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Ortho UE > special tests > Flashcards

special tests Flashcards

1
Q

what are the special tests for GH joint anterior instability

A

1) apprehension test
2) relocation test/surprise test

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2
Q

what does the apprehension test of the GH test for

A

torn inferior GH ligament, anterior capsule, and possible glenoid labrum

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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

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4
Q

what is a positive apprehension test for the GH

A

pt looks or feels apprehensive toward ER movement

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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.

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6
Q

what is a positive GH relocation test

A

decreased apprehension or pain

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7
Q

what are the special tests for GH joint posterior and inferior instability

A

1) jerk test
2) sulcus sign

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8
Q

what does the jerk test identify

A

posterior inferior labral leison

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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

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10
Q

what is a positive jerk test

A

sharp shoulder pain with or without a click

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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

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12
Q

what is a positive sulcus sign

A

depression is seen between the acromion and the humeral head

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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

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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

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15
Q

what is a positive hawkins kennedy test

A

reproduction of the patients familiar pain

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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

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17
Q

what is a positive neers test

A

reproduction of the pts familiar pain

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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

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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
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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

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21
Q

what does empty can indicate or identify

A
  • tear of the supraspinatous
  • impingement
  • suprascapular nerve involvement
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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

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23
Q

what is a positive empty can test

A

reproduction of pain in the supraspinatus tendon and/ or weakness in “empty can” position

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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

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25
Q

what is a positive resisted shoulder ER

A

weakness when compared to the contralateral side

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26
Q

what are the tests for rotator cuff related shoulder pain/subacromial shoulder pain (RCRPS) - supraspinatus

A

1) jobe/empty can
2) full can
3) ER lag sign

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27
Q

what does the ER lag sign identify

A

infraspinatus or supraspinatus pathology

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28
Q

what is the pt and PT position for ER lag test

A

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

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29
Q

what is a positive ER lag test

A

pt cannot hold the position, (shoulder moves into internal rotation)

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30
Q

what is the test for a full thickness infraspinatus tear

A

external rotation lag sign

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31
Q

what are the tests for rotator cuff related shoulder pain/subacromial shoulder pain (RCRPS) - subscapularis

A

1) lift off + belly press
2) belly press + bear hug

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32
Q

what does the lift off test indicate

A

lesion of the subscap

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33
Q

what is the pt and PT position of the lift off test

A

pt: hand placed on the back of their back
PT: instruct the patient to lift the back of their hand off of their back

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34
Q

what is a positive lift off test

A

weakness of aberrant scapular movement

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35
Q

pt and PT position in the belly press test

A

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

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36
Q

what is a positive of the belly press test

A

weakness or pain - can quantify with the pressure cuff

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37
Q

what is the pt and PT position of the bear hug test

A

pt: place hand on opposite shoulder at 90 degrees
PT: patient to press hand down into the shoulder

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38
Q

what is a positive bear hug test

A

pain on provocation

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39
Q

what does internal rotation lag sign indicate

A

a full thickness subscapularis tear

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40
Q

what is the pt and PT position of a IR lag sign

A

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

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41
Q

what is a positive IR lag sign

A

pt is unable to hold testing position

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42
Q

what are the additional tests for full thickness RTC

A

1) drop arm
2) hornblowers sign

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43
Q

what is the pt and PT position of the drop arm test

A

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

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44
Q

what is a positive drop arm sign

A

pt is unable to lower arm back down the the side

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45
Q

what does the hornblowers sign identify

A

lesions of the teres minor or the infra

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46
Q

what is the pt and PT position of the hornblowers sign

A

pt: abduction to 90 in the scapular pain with elbow flexed. Pt will externally rotate shoulder against resistance

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47
Q

what is a positive hornblowers sign

A

pt is unable to externally rotate in his position or the forearm drops

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48
Q

what are the ACJ cluster

A

1) Paxion sign (if positive do #2 if negative do #3)
2) Active compression test
3) Hawkins kennedy

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49
Q

pt and PT position for the Paxinos sign

A

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

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50
Q

active compression pt and PT position

A

pt: sitting with arm in 90 degrees of flexion and with thumb down then thumb up
PT: apply a downward pressure

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51
Q

what is a positive active compression

A

symptoms resolve with ER (palm up)

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52
Q

what are the special tests for a SLAP tear

A

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

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53
Q

pt and PT postion for biceps load 1

A

pt: supine with arm abducted to 90 and full ER
PT: apply resistance at the elbow having the patient resist elbow flexion

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54
Q

what is a positive biceps load 1 test

A

apprehension remains the same or becomes more painful

55
Q

what is the pt and PT position for the biceps load 2 test

A

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
Q

what is a positive biceps load test

A

if the patient complains about pain during resisted elbow flexion

57
Q

what is the pt and PT position for the anterior slide test

A

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
Q

what is a positive anterior slide test

A

pain or click deep in the shoulder

59
Q

what is the pt and PT position for the crank test

A

pt: supine shoulder passively abducted to 120
PT: provide axial compression and move in IR and ER

60
Q

what is a positive crank test

A

pain, clicking or catching at the shoulder

61
Q

what does the yergason test for

A

integrity if the transverse ligament, bicipital tendinosis, SLAP

62
Q

what is the pt and PT position of yergasons test

A

pt: seated with 90 degrees of elbow flexion and forearm pronated
PT: palpate the bicipital groove and have the pt resist supination

63
Q

what is a positive yergason

A

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
Q

what does the speeds test identify

A

bicipital teninosis/SLAP

65
Q

what is the pt and PT position for a speeds test

A

pt: seated elbow extended and forearm supinated to 90 degrees
PT: provide a downward force at the wrist

66
Q

what is a positive speeds test

A

pain or tenderness in the bicipital groove

67
Q

what is the ULTT 1 used to test

A

tension of the median nerve

68
Q

what is the pt and PT position on the ULTT

A

pt in supine
PT depress the shoulder girdle, ABD to 110, externally rotate, supinate the forearm, elbow extended, wrist and finger extended

69
Q

what is a positive ULTT 1 test

A

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
Q

what are the tests used for TOS

A

1) Adsons test
2) Roos test

71
Q

pt and PT position of Adson’s test

A

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
Q

what is a positive adsons test

A

change in pulse or co of paresthesias in this position

73
Q

what is the pt and PT position of roos test

A

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
Q

what is a positive roos test

A

if the pt is unable to maintain this position for 3 minutes, or reports of pain, heaviness, N/T, or disappearance of pulse

75
Q

what does the elbow extension test identify

A

fx or joint injury

76
Q

how to do the elbow extension test

A

have the pt fully extend the elbow after a trauma

77
Q

what is a positive elbow extension test

A

pt is unable to fully extend the elbow

78
Q

what does the valgus stress test identify

A

ulnar collateral ligament (MCL) instability

79
Q

pt and PT position for a valgus stress test of the elbow

A

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
Q

what is a positive elbow valgus stress test

A

laxity or pain

81
Q

what does the varus stress test of the elbow identify

A

radial collateral ligamentous instability (LCL)

82
Q

pt and PT position for the varus stress test of the elbow

A

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
Q

what is a positive varus stress test of the elbow

A

laxity or pain

84
Q

what is the moving valgus test used to identify

A

partial tear of the ulnar collateral ligament (MCL)

85
Q

what is the pt and PT position for the moving valgus test

A

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
Q

what is a positive moving valgus test

A

1) sudden medial elbow pain
2) pain is worse in arc for 120-70 degrees

87
Q

what is the popeye sign

A

distal branching of the biceps with complete loss of function - identifies rupture of the long head of the biceps

88
Q

what are the tests used to identify lateral epicondyalgia

A

1) mills test
2) maudley test
3) cozen test

89
Q

what does mills test identify

A

dysfunction of the extensor carpi radialis brevis

90
Q

what is the pt and PT position for the mills test

A

pt: sitting or standing; forearm in full pronation and wrist flexion
PT: palpate the lateral epicondyle and passively extend the elbow

91
Q

what is a positive mills test

A

pain at the lateral epicondyle

92
Q

what does maudleys test identify

A

disfunction of the extensor digitorum

93
Q

pt and PT position for the maudleys test

A

pt in sitting with arm resting on the table
PT: palpate the lateral epicondyle and have the pt resist 3rd finger extension

94
Q

pt and PT position of the Cozen’s test

A

pt: sitting
PT: resist wrist extension and radial deviation while palpating the lateral epicondyle

95
Q

what is the goal of the medial epicondyalgia/golfers elbow test

A

maximally stretch the muscles that originate from the medial epicondyle.

96
Q

pt and PT position for medial epicondylalgia

A

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
Q

what is a positive golfers elbow test

A

sudden pain at the medial epicondyle

98
Q

what is the elbow flexion test used to identify

A

cubital tunnel syndrome / compression of the flexor carpi ulnaris

99
Q

pt and PT position for the elbow flexion test

A

pt: sitting or standing
PT: maximal elbow flexion, supination and wrist extension maintain position for 3 minutes

100
Q

what is a positive elbow flexion test

A

pain or N/T in the ulnar n. distribution

101
Q

what is the pronator teres syndrome test used to identify

A

median nerve compression

102
Q

what is the pt and PT position for the pronator teres syndrome test

A

pt: in a handshake position
PT: Maintain resistance into pronation while extending through the elbow

103
Q

what is a positive pronator teres syndrome test

A

pain or reproduction of N/T into the forearm/hand

104
Q

what is the pinch grip for median n compression used to identify

A

interosseous nerve (AIM) ischemia/pathology

105
Q

positive pinch grip for median n compression

A

pt is unable to make an OK sign by touching the tip of the thumb to the tip of the second finger

106
Q

what is the ulnomeniscotriquetral dorsal glide test used to test for

A

the triangular fibrocartilage complex (TFCC) pathology

107
Q

that is the pt and PT postion for the ulnomeniscotriquetral dorsal glide test

A

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
Q

what is a positive ulnomeniscotriquetral dorsal glide test

A

excessive pain or laxity

109
Q

what does the scaphoid shift test identify

A

scapholunate interosseous ligament instability

110
Q

what is the pt and PT position for the scaphoid shift test

A

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
Q

what is a positive scaphoid shift test

A

painful “shift” of the scaphoid or a clunk when pressure is removed

112
Q

what is the piano key sign used to identify

A

distal radioulnar joint instability

113
Q

what is the pt and PT position of the the piano key sign

A

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
Q

what is a positive piano key sign

A

loss normal end feel, laxity and pain

115
Q

interphalageal joint varus/valgus stress tests pt and PT position

A

fingers are supported and stabilized. PT applies a varus and valgus force to the PIP and DIP joints in all digits

116
Q

what is a positive interphalangeal joint stress test

A

pain or laxity

117
Q

what does the eichoffs test identify

A

de quervaiuns tenosunovitis of the thumb

118
Q

what is the pt and PT postion for Eichoff’s test

A

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
Q

what is a positive eichoff’s test

A

pain in the wrist

120
Q

what does Finkelstein test identify

A

de quervains of the tumb

121
Q

what is the pt and PT position for finkelstein test

A

pt: active ulnar deviation step one
PT: prove passive ulnar deviation at step 2 and passive flexion of the thumb at step 3

122
Q

what is a positive fankelstein test

A

pain at the tip of the styloid process

123
Q

what is the WHAT test used for

A

identifies de quervain’s

124
Q

what is pt and PT position for the WHAT test

A

pt: actively hyperflexes the wrist then actively fully extends and abducts the thumb
PT: provide a resisted abduction force

125
Q

what is phalens test used for

A

CTS - carpel tunnel syndrome

126
Q

what is the pt position for phalens

A

max. flexion holding the arms against each other for 1 minute

127
Q

what is a positive phalen test

A

tingling or parestesia into the hand in a median nerve distribution

128
Q

what is the froment sign used for

A

ulnar nerve palsy

129
Q

what is pt postion for the froment sign

A

credit card hold

130
Q

what is the modified allen test used for

A

identifying vascular compromise

131
Q

how to do the modified allens test

A
  • 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
Q

what is the hand squeeze test used for

A

to identify pain from MCP RA

133
Q

that is the bunnel-litter test used for

A

identify joint or intrinsic tightness

134
Q

how to do the bunnel-litter test

A
  • 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

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