Practical 1 Special tests Flashcards
1
Q
Explain Neer’s Impingement
A
- indicates external impingement, supraspinatus tendinopathy
- could also indicate ligaments or bursa or tendon crossing joint
- internal rotation and passive flexion while supporting scapula
- positive is pain
2
Q
Explain Neer’s Impingement
A
- indicates external impingement, supraspinatus tendinopathy
- could also indicate ligaments or bursa or tendon crossing joint
- internal rotation and passive flexion while supporting scapula
- positive - pain
3
Q
Explain Hawkins kennedy test
A
- indicates external impingement, supraspinatus tendinopathy
- could also indicate ligaments or bursa or tendon crossing joint
- 90 flexion shoulder and elbow, passive internal rotation
- positive - pain
4
Q
Explain the supraspinatus empty can shoulder test (jobe)
A
- looking for supraspinatus tear
2 part test - shoulder in abduction with thumb up, resistance
- scapular plane with thumb down, resistance
- positive - pain or inability to hold
5
Q
Explain the lift off sign test
A
- looking for subscapularis tear
2 part test - place hand on lower back with palm facing out, then ask patient to lift off
- if successful add resistance to hand and distal forearm
- positive - pain or unable to lift off
6
Q
Explain the drop arm or codman test
A
- tests for supraspinatus tear
- passive ABD 90 neutral hand
- let go and ask the patient to slowly lower the hand, keep hand just below to catch just in case
- positive if pain or lots of compensation
7
Q
Explain yergason’s test
A
- tests long head of biceps or transverse humeral ligament
- 90 elbow flexion, pronated
- ER and supination with resistance and palpation of bicipital groove
- positive, pain in bicipital groove or subluxation of long head tendon
8
Q
Explain the load and shift test
A
- laxity in the anterior or posterior direction of the GH joint
- if the humerus is drooped out of the GH capsule it will need to be loaded back in
- then stabilize the AC and move the humerus anterior and posterior
- positive - pain, clicking, apprehension, excessive movement
9
Q
Explain the anterior apprehension test (crank)
A
- tests for anterior laxity or instability
- supine, passive 90 ABD then ER
- positive is pain or apprehension or excessive ER
10
Q
Explain the posterior apprehension test
A
- tests for posterior laxity or instability
- supine, passive 90 flexion and flex elbow over the body 90, then 10 ADD with pressing through the humerus then internally rotate
- positive is pain, apprehension
11
Q
Explain the scapular assistance test
A
- tests for weakness in upward rotators
- patient actively elevates the shoulder, asses pain and height
- patient actively elevates the arm with passive scapular assistance of UR, ER and posterior tilt via the inferior angle and hand over acromion
- look for less pain or higher ROM
- indicates weakness in upward rotators
12
Q
Scapular retraction test
A
- tests for weakness in retractors
- retract the scapula
- positive is less pain or higher ROM
13
Q
Explain the lateral scapular slide test
A
- tests for weakness or injury in scapular stabilizers
- 3 positions
- arms at side
- hands on hips
- 90 ABD thumbs down
- positive is difference bilaterally of more than 1.5 cm between inferior angle and closest spinous process, further scapula is problematic
14
Q
Explain Watrenberg’s sign-elbow
A
- Tests ulnar nerve entrapment
- passive abduction of all fingers, active adduction
- unable to adduct pinky finger
15
Q
Explain the Pinch Grip-Elbow test
A
- tests anterior interosseous nerve
- ask patient to pinch fingers
- positive it pad to pad,
16
Q
Explain the Froment’s-Elbow test
A
- Ulnar nerve to adductor pollicis
- hold paper over fist with thumb
- positive - therapist can take paper, excessive IP flexion
17
Q
Explain the valgus and varus stress test
A
- MCL or LCL laxity
- Valgus - stabilize humerus pull out
- Varus - stabilize humerus, pull in
- pain and/or laxity
18
Q
Explain the moving valgus test
A
- MCL injury
- 90 shoulder flexion, full elbow flexion, external rotation, push elbow in pull wrist out to create valgus stress
- excessive mobility and or pain
19
Q
Explain Cozen’s elbow test
A
- lateral epicondalgia
- thumb on lateral
epicondyle, wrist extension and radial deviation against resistance - positive - pain underneath thumb contact
20
Q
Explain MIlls elbow
A
- lateral epicondalgia
- passive test, extended elbow, forced wrist flexion
- positive - pain under thumb on lateral epicondyle
21
Q
Explain Tinel’s elbow test
A
- peripheral nerve injury, irritation or repair
- tap for 30 sec to 1 min with finger
- Ulnar nerve at cubital tunnel
- ulnar nerve in guillans canal
- superficial radial nerve in anatomical snuffbox
- median nerve at carpal tunnel
- positive - tingling or numbness distant to contact at relevant distribution
22
Q
Spurling A and B
A
- Tests for cervical nerve root irritation
- A sidebendign only with pressure towards affected side
- B sidebendign rotation and extension
- Positive - pain
23
Q
Abduction test
A
- Radicular arm pain
- place hand on head
- positive - ease of symptoms
24
Q
Neck traction vs distraction
A
- Cervical radiculopathy
- Distraction - laying down - pull from just occiput support forehead
- Traction - standing - cradle head pull up
- Positive - reduction of symptoms
25
Explain Finkelsteins test
- tests for Quervain's tenosynovitis
- support patient's hand, thumb to palm, grip thumb, ulnar deviation
- pain over anatomical snuff box, APL, EPB
26
Explain Bunnell Littler's test
- tests PIP flexion limitation
- MCP flexion then DIP flexion, if same capsular, if more
- assess lmiting tissue
27
Explain Phalen's test
- tests compression median nerve entrapment
- back of hands together
- involved side presents as tingling and numbness distal to carpal tunnel to first 3.5 fingers
28
Explain reverse Phalen's test
- tests traction of the median nerve
- palms together
- involved side presents as tingling and numbness distal to carpal tunnel to first 3.5 fingers
29
Explain Allen's test
- test for vascular capacity of radial and ulnar arteries
- occlude both arteries of the wrist and have patient make a fist 4 times
- positive - dissimilar delayed return poor vasculature
30
Explain the Supination Lift test
- tests for TFCC lesion
- have patent curl up the end of a table
- positive - pain around TFCC area on ulnar side
31
Explain the TFCC load test
- tests for TFCC lesion
- thumb in palm, load wrist, ulnar deviation, then extension and flexion or supination pronation
- positive - pain around TFCC
