Special Tests Flashcards
Biceps Tendon Pathology
Ludington’s
Speed’s
Yergason’s
Rotator Cuff
Drop arm
Infraspinatus test
Lateral rotation Lag sign
Lift off sign
Supraspinatus test
Thoracic Outlet Syndrome
adson maneuver
allen test
costoclavicular syndrome test
roos test
wright test
msc tests for shoulder
AC crossover test
Active compression (O’Brien’s Test)
Glenoid labrum tear test
Jerk test
Upper limb tension tests
Epicondylitis tests
cozens
lateral epicondylitis test (Maudsleys)
medial epicondylitis test
mills test
Neurological Dysfunction for elbow tests
elbow flexion
pinch grip
tinels
Ligamentous instability in wrist/hand tests
ulnar collateral ligament instability test
Vascular insufficiency test in wrist/hand
allen test
capillary refill test
Contracture/tightness test
bunnel-littler test
tight retinacular ligament test
Neurological dysfunction in wrist/hand tests
carpal compression test
froment’s sign
phalen’s test
tinel’s sign
msc tests for wrist/hand
finkelsteins test
grind test
murphy sign
Hip contracture test
tripod sign
Pediatric tests for hip
Barlow’s
Orolani’s
msc tests for hip
anterior labral tear
craig’s
patrick’s tes or FABER
quadrant scouring test
trendelenburg test
Ligamentous instability in knee test
lateral pivot shift test
slocum test
meniscal pathology tests
bounce home test
mcmurray
thessaly
swelling tests
brush test
patellar tap test
msc knee tests
clarkes
hughstons plica
ligamentous intstability tests in the ankle
anterior drawer
lateral rotation stress test (Kleiger test)
Talar tilt
msc ankle tests
Homans
thompson
tibial torsion
true leg length discrepancy test
Cervical spine tests
cervical flexion rotation test
foraminal compression test
vertebral artery test
Lumbar/sacral tests
gaenslen’s
Infraspinatus test
infraspinatus strain/tear (Add description)
Lateral rotation lag sign
infraspinatus and/or supraspinatus pathology if cannot hold position. Can be performed with varying levels of elevation. (add description)
Lift off sign (medial rotation lag sign)
subscapularis lesion (add description)
Neer impingement test
therapist elevates arm through flexion (add description)
Supine impingement test
PT rotates and adducts shoulder (add description)
Supraspinatus test
tear of supraspinatus tendon and impingement or suprascapular nerve involvement (add description)
Adson maneuver
radial pulse monitoring with rotation of the head to test shoulder then extension is performed while PT laterally rotates and extends pt’s shoulder. Diminished radial pulse is a positive test.
Allen test for TOS
arm in 90 degrees of abduction, ER, and elbow flexion. Pt rotates head away from test shoulder while therapist monitors radial pulse. positive=diminished radial pulse.
Costoclavicular syndrome test
military posture and an absent radial pulse is positive but with this one is caused most likely by compression of subclavian artery between the first rib and clavicle.
Roos test
arm in 90 degrees of abduction, ER and elbow flexion. open and closes hands for 3 min. Positive=inability to maintain position, weakness of arms, sensory or ischemic loss or pain. TOS
Wright test (hyperabduction test)
PROM in shoulder abduction while monitoring radial pulse. positive=diminished pulse, compression of costoclavicular space
AC crossover test
PROM to 90 degrees shoulder flexion then fully horizontally adducted
positive=pain in AC joint. Pt can also do this AROM
active compression test (O’Brien’s)
shoulder flexed to 90 degrees, horizontally adducted to 10-15 degrees and IR so thumb points downward. Pt resists as therapist applies downward force to arm. Again when ER.
Positive=superior labral tear when pain with IR but decreased pain in ER. Make sure there isn’t pain over the AC joint.
Glenoid labrum tear test
supine, abducts and ER shoulder over pts head and applies anterior force to humerus.
Positive=indicated by clunk or grinding sound
Jerk test
sitting with shoulder elevated to 90 degrees and IR with elbow bend. PT provides axial compression through the elbow while horizontally adducting the shoulder. Sudden clunk or jerk as humeral head subluxes posteriorly is indicative of posterior instability. Second clunk can be heard when it is returned to starting position. Posterior labral lesion with pain in this.
Upper limb tension test 1 biases which nerve
median, anterior interosseus nerve
Upper limb tension test 2 biases which nerve
median, musculocutaneous nerve, axillary nerve
Upper limb tension test 3 biases which nerve
radial
Upper limb tension test 4 biases which nerve
ulnar
Valgus and Varus elbow stress tests place the elbow in what position
sitting with 20-30 degrees of flexion
Lateral epicondylitis test (Maudsley’s test)
arm and hand on surface and resist pressure on third digit.
positive=pain in lateral epidcondylitis area
Medial epicondylitis test
sitting, therapist PROM supinates forearm, extends wrist and elbow. Pain in medial epicondyle region=positive
Mill’s test
sitting, therapist PROM pronates pt’s forearm, flexes wrist, and extends the elbow. Pain in lateral epicondyle region=positive.
Elbow flexion test
fully flexes both elbows while extending wrists for 3-5 minutes. Positive for cubital tunnel syndrome if tingling or paresthesia is noted in ulnar nerve distribution.
Pinch grip if they cannot touch the tips means there is something wrong with which nerve?
anterior interosseus
Ulnar collateral instability test in wrist/hand
applying a valgus force to MCP joint of thumb in extension. Excessive movement could be a tear in ulnar collateral ligaments and/or accessory collateral ligaments. Aka gamekeeper’s or skier’s thumb
Allen test in wrist/hand
open and close hand several times; then maintain closed position; then therapist compresses radial and ulnar arteries; then pt relaxes hand while therapist relaxes grip and if there is delayed or abset flushing of radial or ulnar half of hand there could be occlusion there
Bunnel-littler test
wrist and hand contracture tests. Try to move PIPs into flexion while MCPs are in slight extension.
If PIP does not flex with MCP extension=tight intrinsic muscle or capsular tightness.
If PIP fully flexes with MCP in slight flexion=intrinsic muscle tightness without capsular tightness.
Tight retinacular ligament test
PIP is neutral and therapist tries to move DIP in flexion.
If DIP doesnt flex, the retinacular ligaments or capsule may be tight.
If DIP does flex, the retinacular ligaments may be tight and the capsule may be normal.
Carpal compression test (median nerve compression test)
hold pressure over pts wrist with both hands for 30 seconds. Can also place wrist in 60 degrees of flexion before applying the pressure. Pain or parasthesias in median nerve distribution can indicate a positive sign.
Froment’s sign
taking a piece of paper away from someone in pinch grip.
Positive= distal phalanx of thumb flexes due to adductor pollicis muscle paralysis.
If above happens plus MCP is hyperextended in thumb, it is called Jeanne’s sign.
Could be due to ulnar nerve compromise or paralysis.
Phalens is used for
carpal tunnel
Finkelstein’s test
positive for pain over abductor pollicis longus and extensor pollicis brevis tendons at the wrist and may be indicative of tenosynovitis or DeQuervain’s
Grind test
apply compression and rotation through metacarpal of thumb and pain will be positive test.
Indicative of DJD in CMC
Murphy sign
make a fist and pt’s third MCP will not be level with the rest, can be a sign of dislocated lunate
Piriformis test is performed with hip in
60 degrees flexion
Tripod sign
sitting with knees flexed to 90 over the edge of the table, therapist PROM extension to one knee. Positive is tightness in hammies or extension of trunk
90-90 hamstring SLR test
positive indicated by knee remaining in 20 degrees or more of flexion
Barlow’s test
dislocation of hips posteriorly by adduction and pushing a posterior force
Orolani’s test
relocation of hips by abducting and apply force over greater trochanters around 30 degrees.
Anterior labral tear test in hip
full flexion, ER, abd then therapist moves leg into extension, IR, and add. If there is pain or click then it could be a tear but could also be iliopsoas tendonitis or anterior-superior impingement
Normal anteversion in craig’s test is
8-15 degrees
Quadrant scouring test grinding, catching or crepitation could be from
arthritis, avascular necrosis, or osteochondral defect
lateral pivot shift test for knee
palpable shift and clunk around 20-40 degrees of flexion and indicative of anterolateral rotatory instability
Slocum test
checking anterolateral instability due to lateral movement of tibia
Can test directly for anterolateral instability by rotating the foot 15 degrees laterally
Bounce home test
maximally flexes pts knee and then it is extended passively. If there is incomplete extension or rubbery end-feel this could be a meniscal lesion.
patellar tap test
if tapped and the patella appears to be floating due to effusion it is positive
Clarke’s sign
pushing the patella inferiorly then asking the pt to contract the quad. If cannot contract the quad there might be some patellofemoral dysfunction.
Hughston’s plica test
flexing knee and IR tibia while trying to move the patella medially. Positive=popping during passive flexion/extension
Noble compression test
pressure over lateral epicondyle and maintain while pt extends knee slowly. Pain over that area at ~30 degrees of flexion may indicate IT band friction syndrome
Lateral rotation stress test (Kleiger test)
knees hanging off the table, therapist stabilizes lower leg and then holds food in neutral with other. therapist applies lateral rotation force to foot. pain over anterior or posterior tibiofibular ligaments and the interosseous membrane then positive for high ankle sprain. Test will be positive for deltoid ligament tear if there is pain medially and can feel the talus shift away from medial malleolus.
Talar tilt test
sidelying, tilts talus in inversion and eversion.
Positive=excessive inversion and may show calcaneofibular ligament sprain.
Normal tibial torsion
12-18 degrees
Cervical flexion rotation test
fully flexes head and then rotates in each direction passively. Pt should be able to get 45 degrees of motion each way. If there is limited motion, there is an issue with atlantoaxial joint. Could also show cervicogenic headaches
Distraction test
place hand under pts chin and other under occiput and applies upward distraction force
Foraminal compression test
sitting with head laterally flexed, therapist places both hands on top of the head and exerts downward force .(spurlings)
Vertebral artery test
supine, pts head is placed in extension, lateral flexion and rotation to ipsilateral side. Positive test=dizziness, nystagmus, slurred speech or loss of consciousness
Gaenslen’s test
supine with hip in full extension off the table. Opposite hip is held in flexion by therapist. simultaneous force on each leg in opposite directions. If there is pain this is a sign of SI joint dysfunction, pubic symphysis instability or hip pathology or L4 nerve root lesion
When SI compression test is positive it is testing for which ligaments?
posterior SI ligament sprain
When SI distraction is positive it is testing for which ligaments?
anterior SI ligament sprain
