

Process = pt. seated