special tests Flashcards
1
Q
what are the special tests for GH joint anterior instability
A
1) apprehension test
2) relocation test/surprise test
2
Q
what does the apprehension test of the GH test for
A
torn inferior GH ligament, anterior capsule, and possible glenoid labrum
3
Q
what is the pt and PT position for GH apprehesion test
A
pt: supine with shoulder at 90 degrees of abd
PT: move the shoulder into full ER
4
Q
what is a positive apprehension test for the GH
A
pt looks or feels apprehensive toward ER movement
5
Q
what is the pt and PT position of the relocation test
A
pt: is supine with 90 degrees abd and full ER
PT: apply a posterior translation to the humeral head where the patient felt apprehension in the apprehension test.
6
Q
what is a positive GH relocation test
A
decreased apprehension or pain
7
Q
what are the special tests for GH joint posterior and inferior instability
A
1) jerk test
2) sulcus sign
8
Q
what does the jerk test identify
A
posterior inferior labral leison
9
Q
what is the PT and pt postion of the jerk test
A
pt: seated with elbow at 90 degrees abd and IR.
PT: one hand on the elbow and one hand on the scapula. Horizontally add the arm
10
Q
what is a positive jerk test
A
sharp shoulder pain with or without a click
11
Q
what is the pt and PT position for the sulcus sign test
A
pt: in sitting with arm in 20-50 degrees of abd
PT: grasp the elbow and pull the arm inferiorly
12
Q
what is a positive sulcus sign
A
depression is seen between the acromion and the humeral head
13
Q
what are the special tests for subacrominal pain syndrome
A
1) hawkins kennedy
2) neer
3) painful arc
4) full can to empty can
5) ER isometric at 90
14
Q
What is the pt and PT position for hawkins kennedy
A
pt: sitting with 90 degrees shoulder flexion and 90 degrees of elbow flexion
PT: stabilize the scapula, compress the humerus into the glenoid and passively IR the humerus
15
Q
what is a positive hawkins kennedy test
A
reproduction of the patients familiar pain
16
Q
what is the pt and PT position for neer impingement test
A
pt: seated
PT: stand behind the patient, depress the scapula. passively IR and flex the shoulder through the entire ROM
17
Q
what is a positive neers test
A
reproduction of the pts familiar pain
18
Q
painful arc pt and PT position
A
pt actively abducts the shoulder and reports that start and spot range of any pain.
PT just observing
19
Q
that is a positive painful arc
A
- pain at 60-120 degrees indicated GH joint
- pain at more then 170 deg indicated ACJ
20
Q
what is the pt and PT postion for full can
A
pt is sitting with arm in a scapution plane thumb up.
PT applies a downward force in the scapular plane
21
Q
what does empty can indicate or identify
A
- tear of the supraspinatous
- impingement
- suprascapular nerve involvement
22
Q
what is the pt and PT position in jobe/empty can
A
pt: shoulder elevated to 90 degrees in the scapular plane, shoulder IR (thumb down)
PT: applies a downward force at the wrist
23
Q
what is a positive empty can test
A
reproduction of pain in the supraspinatus tendon and/ or weakness in “empty can” position
24
Q
Pt and PT postion of the resisted shoulder ER iso
A
pt: sitting with elbows at side
PT: add in a medial force so that patient resists ER
25
what is a positive resisted shoulder ER
weakness when compared to the contralateral side
26
what are the tests for rotator cuff related shoulder pain/subacromial shoulder pain (RCRPS) - supraspinatus
1) jobe/empty can
2) full can
3) ER lag sign
27
what does the ER lag sign identify
infraspinatus or supraspinatus pathology
28
what is the pt and PT position for ER lag test
pt: seated
PT: passively abduct the shoulder to 20 degrees in the scapular plane with full ER. Come off of full ER 5 degrees and instruct the patient to hold
29
what is a positive ER lag test
pt cannot hold the position, (shoulder moves into internal rotation)
30
what is the test for a full thickness infraspinatus tear
external rotation lag sign
31
what are the tests for rotator cuff related shoulder pain/subacromial shoulder pain (RCRPS) - subscapularis
1) lift off + belly press
2) belly press + bear hug
32
what does the lift off test indicate
lesion of the subscap
33
what is the pt and PT position of the lift off test
pt: hand placed on the back of their back
PT: instruct the patient to lift the back of their hand off of their back
34
what is a positive lift off test
weakness of aberrant scapular movement
35
pt and PT position in the belly press test
pt: have the patient place their hand on their belly
PT: place your hand in between the patients hand and their belly have them resist IR
36
what is a positive of the belly press test
weakness or pain - can quantify with the pressure cuff
37
what is the pt and PT position of the bear hug test
pt: place hand on opposite shoulder at 90 degrees
PT: patient to press hand down into the shoulder
38
what is a positive bear hug test
pain on provocation
39
what does internal rotation lag sign indicate
a full thickness subscapularis tear
40
what is the pt and PT position of a IR lag sign
pt: in a lift off position
PT: manually lifts the arm off the back of the patients back and cues them to hold that position
41
what is a positive IR lag sign
pt is unable to hold testing position
42
what are the additional tests for full thickness RTC
1) drop arm
2) hornblowers sign
43
what is the pt and PT position of the drop arm test
pt: seated with arm passively abducted to 120
PT: instruct the pt to slowly lower the arm to the side. guard the arm for an unexpected drop
44
what is a positive drop arm sign
pt is unable to lower arm back down the the side
45
what does the hornblowers sign identify
lesions of the teres minor or the infra
46
what is the pt and PT position of the hornblowers sign
pt: abduction to 90 in the scapular pain with elbow flexed. Pt will externally rotate shoulder against resistance
47
what is a positive hornblowers sign
pt is unable to externally rotate in his position or the forearm drops
48
what are the ACJ cluster
1) Paxion sign (if positive do #2 if negative do #3)
2) Active compression test
3) Hawkins kennedy
49
pt and PT position for the Paxinos sign
pt: seated, arm relaxed at side
PT: places thumb under the posterior lateral aspect of the acromion and the index/ long fingers of the same hand over the middle part of the clavicle : pressure applied with thumb in an anterior superior direction and with fingers in an inferior direction
50
active compression pt and PT position
pt: sitting with arm in 90 degrees of flexion and with thumb down then thumb up
PT: apply a downward pressure
51
what is a positive active compression
symptoms resolve with ER (palm up)
52
what are the special tests for a SLAP tear
1) active compression
2) passive distraction (distraction with pronation)
3) biceps load 1
4) biceps load 2
5) anterior slide
6) crank test
7) yergasons
8) speeds
53
pt and PT postion for biceps load 1
pt: supine with arm abducted to 90 and full ER
PT: apply resistance at the elbow having the patient resist elbow flexion
54
what is a positive biceps load 1 test
apprehension remains the same or becomes more painful
55
what is the pt and PT position for the biceps load 2 test
pt: supine with shoulder abducted to 120, elbow flexed at 90 and forearm supinated
PT: apply resistance to have the pt resist elbow flexion
56
what is a positive biceps load test
if the patient complains about pain during resisted elbow flexion
57
what is the pt and PT position for the anterior slide test
pt: seated with hands on the waist, thumbs posterior
PT: place index finger at acromion and humerus and stabilize the scapula then provide a anterior superior force from the elbow
58
what is a positive anterior slide test
pain or click deep in the shoulder
59
what is the pt and PT position for the crank test
pt: supine shoulder passively abducted to 120
PT: provide axial compression and move in IR and ER
60
what is a positive crank test
pain, clicking or catching at the shoulder
61
what does the yergason test for
integrity if the transverse ligament, bicipital tendinosis, SLAP
62
what is the pt and PT position of yergasons test
pt: seated with 90 degrees of elbow flexion and forearm pronated
PT: palpate the bicipital groove and have the pt resist supination
63
what is a positive yergason
pain or tenderness of the bicipital groove without a palpable popping of the tendon indicates a tendinopathy or SLAP. rupture of the transverse ligament if positive if the therapist feels a tending popping out of the bicipital groove
64
what does the speeds test identify
bicipital teninosis/SLAP
65
what is the pt and PT position for a speeds test
pt: seated elbow extended and forearm supinated to 90 degrees
PT: provide a downward force at the wrist
66
what is a positive speeds test
pain or tenderness in the bicipital groove
67
what is the ULTT 1 used to test
tension of the median nerve
68
what is the pt and PT position on the ULTT
pt in supine
PT depress the shoulder girdle, ABD to 110, externally rotate, supinate the forearm, elbow extended, wrist and finger extended
69
what is a positive ULTT 1 test
1) symptoms are reproduced
2) side to side difference in elbow extension greater then 10 degrees
3) contralateral C/S SB increases symptoms, ipsilateral SB decreases symptoms
70
what are the tests used for TOS
1) Adsons test
2) Roos test
71
pt and PT position of Adson's test
pt: seated with arms at 15 degrees abd
PT: palpate the radial pulse and ask the pt to hold their breath; pt is asked to tilt the head back and rotate the head so that the chin faced toward the examined side
72
what is a positive adsons test
change in pulse or co of paresthesias in this position
73
what is the pt and PT position of roos test
pt: seated with arms positions in 90 abd and 90 elbow flexion
PT: ask the pt to perform slow finger clenching for 3 minutes
74
what is a positive roos test
if the pt is unable to maintain this position for 3 minutes, or reports of pain, heaviness, N/T, or disappearance of pulse
75
what does the elbow extension test identify
fx or joint injury
76
how to do the elbow extension test
have the pt fully extend the elbow after a trauma
77
what is a positive elbow extension test
pt is unable to fully extend the elbow
78
what does the valgus stress test identify
ulnar collateral ligament (MCL) instability
79
pt and PT position for a valgus stress test of the elbow
pt: sitting or standing with elbow in 20 degrees of flexion
PT: stabilize the humerus with the outside hand. use your inside had to provide a valgus (abduction) force
80
what is a positive elbow valgus stress test
laxity or pain
81
what does the varus stress test of the elbow identify
radial collateral ligamentous instability (LCL)
82
pt and PT position for the varus stress test of the elbow
pt: sitting or standing with elbow in 20 degrees of flexion
PT: stabilize the humerus from the inside hand and place a varus force with the outside hand
83
what is a positive varus stress test of the elbow
laxity or pain
84
what is the moving valgus test used to identify
partial tear of the ulnar collateral ligament (MCL)
85
what is the pt and PT position for the moving valgus test
pt: in sitting or standing shoulder in 90 degrees abduction and full elbow flexion
PT: stand behind the pt maintaining max ER (valgus stress) and quickly move pt elbow from full flexion to 30 degrees of flexion
86
what is a positive moving valgus test
1) sudden medial elbow pain
2) pain is worse in arc for 120-70 degrees
87
what is the popeye sign
distal branching of the biceps with complete loss of function - identifies rupture of the long head of the biceps
88
what are the tests used to identify lateral epicondyalgia
1) mills test
2) maudley test
3) cozen test
89
what does mills test identify
dysfunction of the extensor carpi radialis brevis
90
what is the pt and PT position for the mills test
pt: sitting or standing; forearm in full pronation and wrist flexion
PT: palpate the lateral epicondyle and passively extend the elbow
91
what is a positive mills test
pain at the lateral epicondyle
92
what does maudleys test identify
disfunction of the extensor digitorum
93
pt and PT position for the maudleys test
pt in sitting with arm resting on the table
PT: palpate the lateral epicondyle and have the pt resist 3rd finger extension
94
pt and PT position of the Cozen's test
pt: sitting
PT: resist wrist extension and radial deviation while palpating the lateral epicondyle
95
what is the goal of the medial epicondyalgia/golfers elbow test
maximally stretch the muscles that originate from the medial epicondyle.
96
pt and PT position for medial epicondylalgia
pt: standing or sitting
PT: cradle the humerus and palpate the medial epicondyle; passively supinate forearm, extend the pts wrist then full extend the elbow
97
what is a positive golfers elbow test
sudden pain at the medial epicondyle
98
what is the elbow flexion test used to identify
cubital tunnel syndrome / compression of the flexor carpi ulnaris
99
pt and PT position for the elbow flexion test
pt: sitting or standing
PT: maximal elbow flexion, supination and wrist extension maintain position for 3 minutes
100
what is a positive elbow flexion test
pain or N/T in the ulnar n. distribution
101
what is the pronator teres syndrome test used to identify
median nerve compression
102
what is the pt and PT position for the pronator teres syndrome test
pt: in a handshake position
PT: Maintain resistance into pronation while extending through the elbow
103
what is a positive pronator teres syndrome test
pain or reproduction of N/T into the forearm/hand
104
what is the pinch grip for median n compression used to identify
interosseous nerve (AIM) ischemia/pathology
105
positive pinch grip for median n compression
pt is unable to make an OK sign by touching the tip of the thumb to the tip of the second finger
106
what is the ulnomeniscotriquetral dorsal glide test used to test for
the triangular fibrocartilage complex (TFCC) pathology
107
that is the pt and PT postion for the ulnomeniscotriquetral dorsal glide test
pt: seated with the arm pronated
PT: apply a posterior force through the thumb over the dorsal ulna and an anterior force over the pisiform
108
what is a positive ulnomeniscotriquetral dorsal glide test
excessive pain or laxity
109
what does the scaphoid shift test identify
scapholunate interosseous ligament instability
110
what is the pt and PT position for the scaphoid shift test
pt: elbow supported, neutral forearm
PT: fixate the radius and give pressure to the scaphoid in a dorsal direction. Other hand grasp the metacarples from the ulnar side.
passively move the wrist from ulnar deviation with slight extension to radial deviation with slight flexion while maintaining dorsal pressure
111
what is a positive scaphoid shift test
painful "shift" of the scaphoid or a clunk when pressure is removed
112
what is the piano key sign used to identify
distal radioulnar joint instability
113
what is the pt and PT position of the the piano key sign
pt: pronated forearm
PT: support metacarpals from the ulnar size; with the other hand apply a palmar pressure on the distal ulna and a dorsal pressure to the distal radius
114
what is a positive piano key sign
loss normal end feel, laxity and pain
115
interphalageal joint varus/valgus stress tests pt and PT position
fingers are supported and stabilized. PT applies a varus and valgus force to the PIP and DIP joints in all digits
116
what is a positive interphalangeal joint stress test
pain or laxity
117
what does the eichoffs test identify
de quervaiuns tenosunovitis of the thumb
118
what is the pt and PT postion for Eichoff's test
pt: positioned so that the distal ulna in at the edge of the table. pt makes a fist with tumb inside
PT: passively move the wrist into ulnar deviation
119
what is a positive eichoff's test
pain in the wrist
120
what does Finkelstein test identify
de quervains of the tumb
121
what is the pt and PT position for finkelstein test
pt: active ulnar deviation step one
PT: prove passive ulnar deviation at step 2 and passive flexion of the thumb at step 3
122
what is a positive fankelstein test
pain at the tip of the styloid process
123
what is the WHAT test used for
identifies de quervain's
124
what is pt and PT position for the WHAT test
pt: actively hyperflexes the wrist then actively fully extends and abducts the thumb
PT: provide a resisted abduction force
125
what is phalens test used for
CTS - carpel tunnel syndrome
126
what is the pt position for phalens
max. flexion holding the arms against each other for 1 minute
127
what is a positive phalen test
tingling or parestesia into the hand in a median nerve distribution
128
what is the froment sign used for
ulnar nerve palsy
129
what is pt postion for the froment sign
credit card hold
130
what is the modified allen test used for
identifying vascular compromise
131
how to do the modified allens test
- make a tight closed fist
- compress the ulnar and the radial artery
- release the ulnar artery
- white to normal coloring should occur within 5-15 secs
132
what is the hand squeeze test used for
to identify pain from MCP RA
133
that is the bunnel-litter test used for
identify joint or intrinsic tightness
134
how to do the bunnel-litter test
- stabilize the MCP in slight extension while the pip is flexed
- flex the MCP with the PIP flexed
- intrinsic tightness if PIP flexion is worse with MCP flexion
