Savarese chapter 18 (Special Tests) Flashcards
Spurling Test
Looks for narrowing of the neural foramina
Extend and sideband the C-spine to the side being tested, the push down on the top of the head
+ if pain radiates into the IL arm
Wallenberg test
Looks for vertebral artery insufficiency
Hold the head in flexion, extension, rotation R, and rotation L for 10 seconds each
+ if patient gets dizzy, visual changes, lightheaded, or nystagmus
Underberg Test
Looks for vertebral artery insufficiency
Backward bend the head and fully rotate it to either side
+ if the patient develops vascular or neurologic symptoms, HVLA is contraindicated
Adson’s Test
Looks to see if the neurovascular bundle is being compromised by tight scalenes
While monitoring the patient’s pulse, extend, externally rotate, and abduct their arm. Then have the patient take a deep breath and turn their head towards the IL arm
+ if the pulse severely decreases
Wright’s Test
hyperextension test
Looks to see if the neurovascular bundle is being compressed when it passes under pec minor
While monitoring the patient’s pulse, hyperabduct the arm over the head with slight extension.
+ if the pulse severely decreases
Costoclavicular syndrome test
Military posture test
Looks to see if the neuromuscular bundle is being compressed between the clavicle and first rib
While monitoring the patient’s pulse, depress and extend the shoulder.
+ if the pulse severely decreases
Apley’s scratch test
Used to evaluate ROM of the shoulder
Look for asymmetry
Drop arm test
Looks for tears in the rotator cuff
Have patient abduct their arm to 90 degrees, then slowly lower it
+ if the patient cannot smoothly lower their arm
Speed’s test
Assesses the biceps tendon in the bicipital groove
Fully extend the elbow, flex the shoulder, and supinate the forearm. Physician resists flexion of the shoulder.
+ if tenderness in the bicipital groove
Yergason’s test
Determines the stability of the biceps tendon in the bicipital groove
Flex the patient’s elbow to 90 degrees, grasp their elbow and their wrist. Pull down on their elbow and externally rotate the forearm while they resist
+ when pain is elicited as the biceps tendon pops out of the bicipital groove
Allen’s test
Tests the adequacy of the blood supply to the hand
Have patient make a fist, occlude the radial and ulnar arteries, have them open their hand and release one of the arteries, repeat on other artery
+ if the hand flushes slowly or not at all
Finklestein test
Looks for tenosynovitis in abductor pollicis longus and extensor pollicis brevis @ wrist
Make a fist with thumb inside, then deviate the wrist ulnarly.
+ if pain over tendons of the wrist
Hip-drop test
Like trendelenberg, but to evaluate side bending of the lumbar spine
Straight leg raise test
Looks for sciatic nerve compression
Lift the patient’s leg until pain is felt
Normally the leg can be raise to 70-80 degrees
+ tests are often due to tight hamstrings
Braggard’s Test
Used to determine cause of pain in straight leg test
Bring leg to just before where pain was felt in the straight leg test, then dorsiflex the foot (stretches the sciatic nerve)
+ if pain - sciatic nerve is the cause of the pain
Pelvic side shift test
Determines if the sacrum is midline
Stabilize the patient’s shoulders with one hand and push their pelvis with the other hand
+ on the side with freer translation, means the pelvis is shifted to that side
Ober’s Test
Looks for a tight tensor fascia lata and iliotibial band
Flex the knee to 90 degrees, abduct the hip as far as possible, and slightly extend the hip while stabilizing the pelvis. Then slowly allow the leg to fall to the table
+ if the thigh remains in the abducted position
Patrick’s test
FABERE Test
Used to asses pathology of the sacroiliac and hip joints, esp osteoarthritis of the hip
Flex, abduct, externally rotate, and extend the hip
+ if pain in or around the hip joint
Bounce Home test
Evaluates problems with full knee extension, usually due to meniscal tears or joint effusions
Knee is flexed completely and then allowed to drop into extension
+ if incomplete extension or a rubbery feel to end-point extension
Apley’s Compression test
Looks for a meniscal tear
With patient prone, flex knee to 90 degrees, push straight down, and rotate the tibia
+ if pain
Apley’s Distraction test
Looks for ligamentous injury (usually LCL or MCL)
With patient prone, flex knee to 90 degrees, pull straight up, and rotate the tibia
+ if pain
McMurray’s Test
Looks for tears in the posterior aspect of the menisci
Fully flex the knee palpating the medial joint line, externally rotate the tibia, add a valgus stress, then slowly extend the knee (medial meniscus). Then do it again with internal rotation and a varus stress.(lateral meniscus)
+ if there is a palpable or audible click
Patellar Grind test
Assesses the posterior articular surface of the patella
Patient lies supine with legs extended, push the patella distally and have the patient tighten their quads.
+ if pain
