Savarese chapter 18 (Special Tests)

Question 1

Spurling Test

Answer 1

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

Question 2

Wallenberg test

Answer 2

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

Question 3

Underberg Test

Answer 3

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

Question 4

Adson’s Test

Answer 4

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

Question 5

Wright’s Test

hyperextension test

Answer 5

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

Question 6

Costoclavicular syndrome test

Military posture test

Answer 6

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

Question 7

Apley’s scratch test

Answer 7

Used to evaluate ROM of the shoulder

Look for asymmetry

Question 8

Drop arm test

Answer 8

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

Question 9

Speed’s test

Answer 9

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

Question 10

Yergason’s test

Answer 10

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

Question 11

Allen’s test

Answer 11

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

Question 12

Finklestein test

Answer 12

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

Question 13

Hip-drop test

Answer 13

Like trendelenberg, but to evaluate side bending of the lumbar spine

Question 14

Straight leg raise test

Answer 14

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

Question 15

Braggard’s Test

Answer 15

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

Question 16

Pelvic side shift test

Answer 16

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

Question 17

Ober’s Test

Answer 17

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

Question 18

Patrick’s test

FABERE Test

Answer 18

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

Question 19

Bounce Home test

Answer 19

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

Question 20

Apley’s Compression test

Answer 20

Looks for a meniscal tear
With patient prone, flex knee to 90 degrees, push straight down, and rotate the tibia
+ if pain

Question 21

Apley’s Distraction test

Answer 21

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

Question 22

McMurray’s Test

Answer 22

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

Question 23

Patellar Grind test

Answer 23

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