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5 Ortho > Practical > Flashcards

Practical Flashcards

1
Q

Neer’s Positioning

A

Stabilize scapula
IR humerus
passively flex arm to max range in scapular plane

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2
Q

Neer’s Positive

A

Pain at sub-acromial or anterior edge of acromion, often visible pain

test is sensitive but not specific. Negative gives us more information

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3
Q

Meaning of Positive Neers

A

supraspinatus impingement

jams greater tuberosity against acromion, pinching supraspinatus or biceps tendon

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4
Q

Empty Can positioning

A

abduct arm to 90°
move to 30° in scapular plane
IR arm, with hand pointing down
provide resistance down

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5
Q

Empty Can positive

A

pain or weakness in the position w/resistance at subacromial space

not a great test b/c it decreases the joint space
High specificity, can rule in a positive

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6
Q

Empty can positive meaning

A

supraspinatus is pinched in subacromial space, contractile tissue weakness

supraspinatus impingement

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7
Q

Full can positioning

A

abduct arm to 90°
move to 30° in scapular plane
provide resistance down

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8
Q

Full can Positive

A

pain or weakness in the position w/resistance at subacromial space

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9
Q

Meaning of Full Can positive

A

supraspinatus is weak or has pain in normal position w/normal action

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10
Q

Hawkins-Kennedy Positioning

A

passively raise arm to 90° of flexion
Flex elbow to 90°
Support distal humerus
Move arm into IR at wrist

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11
Q

Hawkins-Kennedy Positive

A

Provocation test, pain
Most likely at subacromial

sensitive, not highly specific

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12
Q

Meaning of positive hawkins-kennedy

A

supraspinatus tendon is pushed against coracoids process

impingement

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13
Q

Cross Adduction Positioning

A

passively flex arm to 90°
max adduct arm

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14
Q

Cross Arm Positive

A

localized pain over acromioclavicular

more specific than sensitive

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15
Q

Cross Arm Positive Meaning

A

RC tendons and biceps tendons are pinched
impingement

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16
Q

Yocum positioning

A

pt places involved side hand on opposite shoulder
pt actively raises elbow

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17
Q

Yocum positive

A

painful at anterior shoulder

sensitive, not specific

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18
Q

Yocum positive meaning

A

RC tendons and biceps tendon are pinched
impingement

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19
Q

Drop Arm Positioning

A

passively abduct arm to 90°
pt slowly lowers arm

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20
Q

Drop Arm Positive

A

weakness or pain causes patient to drop arm to their side

high specificity, good at ruling in

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21
Q

Drop Arm Positive Meaning

A

function and integrity of supraspinatus
positive would indicate a tear

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22
Q

ER Lag Positioning

A

20° elevation in scapular plane
passively flex the elbow to 90°
ER shoulder maximally, then back 5°
ask pt to hold in that position

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23
Q

ER Lag Positive

A

arm starts to drift into IR
increased specificity, good at ruling in

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24
Q

ER Lag Positive Meaning

A

tests for infraspinatus pathology, possible tear

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25
Q

Hornblower Positioning

A

bring shoulder to 90° of abduction, 90° ER
ask pt to hold this

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26
Q

Hornblower Positive

A

arm falls into internal rotation
high specificity and sensitivity

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27
Q

Hornblower Positive Meaning

A

Indicates a massive teres minor tear

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28
Q

Gerber Positioning

A

hand goes behind back, with back of hand resting at mid lumbar
lift hand off back with IR
apply resistance

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29
Q

Gerber Positive

A

hand can’t be lifted off the back
compensation w/shoulder or elbow extension

30
Q

Gerber Positive Meaning

A

subscapularis pathology
possible tear

31
Q

Belly Press Positioning

A

alternative to gerber
elbow 90° and hand on stomach
apply force to ER to forearm

32
Q

Belly Press Positive

A

weak compared to non-affected
compensation w/shoulder extension or wrist flexion

high specificity, ruling in

33
Q

Belly Press Positive Meaning

A

subscapular pathology
possible tear

34
Q

Obrien’s Positioning

A

pt flexes to 90° while keeping elbow extended, adducted 10°, supinated. Apply force down.

pt IRs, with thumb down, Apply force down.

35
Q

Obrien’s Positive

A

pain in GHJ in pronation but NOT in supination

high sensitivity, better at ruling out

36
Q

Obrien’s Positive Meaning

A

possible labral tear, or SLAP tear

37
Q

Compression Rotation Test Positioning

A

pt supine, abduct arm to 90°, elbow in 90° of flexion
provide axial compression, then humerus is circumducted and rotated

38
Q

Compression Rotation Positive

A

pain or clicking

high specificity, can rule in

39
Q

Compression Rotation Positive Meaning

A

indicates SLAP or labral tear

40
Q

Crank Positioning

A

supine, elevate arm to 160° in scapular plane
apply axial force and rotate into IR and ER

41
Q

Crank Positive

A

clicking or pain in GHJ
high specificity, can rule in

42
Q

Crank Positive Meaning

A

indicates labral pathology

43
Q

Apley’s Scratch Positioning

A

pt brings 1 arm into extension, IR, adduction
pt brings other arm into flexion, ER, abd
pt tries to touch fingers

44
Q

Apley’s Scratch Positive

A

unable to touch fingers together or overcompensates with one arm

45
Q

Apley’s Scratch Positive Meaning

A

pt has decreased ROM in GHJ

46
Q

Sulcus Sign Positioning

A

pt sits or stands with arms relaxed by side
hold at proximal elbow and pull down

47
Q

Sulcus Sign Positive

A

sulcus forms at superior humeral head

48
Q

Sulcus Sign Positive Meaning

A

may indicate multidirectional or inferior stability

49
Q

Apprehension Positioning

A

supine, PT abducts arm to 90°, slowly ER

if no symptoms, apply force anteriorly

50
Q

Apprehension Positive

A

pt experiences instability, apprehension, pain at front

high spin, can rule in

51
Q

Apprehension Positive Meaning

A

pain at front = anterior instability

pain at back = impingement

52
Q

Relocation Positioning

A

supine, PT abducts arm to 90°, slowly ER
no symptoms, apply force posteriorly

53
Q

Relocation Positive

A

pain or apprehension decreases
high spin, can rule in

54
Q

Relocation Positive Meaning

A

anterior instability

55
Q

Anteromedial + Posterior Lateral Joint Play Placement

A

0-30° abd = superior GHL
30-60° abd = middle GHL
90° abd = inferior GHL

56
Q

Force of AM Joint Play

A

hand is on greater tubercle, and head of humerus force is up

other hand is on distal humerus, distract and push down

57
Q

Force of PL joint play

A

hand is on greater tubercle and head of humerus force is down

other hand is on distal humerus, distract and pull up

58
Q

Indication of AM or PL Joint Play

A

determining the integrity of the ligaments, hypermobility (gd 2), capsule integrity, ROM, end feel

59
Q

GH distraction placement

A

-use hand closest to pt, place in axilla
-thumb goes distal to jt margin, fingers 90° posteriorly
-other hand supports lateral humerus

60
Q

GH Distraction Force

A

hand in axilla moves humerus laterally

61
Q

GH Distraction Indications

A

testing
initial tx = gd 2
pain = gd1/2
mobility = gd 3

62
Q

GH Inferior Glide Placement

A

one hand in pts axilla
web space of other hand goes distal to acromion process

63
Q

GH Inferior Glide Force

A

w/superior hand, glide humerus in inferior direction
gd 1 distraction on axilla

64
Q

GH Inferior Glide Indications

A

increase abduction = gd 3
reposition the humeral head

gd 1 distraction and inferior glide for progression, when there’s 90° of abduction

65
Q

GH Posterior Glide Positioning

A

patient: 45° abduction, and 30° flexion

PT: back to pt, arm goes against trunk, grab distal humerus. Other hand goes distal to ant jt line, fingers are superiorly faced

66
Q

GH Posterior Glide Force

A

grade 1 distraction on elbow
glide posterior-lateral with other hand

67
Q

GH Posterior Glide Indication

A

increase flexion
increase IR

68
Q

GH Anterior Glide Positioning

A

pt: prone with padding in acromion

PT: pt arm goes on thigh, outside hand goes on distal humerus. Other hand goes distal to acromion, fingers are superiorly faced

69
Q

GH Anterior Glide Force

A

gd 1 distraction to distal humerus
anterior and slight medial force

70
Q

GH Anterior GLide Indications

A

increase extension
increase ER

5 Ortho (14 decks)

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