Special Skills Quiz Flashcards
What does Hawkings Impingement test for?
Supraspinatus impingement/ rotator cuff tendinitis
What is a positive sign for Hawking’s impingement?
Pain during the maneuver
How is the Hawking’s impingement test done?
Flex pts shoulder and elbow to 90 degrees with palm facing down, rotate arm internal with one hand on arm and one on forearm
What is Phalen’s sign testing for?
Carpal Tunnel Syndrome (CTS)
What is a positive Phalen’s sign?
Numbness and tingling in the thumb, index finger, third finger, and lateral side of the 4th finger while holding the maneuver for 60 seconds
How is Phalen’s sign done?
Ask pt to hold wrists in flexion for 60 seconds with elbows fully extended
Alternatively ask patient to press backs of both hands together to form right angles
Which nerve is effected in carpal tunnel syndrome?
Median nerve
What is carpal tunnel syndrome?
Compression of the median nerve
What does Finkelstein’s Test show?
De Quervain tenosynovitis
De Quervain tenosynovitis is inflammation from which two tendon and tendon sheaths?
Abductor pollicis longus
Extensor pollicis brevis
What is the function of extensor pollicis brevis?
Radial abduction of the wrist and thumb extension
What is the function of the abductor pollicis longus?
Wrist radial abduction and thumb abduction
What is De Quervains tenosynovitis?
Irritation or inflammation of the wrist tendons at the base of the thumb, making thumb and wrist movement painful
Which side should be tested first for Finkelstein’s test?
Unaffected side done first!
How is Finkelstein’s test done?
Ask patients to grasp thumb against the palm and move the wrist toward the midline in ulnar deviation
What does the Thompson test examine?
The integrity of the Achilles’ tendon by squeezing the calf
What will a positive sign show for the Thompson test?
Minimal planter flexion of the foot, the Achilles will be ruptured
How is the Thompson test done?
Have pt lay prone with the feet hanging off, squeeze the calf, determine if there is any planter flexion of the foot
What does the Lachman test examine?
The integrity of the anterior crucial effort ligament (ACL) of the knee
What is a positive sign for Lachman’s test?
If the tibia pulls forward
What should be stated when finishing the Lachman’s test if the ACL appears normal?
Firm endpoint if no laxity in your patients knee
How is the Lachman’s test done?
Flex patients knee 15-30 degrees, grasp distal femur on lateral side and the proximal tibia on the medial side
Simultaneously pull the tibia forward and the femur back
A torn ACL will suggest what during the Lachman’s test?
An anterior tibial translation of more than 2-3mm compared to non-affected side
McMurray’s test is to examine what?
The presence of a meniscus tear within the knee
What is valgus stress on the knee?
External rotation at the ankle joint
What is Vargus stress on the knee?
Internal rotation at the ankle joint
The examiner applies a valgus stress to examine which meniscus?
Medial meniscus
The examiner applies a varus stress to examine which meniscus?
Lateral meniscus
What will a positive McMurray’s test be?
If the patient experiences pan or an audible click
What does Adson’s test examine?
For thoracic outlet syndrome
What is thoracic outlet syndrome?
Compression of the subclavian artery by a rib or tightened anterior and middle scalene muscles
How is Adson’s test done?
Take patients radial pulse at wrist, abduct extend and externally rotate the arm, instruct pt to take a deep breath and turn his head toward arm being tested
What is a positive sign for Adson’s test?
If there is a marked diminution or absence of radial pulse during the maneuver
What is Gaenslen’s test examining?
For SI joint pathology
How is Gaenslen’s test done?
Have patient lie supine, ask to draw both legs onto chest
Shift them to side of table so one buttock extends over the edge of table, allow unsupported leg to drop over the edge
What is Yergason’s test for?
Biceps tendon pathology, the stability of the long head of the biceps tendon in the bicipital groove; bicipital tendinitis
How if Yergason’s test done?
Instruct pt to flex elbow, grasp flexed elbow in one hand while holding the wrist with other hand, externally rotate the patients arm and as the patient resists, at the same time pull downward on elbow
What is a positive Yergason’s sign?
If the bicipital tendon pops out of the groove, pt will experience pain
What are the two elements to test for meningismus?
Brudzinski’s sign and Kernig’s sign
What is a positive Kernig’s sign?
Pain and increased resistance to knee extensions
What is a positive Brudzinski’s sign?
While lifting the head, if the hips and knees involuntarily lift up
How is Kernig’s sign done?
Flex patients leg at both hip and knee, slowly extend the leg and straighten the knee
What is a positive sign for splenic percussion sign?
Change in percussion note from tympani to dullness on inspiration is positive
How is the splenic percussion sign done?
Percuss lowest interspace in left anterior axillary line (Traube’s space), ask patient to take a deep breath and percussion again
What is the normal result of splenic percussion sign (no splenomegaly)?
Percussion not usually remains tympanic
When should you assess for ankle clonus?
When reflexes seem hyperactive
Sustained clonus points to what?
CNS disease
Clonus must be present for a reflex to be graded a what?
4
If ankle clonus test is positive, where is the lesion located?
Upper motor neuron lesion
How do you assess for ankle clonus?
Support knee, with other hand, dorsiflex and plantarflex the foot a few times while encouraging patient to relax, then sharply dorsiflex and maintain it
What is the normal result of ankle clonus assessment?
After sharp dorsiflexion, the ankle does not react to the stimulus
What does pronator drift assess for?
Stroke
What is a positive pronator drift sign?
If the arms are unequal its a stroke until proven otherwise
How is pronator drift assessed?
Pt should stand for 20-30 seconds with eyes closed and both arms held straight forward with palms up, tap the arms briskly downward and they should return to horizontal position
What does the straight leg raise test examine?
Designed to reproduce back and leg pain so its cause can be identified as sciatica or hamstring tightness
How is straight leg raise test done?
Keep leg straight, raise it up until patient feels pain, lower leg slightly, then dorsiflex the foot to stretch the sciatic nerve and re-produce sciatic pain
How do you do the well leg straight leg raise test?
Have patient lie supine, raise uninvolved leg
If the patient complains of back and sciatic pain on the opposite side, what does that point to when doing the well leg straight leg raise test?
Herniated disk in the lumbar area
Which murmur is best heard at the apex with radiation to the left axillary area?
Mitral regurgitation
Which murmur is harsh and holosystolic?
Mitral regurgitation
Which murmur is best heard when patient is in left lateral decubitus position?
Mitral Stenosis
Which murmur is usually limited to apex with little or no radiation?
Mitral stenosis
Which murmur has a decrescendo low-pitched rumble?
Mitral stenosis
Which murmur is best heard with the bell of the stethoscope?
Mitral stenosis
