special tests Flashcards
1
Q
O’Brien’s Test
A
- Standing shoulders to 90 degrees of flexion and 10 degrees of horizontal adduction and max IR/pronation (actively)
- PT applies force inferiorly at wrists, patient to resist, perform again with patient in max Er and supine (palms flat)
- Positive = pain is decreased in 2nd position (than it was in first) (more pain in the first position than the second position = positive)
- Indicates a SLAP lesion (by itself)
o However, it’s also part of the test cluster for AC joint pathology
2
Q
AC Resisted Extension Test
A
- Pt seated
- Passively flex shoulder to 90 degrees, elbow to 90 degrees, then 90 degrees of IR, then patient performs resisted horizontal abduction
- Positive = Pain near the AC joint
- Part of test cluster for AC joint pathology
3
Q
Cross Body Adduction Test
A
- Seated
- Passively flex shoulder to 90 degrees then into max horizontal Adduction
- Positive = Pain near the AC joint
- Part of the test cluster for AC joint pathology
4
Q
Gilcrest Palm up Test
A
- Pt sitting or standing hold 5 lbs weight in hand
- Palpate the bicipital groove as pt raises arm in ER and Supination (abduction on the way up)
- Positive = pain / tenderness to palpation – May hear a snap
- Indicates a LBH tendinopathy
5
Q
Speed Test
A
- Pt Standing w/ arm at 90 degrees of shoulder flexion in full supination
- Resist shoulder flexion at wrist
- Positive = pain in anterior shoulder
- LHB tendinopathy
6
Q
Yergasons Test
A
- Sitting or Standing, elbow at 90 degrees, full pronation, arm at side
- PT = palpate bicipital groove
- Pt performs resisted supination against PT resistance
- Positive = LHBT popping out of grove = Tear of the transverse humeral ligament
- Positive = Tenderness / pain = Bicipital tendinosis / SLAP lesion
7
Q
Posterior Impingement sign
A
- Pt is supine
- Passively move shoulder into 90-100 degrees of abduction, 10 degrees of extension and max ER, elbow at 90 degrees of flexion
- Positive = deep posterior shoulder pain
- Indicates Articular-Sided Internal impingement syndrome
8
Q
Crank Test
A
- Pt seated or supine
- Passively bring shoulder to 160 degrees of scaption, axially load GH joint and ER/IR
- Positive = clicking (with or without pain) or apprension of test
- Part of test cluster for anterior Bankart lesion / labral tear (not strong on its own)
o Bankart lesion goes through the humerus (or is the humerus) and this part of the glenoid cavity (if its boney)
9
Q
Biceps Load 2
A
- Pt is supine
- Flex elbow to 90 degrees, abduct shoulder to 120 degrees, resist elbow flexion
- Positive = pain
- Indicates a SLAP lesion
10
Q
Biceps Load 1
A
- Pt is in supine
- Hold arm at elbow/wrist, at 90 degrees of elbow flexion and shoulder abduction, passively ER to max, then have patient perform resisted elbow flexion
- NOTE: Make sure to not let elbow move out of that abduction the entire time
- Positive = Pain
- Indicates a SLAP lesion
11
Q
Jerk Test
A
- Pt is sitting
- Passively move shoulder into 90 degrees of abduction and slight IR (w/ elbow flexed)
- Positive = clunk or instability of the humeral head
- Positive = Posterior / inferior labral tear
12
Q
Kim Test
A
- pt seated w/ back support
- PT starts by holding the elbow of pt at 90 degrees of flexion and shoulder at 90 degrees of abduction
- Apply axially load with body and use other hand to inferiorly translate proximal humerus while you bring shoulder in/up on a diagonal (think dabbing)
- Positive = Pain, clinic in posterior shoulder
- Indicates a Posterior/inferior labral lesion
13
Q
Anterior Load and Shift Test
A
- Seated
- Behind pt, grasp head of humerus between fingers and thumb
- Shift the head of the humerus anteriorly and posteriorly (stabilizing w/ posterior hand)
- Positive = Clunking / subluxation dislocation replication of symptoms
- Part of test item cluster of anterior Bankart lesion/labral tear
14
Q
Sulcus Sign
A
- Seated
- Grab pts arm just proximal to the elbow and pull inferiorly gradually (over hand is on distal clavicle and wraps over to posterior side to support the scapula – this hand acts only as support and does not move)
- Positive = subluxation, excessive humeral translation inferiorly (getting 3 fingers in space = positive) – looking for little dip under the acromion (sub acromial space)
- Part of test cluster for anterior Bankart lesion/labral tear
15
Q
Jobe Relocation Test
A
- Pt in supine
- Passively abduct to 90 degrees and ER maximally with elbow at 90 degrees of flexion, opposite hand then provides posterior pressure when apprehension starts
- Positive = decreased apprehension when pressure is added
- Part of test item cluster for anterior Bankart lesion / labral tear
16
Q
Anterior release Test
A
- PT in supine
- Passively abduct to 90 degrees and ER maximally w/ elbow at 90 degrees of flexion – PT other hand provides pressure the entire time until max ER is reached then is released.
- Positive = apprehension when hand is removed
- Indicates anterior inferior instability
17
Q
Apprehension test
A
- Pt in supine
- Passively abduct to 90 degrees and ER maximally with elbow at 90 degrees of flexion
- Positive = Apprehension to test
18
Q
Empty can test
A
- Pt seated
- Pt passively put into 90 degrees of scaption w/ thumb up
- Provide moderate resistance proximal to the wrist
o Positive = pain / weakness = supraspinatus pathology - Same thing except thumbs down
o Positive = increased pain/weakness compared to first position = supraspinatus impingement
19
Q
Neer test
A
- Pt seated
- Passively pronate and internally rotate shoulder (pronating basically makes it internally rotate on its own)
- Then passively flex shoulder to end range
- Positive if pain replication / exaggeration of symptoms
- Indicates subacromial impingement (the internal rotation really pinchers down here and the flexion further exaggerates this)
20
Q
Internal rotation lag sign
A
- Pt seated or standing hand behind back, elbow flexed to 90 degrees (touch lower back)
- Passively extend shoulder to 20 degrees (holding elbow and hand)
- Then release pts hand (but not elbow)
- Positive = hand is unable to stay off back when released
- Indicates and Subscapularis tear
o NOTE: if pt does not have enough ROM (extension) test cannot be performed
21
Q
External rotation lag sign
A
- Pt seated w/ elbow flexed to 90 degrees (actively)
- Passively bring them to 20 degrees of scaption then maximally externally rotate them – then pt must hold that position
- Positive = pt unable to hold the position
- Indicates supraspinatus / infraspinatus tear
o Supraspinatus helps w/ the scaption
o Infraspinatus does the external rotation
22
Q
Hornblowers sign
A
- Pt seated
- Passively bring into 90 degrees of scaption and 90 degrees of elbow flexion
- Pt does external rotation against pt resistance
- Positive = unable to hold against resistance or not able to hold max external rotation (I think tested at the same time)
- Indicates a teres minor tear
23
Q
Dropping sign
A
- Pt seated w/ arms at side
- Passively abduct shoulder to 90 degrees – then bend elbow to 90 degrees – then maximally externally rotate them (then release them?)
- Positive = unable to hold position / falling
- Indicates an infraspinatus tear
24
Q
Drop arm
A
- Pt seated
- PT passively raises pt arm to 90 degrees of abduction
- Positive = pt unable to hold position
- Part of RTC tear cluster
25
Q
Painful Arc
A
- Seated / standing
- Patient actively abducts shoulder
- Positive = pain during abduction / at the end of motion
- 45 – 120 degrees = positive for impingement / tear
- 170-180 degrees = positive AC joint injury
26
Q
Hawkins-Kennedy
A
- Seated / Standing
- Passively bring pt into 90 degrees of shoulder flexion, bend elbow to 90 degrees and maximally IR the shoulder
- Positive = pain / symptoms getting worse
- Part of test cluster for RTC impingement
27
Q
Infraspinatus MMT
A
- Seated w/ arm at side and 90 degrees of elbow flexion
- Pt performs isometric ER against PT resistance
- Positive = Pain / weakness
- Part of cluster for rotator cuff impingement / tendinopathy (tear)
28
Q
olecranon manubrium precussion test
A
- Pt sitting w/ ARMS CROSSED
- Hold stethoscope over manubrium of sternum while tapping on the olecranon
- NOTE: Don’t do this over shirt
29
Q
boney apprehension test
A
- Abduct shoulder 45 degrees
- Max external rotation
- Positive = apprehension, pain, instability
- Purpose = to rule out shoulder instability
30
Q
Test Cluster of Rotator Cuff impingement:
A
- Hawkins-Kennedy
- Painful Arc
- Infraspinatus MMT
31
Q
Test Cluster for RTC Tear:
A
- Drop Arm Test
- Painful Arc
- Infraspinatus MMT
32
Q
Test Cluster for Anterior Bankart/Anterior Labral Tear
A
- Crank Test
- Apprehension Test
- Jobe Relocation Test
- Anterior Load and Shift Test
- Sulcus Sign
33
Q
Test Cluster for AC joint Pathology
A
- Cross Body Adduction
- AC Resisted Extension
- O’Brien Test
