Special Tests Flashcards
Yergason’s Test
Where?
What for?
Main purpose?
Where: shoulder
What for: muscle/tendon pathology.
Main purpose: check that the transverse humeral ligament is in tact (this ligament holds the biceps tendon down in the bicipital groove).
Technique: have Pt flex forearm to 90* + fully pronated. + stabilized against the body. Pt will then perform supination against resistance; at the same time Prac will palpate the biceps tendon in the bicipital groove.
Positive sign: “popping out” of the biceps tendon in the bicipital groove= transverse humeral lig tear. OR pain/tenderness w/o “popping” indicates biceps tendinosis or SLAP lesion.
Mill’s Test
Where: Elbow
What for: testing for elbow pathology (epicondylalgia) caused by tension in the ext carpi radialis brevis mm.
Main purpose: diagnosing tennis elbow (lateral epicondylitis). Provocative test.
Technique: Pt flexes arm to 90* + forearm pronated. Prac will palpate lateral epicondyle at the same time as passively flexing wrist and then slowly ext elbow.
Positive sign: reproduction of Pt’s lateral elbow pain
Cozen’s Test
Where: Elbow
What for: test for elbow patho (epicondylalgia)
Main purpose: Dx lateral epicondylitis (ext carpi radialis mm)
Technique: Pt’s arm rested on table + forearm pronated + hand in a fist. Prac will palpate lat epicondylitis while the Pt performs wrist ext and radial deviation against resistance.
Positive sign: reproduction of Pt’s lateral elbow pain.
VAT (vertebral artery test)
Where? What for? Main purpose? Technique \+ SIgn
Where: C-spine
What for: testing for any arteriole, basilar or vertebral stenosis or compression present.
Main purpose: evaluate the adequacy of blood supply to the brain by compressing the vertebral artery + examining the onset of S+S of VAT.
Technique: Pt lying supine with head supported by prac off the table. Passively ext pt’s head then slightly flex to the side then rotate. Hold for 30 sec. Watch for any nystagmus or abnormal head mvmnts.
Positive Sign: If pt reports any dizziness, lightheadedness, difficulty swallowing or speaking, vision changes or any numbness anywhere.
Compression Test
Axial
Where: C-spine
What for: orthopedic special test for cervical spine
Main purpose: examining for nerve root impingement. Provocative test.
Technique: Pt’s head in neutral position with prac applying downward pressure on top of head.
Positive sign: if pt feels a radiating pain down their arm, indicating compression on a nerve root. Pain distribution may indicate which nerve root is being impinged (dermatome).
Compression test
Spurling’s
Where: C-spine
What for: used if pt complains of nerve root pain like symptoms that have diminished or are absent at the time of examination.
Main purpose: provocative test for nerve root impingement
Technique: 3 stages–> Pt seated,
first stage is with Pt’s head in a neutral
position.
Second stage is with Pt’s head extended
Third stage is Pt’s head in ext + rotation
Positive sign: reproduction of pain down pt’s arm on the same side causing the vertebral compression. (vertebral radiculitis).
Yeoman’s test
Where: SIJ
What for: 2 part test for sacroiliitis (inflammation of 1 or both SIJ) causing pain.
Main purpose: tests for SIJ dysfunction
Technique: Pt prone, first part is passive hip ext with Pt’s knee fully ext. Second part is passive hip ext with Pt’s knee flexed to 90*
Positive sign: pain reproduced in SIJ or buttock pain.
Nachlas Test
Where: L-spine
What for: neurological dysfunction
Main purpose: to examine if there is L-spine nerve root lesion (typically in L2 L3)
Technique: Pt is prone–> Prac will passively flex knee (heel to buttock). If Pt is unable to flex knee past 90*, prac will flex knee as far is will go then passively ext the hip.
Positive sign: Pain in the anterior thigh= tight rec fem.
Pain in the LB region= L2/L3 nerve root
lesion
If ipisilateral ASIS rotates forward prior to
knee reaching 90* flexion + pain in SIJ=
hypermobile joint.
Jackson Compression Test
modification of Spurling’s compression test
What for: if Pt reports of nerve root symptoms like radicular pain into the arm.
Technique: Pt rotates head to one side and then the prac will compress down ontop of the head. BILAT.
Positive sign: reproduction of pain.
Gillet’s Test
aka Stork Test
Where: SIJ
What for: SIJ pathology
Main purpose: to exmine the movement of the SIJ to determine if the joint is hypomoble
Technique: Pt is asked to flex one hip to 90* while the prac palpates the PSIS with one thumb and the SP of the SIJ with the other.
Positive sign: IF the PSIS goes down= normal mvmnt. IF the PSIS goes up= hypomobility in the flexed side.
Speed’s Test
aka straight arm test
Where: shoulder
What for: tests for a pathology of the biceps tendon
Main purpose: to examine if there is labral tears or bicipital tendonitis.
Technique: Pt sitting or standing, their shoulder will be flexed to 90* + fully ext rot, elbow fully ext, and forearm supinated. Prac will apply a downward force that the Pt will resist.
Positive sign: reproduction of pain the bicipital groove.
Painful Arc
Where: shoulder
What for: to test for subacromial impingement syndrome.
Technique: Pt will ABD arm in the scapular plane
Positive sign: During ABD, Pt will feel pain ONLY b/w 60-120 of GH ABD. NO PAIN BEFORE 60, NO PAAIN AFTER 120.
ULTT
How many are there?: 4
Median 1 and Median 2
Ulnar
Radial
Main purpose: to stretch the upper limbs’ neurological structures.
ULTT Median 1
Structures tested: Median nerve, anterior interosseous nerves and nerve roots C5-C7.
Technique: Pt supine, depress their shoulder + ABD 110* + Lat rotate 90. Flex elbow to 90. From this position, extend elbow while also ext wrist and fingers.
ULTT Medain 2
Structures tested: Median nerve, musculocutaneous nerve, and axillary nerve.
Technique: SAME mvmnt as ULTT Medain1 except only ABD shoulder to 10* ABD.
ULTT Radial
Structures tested: Radial nerve
Technique: Depress Pt shoulder, ABD shoulder to 10, flex elbow to 90, flex wrist and fingers, hand pronated, then passively ext elbow until symptoms are provoked.
ULTT Ulnar
Structures tested: Ulnar nerve
Technique: Pt shoulder depressed, ABD shoulder 10* and passively bring pronated/flexed wrist to ear (waiter’s pose).
