Special tests

Question 1

Apprehension test

Answer 1

Technique: patient in supine with the shoulder in 90 degrees of abduction. Slowly take the patient into external rotation.
What is it used to diagnose?: anterior instability

Question 2

Relocation

Answer 2

Technique: With a positive apprehension test a posterior translation is applied to the humeral head. Positive test if the patient loses symptoms with posterior translation.
What is it used to diagnose?: Anterior instability.

Question 3

Jerk Test (posterior)

Answer 3

patient is seated and then has the shoulder flexed to 90 degrees and internally rotated. Axially load the humerus and horizontally adduct the arm. The test is positive if there is a sudden jerk or clunk as humeral head subluxes off the back of the glenoid.

diagnoses posterior instability

Question 4

Sulcus sign

Answer 4

Technique:
patient in standing - patients arm by the side - patients arm is pulled distally. The test is positive if the sulcus is inferior to the acromion combined with reproduction of symptoms.
What is it used to diagnose?:
inferior instability.

Question 5

hawkins kennedy test

Answer 5

Technique:
patient in sitting or standing - shoulder is passively flexed to 90 degrees and then internally rotated maximally - positive test if pain is reproduced
What is it used to diagnose?: subacromial impingement

Question 6

neer test

Answer 6

Technique:
patient in sitting arm is internally rotated and passively flexed fully - positive if reproduces pain
What is it used to diagnose?: subacromial impingement

Question 7

painful arc

Answer 7

Technique: arm pain between 60 and 120 degrees of abduction
What is it used to diagnose?: subacromial impingement and also in the cluster for rotator cuff

Question 8

empty can test

Answer 8

Technique: patient seated with 90 degrees of shoulder abduction - patient placed in the empty can position and inter
positive if it reporoduces pain in the supraspinatus tendon and weakness.
What is it used to diagnose?:

Question 9

drop arm

Answer 9

Technique: patient in sitting with their shoulder passively abducted to 120 degrees and the patient is instructed to slowly lower the arm down to their side. if the patient cannot lower their arm, the test is positive. Make sure to guard the arm so that they do not get hurt.
What is it used to diagnose?:

rotator cuff pathology.

Question 10

external rotation lag sign

Answer 10

Technique: passively abduct the shoulder to 90 degrees and externally rotate the shoulder to end range. Instruct the patient is maintain the position of the shoulder. If the patient cannot maintain the position, positive test.
What is it used to diagnose?:
rotator cuff pathology.

Question 11

infraspinatus muscle test

Answer 11

Technique: patient is in sitting or standing - resisting external rotation with the arm neurtrally rotated and adducted to the trunk. positive test if the patient cannot hold resistance
What is it used to diagnose?: rotator cuff (infrapsinatus)

Question 12

Hornblower sign

Answer 12

Technique: patient is in standing: passivelt elevate the arm to 90 degrees in scapular plan and flex the elbow to 90 degrees. patient externally rotates the arm against resistance. Positive test if the patient cannot externally rotate the arm.
What is it used to diagnose?: rotator cuff pathology (infraspinatus)

Question 13

internal rotation lag sign

Answer 13

Technique: seated - hand behind the back in the lumbar region in full internal rotation. Positive if the patient is unable to maintain the position.
What is it used to diagnose?: rotator cuff injury - subscapularis

Question 14

Horizontal adduction test

Answer 14

Technique: patient is in standing. Arm is flexed to 90 degrees. arm is actively and passively adducted across the body. positive if the test reproduces pain in the AC joint
What is it used to diagnose?: AC joint pathology.

Question 14

paxinos

Answer 14

Technique: patient is in sitting with the arm at the side. pressure applied to the ac joint with the fingers.

What is it used to diagnose?: ac joint pathology

Question 15

Active compression (obriens)

Answer 15

Technique: patient is in standing and arm is flexed to 90 degrees and elbow is fully extended. arm is horizontally adducted to 15 degrees, fully internally rotated and downward force given to the arm. Arm is then returned to the starting position and fully externally rotated and done once again. Test is positive if the internal rotation hurt and the external rotation did not.

What is it used to diagnose?: SLAP lesion labrum

Question 16

Biceps load II

Answer 16

Technique: patient is in supine and the arm is abducted to 120 degrees, elbow flexed to 90 degrees and forearm supinated. shoulder is fully externally rotated. if apprehension appears then ask the patient to resist against flexion. test is positive if apprehension remains the same or the shoulder becomes more painful.
What is it used to diagnose?: SLAP labrum

Question 17

anterior slide test

Answer 17

Technique: arm with hand on the hip. anterior and superior force applied to the elbow. Positive test if pain or click is reproduced.
What is it used to diagnose?: SLAP

Question 18

compression rotation test

Answer 18

Technique: Patient is in supine, shoulder passively abducted 20-90 degrees - axial compression is applied while passively circumducting the GH joint. Positive test if there is pain popping or clicking.
What is it used to diagnose?: SLAP

Question 19

Yergason (supination test )

Answer 19

Technique: arm in neutral against the side with the forearm pronated. Patient supinates against resistance.

What is it used to diagnose?: Used for transverse ligament integrity, bicipital tendenosis, and SLAP lessions.

Question 20

Speeds test

Answer 20

Technique: arm in full extension and forearm supinated - resist shoulder flexion. may also place the shoulder in 90 degrees of flexion and push the upper limb into extension causing an eccentric contraction of the biceps. positive test if there is pain in the anterior shoulder.

What is it used to diagnose?: bicipital tendinopathy, SLAP, and transverse ligament integrity.

Question 21

UPPER LIMB TENSION TESTS FOR NEUROLOGICAL TESTING

Answer 21

ULTT A - median
ULTT B - ulnar
ULTT C - radial

identifies peripheral nerve dysfunction by stressed the neurological tissue.

positive tests are reproduction of symptoms.

Question 22

Adsons

Answer 22

Technique: in sitting, find the radial pulse. rotate the head toward the involved upper extremity and then extend and exxternally rotate the shoulder while extending the head.

positive test is reproduction of neuro and vascular symptoms AND loss of radial pulse
What is it used to diagnose?: Thoracic outlet syndrome.

Question 23

ROOS - elevated arm test.

Answer 23

Technique: patient in standing with the shoulders fully externally rotated and abducted to 90 degrees. for 3 minutes the patient opens and closes their hands.

positive if the same symptoms as the adsons test are reproduced.

What is it used to diagnose?: thoracic outlet test

Question 24

Elbow extension test

Answer 24

Technique: positive if the patient is unable to fully extend the elbow.
What is it used to diagnose?: fracture or joint injurt

Question 25

Valgus/varus test

Answer 25

Technique: patient in sitting or supine with the elbow places in 0 to 20 degrees of elbow flexion. Varus and valgus stress imposed on the joint in order to determine which ligament is lax.
What is it used to diagnose?: ligamentous instability

Question 26

moving valgus stretch

Answer 26

Technique: patient is standing or supine - arm abducted and elbow fully flexed - maintain the valgus stress and quickly extend the patients elbow.

Reproduction of pain from 70 to 120 degrees of elbow flexion indicates an ulnar collateral ligament tear.
What is it used to diagnose?: UCL tear

Question 27

elbow flexion test

Answer 27

Technique: patient in supine - performed bilaterally with the shoulder in full ER and the elbow actively held in maximal flexion with wrist extension for one minute.

positive if pain is present at the medial aspect of the elbow and the numbness and tingling in the ulnar distribution of the involved side.

What is it used to diagnose?:Neurological dysfunction/cubital tunnel syndrome.

Question 28

pinch grip test

Answer 28

Technique: patient asked to pinch the index finger and the thumb together.

positive if the patient is unable to complete this activity.

What is it used to diagnose?: entrapment of the anterior interosseous nerve

Question 29

ulnomeniscotriquetral dorsal glide test

Answer 29

Technique: patient is seated with the arm pronated - posteriorly directed force applied with examinaers thumb over the ulna and index finger over the pisotriquetral complex anteriorly.

excessive pain or instability indicated triangular fibrocartilage complex pathology.
What is it used to diagnose?:triangular fibrocartilage complex pathology -

Question 30

watson test - Scaphoid shift test

Answer 30

technique: patient is seated - elbow resting on the table - forearm pronated - wristed placed in full ulnar deviation with slight extension while stabilizing the metacarpals. —pressure is placed on the distal pole of the scaphoid while radially deviating and slightly flexing the patients hand.

a painful shift of the scaphoid indicates carpal instability.
What is it used to diagnose?: scaphoid and carpal instability.

Question 31

eichoffs test + finkelstein test

Answer 31

technique: patient makes a fist with tumb flexed within confines of fingers
What is it used to diagnose?: identify the weird name tendon condition for the thumb synovitis. - basically tendonitis of the abductor pollicis longus and extensor pollicis brevis.

Question 32

wrist hyperabduction and abduction of the thumb test WHAT

Answer 32

technique:
What is it used to diagnose?: same as finkelstein and eichmoff

Question 33

phalen test

Answer 33

technique: identifies carpal tunnel compression. Patient maxes wrists together and holds them for one minute. positive test if it reproduces their symptoms in the median nerve distribution.

what is it used to diagnose?: Carpal tunnel syndrome.

Question 34

two point discrimination test

Answer 34

technique: identifies the level of sensory innervation within hand that correlated with functional ability to perform certain tasks involving grasp.

using a caliper, apply to the palmar surface of the fingers to assess the patients ability to distinguish between two points of testing device - record the smallest difference

NORMAL is less than 6mm can be distinguished.

What is it used to diagnose? : loss of sensation

Question 35

tinel sign

Answer 35

can be used at any nerve entrapment site in order to reproduce tingling and or paresthesias into the hand.

Question 36

modified allen test

Answer 36

technique: identify radial and ulnar arteries at the wrist and then have the patient open and close the fingers quickly several times and then make a closed fist.

compress the ulnar artery and have the patient open the hand. observe the palm of the hand and then release the artery and observe for vascular filling

what is it used to diagnose?: vascular compromise of the radial or ulnar artery.

Question 37

bunnel littler test

Answer 37

technique:MCP is stabilized in slight extension whil the PIP is flexed. - then the MCP is flexed and the PIP is flexed.

differentiates between tight intrisic muscles and tight tight capsule

(if flexion is limited in both then the capsule is tight)
(if more PIP flexion with MCP flexion then the intrinsic muscles are tight)
What is it used to diagnose: tightness of the PIP joints

Question 38

tight retinacular test

Answer 38

technique: PIP is stabilized in neutral while DIP is flexed —-then the PIP is flexed and the DIP is flexed —differentiates between a tight fapsule and a tight reticular ligament. IF flexion is limited in both cases, then the capsule is tight. If more DIP fleixion with PIP flexion then retinacular ligaments are tight.

What is it used to diagnose: tightness around the PIP joints