Practical Flashcards
THORACO-LUMBAR: FLEXION AND EXTENSION (SCHOBER METHOD)
-tape measure
-top on C7
-bottom on S1
-leave extra hanging down at the bottom
-stand to the side
-measure
the distance and change in distance
SHOULDER PROM: FLEXION
-patient on back with knees bent
SHOULDER PROM: EXTERNAL ROTATION
-supine, knees bent, arm at goal post
-Shoulder IR/ ER put towel under elbow at goal post position
Fulcrum: Olecranon process
Proximal: Parallel or Perpendicular to the floor
Distal Arm: Ulnar shaft (olecranon/ ulnar styloid for
reference)
SHOULDER PROM: INTERNAL ROTATION
-supine, knees bent, arm at goal post
-Shoulder IR/ ER put towel under elbow at goal post position
-head facing away from
shoulder
-IR- stabilize front of shoulder with other hand so that the scapula doesn’t lift
Fulcrum: Olecranon process
Proximal: Parallel or Perpendicular to the floor
Distal Arm: Ulnar shaft (olecranon/ ulnar styloid for
MYOTOME: C7 (ELBOW MOVEMENT AND WRIST MOVEMENT)
C7 – Elbow extension/ Wrist flexion
-try to push arm toward a bicep curl “don’t let me move you- or resists my pressure”
-push on palm down
MYOTOME: L5
L5 – Great toe extension
REFLEX TEST: C5-C6 (BICEPS)
0: Absent reflex.
1+: Hypoactive or diminished reflex.
2+: Normal reflex.
3+: Hyperactive reflex without clonus.
REFLEX TEST: S1-S2
achilles tendon reflex
-patient sitting on table with leg dangling off
-have one hand below the ball of foot in dorsiflexion
0: Absent reflex.
1+: Hypoactive or diminished reflex.
2+: Normal reflex.
3+: Hyperactive reflex without clonus.
HIP PROM: FLEXION
Fulcrum: Aligned with Greater Trochanter
Proximal: Lateral midline of the pelvic
Distal Arm: Lateral midline of femur, referencing Lateral
epicondyle
KNEE PROM: EXTENSION AND FLEXION
-patient on back, both knees bent
Fulcrum: Lateral epicondyle of the femur
Proximal: Lateral midline of the femur, referencing the greater
trochanter
Distal Arm: Lateral midline of fibula, referencing Lateral malleolus and
fibula head
Knee extension-
Put a rolled towel under the ankle
Clearance of calf muscle off of table
FABER Test
FABER Test: F(lexion) AB(duction) E(xternal)
R(otation)
-hands on ASIS and knee
Positive Finding – Acute pain in the hip
- 1st – Examiner grasps ankle of one leg and places
it proximal to the knee of the contralateral limb - FABER
- Flexion (Hip & Knee)
- Abduction
- External Rotation
- 2nd – Stabilize the joint by applying a steady
force to the contralateral ASIS
Shoulder Apprehension Test (with Relocation Test)
-patient supine
-place 5th digit over coracoid process
1st – Examiner abducts the shoulder and
slowly externally rotates
* 2nd – Watch patient’s face for grimace or
guarding (apprehension)
* 3rd – Extreme caution, possible to
reinjure/dislocate the shoulder
Positive Finding – Pain, guarding, or grimace
Relocation Test
-only do relocation if aprehension is positive
RELOCATION TEST:
-repeat ER movement but place hand on anterior aspect of
the humeral head and maintains approximation of the humeral head and
labrum. This allows external rotation without apprehension.
Straight Leg Raise (with test for a Bragard’s sign)
Positive straight leg raising test= pain
-knees STRAIGHT
-give measurement
Fulcrum: Aligned with Greater Trochanter
Proximal: Lateral midline of the pelvic
Distal Arm: Lateral midline of femur, referencing Lateral
epicondyle
Bagards Nerve Tension Test-
Patient Position: Supine
* 1st – Bragard’s sign is a follow-up to
Straight-Leg and Lesague Test
* 2nd - Examiner slowly flexes the hip
with extended knee until the limb is
brought into the range positive for
pain.
* 3rd - Abruptly dorsiflex the foot
Cervical Compression/ Distraction test
Patient Position: Seated
* Take great caution in applying force. Increase
amplitude gradually. Space each ‘press’ with a
pause. Note any changes in pain or sensation.
* 1st – Patient performs active ROM, note taken for
provocation of pain or atypical symptoms.
* 2nd – From anatomical position, examiner exerts
downward pressure on vertex of skull.
* 3rd – From an end-range cervical rotation position
towards affected side, apply downward force.
Assess contralaterally as well.
Positive test= pain
Distraction Test
Roo’s Test (east): (only for 15 seconds)
Roos Stress Test:
AKA[Elevated Arm Stress Test (EAST)]
- Shoulder abducted to 90 and externally
rotated, elbow flexed to 90. - 1st – Patient “pumps” fists,
open/closing hands repeatedly for
positive= pain or symtoms
Cozen Test/ Reverse Cozen Test
**-cozen= push wrist down (flexion)
-reverse cozen= push wrist up (extension)
**
Cozen= lateral elbow pain
Reverse Cozen= medial elbow pain
Patient Position: Seated
* 1st – Patient is instructed to make a fist and
extend the wrist
* 2nd – Examiner places hands to stabilize the
elbow and apply force to the dorsum of
the hand
* 3rd – Examiner applies a moderate force
attempting to flex the wrist while patient
resists (providing resistance to the wrist
extensors
-cozen= push wrist down (flexion)
-reverse cozen= push wrist up (extension)
Knee: Drawer Test (anterior/ posterior)
Patient on back feet planted
-sit on foot
* 1st – Examiner grasps superior aspect of calf, distal to the knee.
* 2nd – Apply a mild force attempting to translate the tibia anteriorly
* 3rd – Apply a mild force attemptin
Ligament laxity causing
excessive translation of tibia >5mm
MTrp solid filiform needling: GB 21 (supine)
NON needling hand has glove and cotton ball
left hand has glove
R hand has needle- no glove
Needle in between where fingers are on the upper trap
MMT: Shoulder infraspinatus/ teres minor (prone)
Arm rests on the table. Examiner
places one hand under the arm near the
elbow and stabilizes the humerus to ensure a
rotation action by preventing adduction or
abduction motion. Examiner’s hand cushions
against the table pressure.
Test: Lateral rotation of the humerus with the
elbow held at a right angle.
Pressure: Using the forearm as a lever,
pressure is applied in the direction of medial
rotation or the humerus
