Special tests Flashcards
List all the psych special test questions (5)
1) Over the past 2 weeks have you felt down, depressed, or hopeless?
2) Over the past 2 weeks, have you felt little pleasure in doing things?
3) Over the past 2 weeks, have you felt nervous, anxious, or on edge?
4) Over the past 2 weeks, have you been unable to stop or control worrying?
5) Over the past 4 weeks, have you had an anxiety attack; suddenly feeling fear or panic?
Describe the two hearing special tests
- Tuning fork on top of head: Webber test shows no lateralization
- Tuning fork on back of ear and in front: Rinne shows that air conduction is greater than bone conduction
List the 4 special tests for appendicitis
1) McBurney’s pt
2) Rovsing sign
3) Psoas sign
4) Obturator sign
Describe McBurney’s pt for appendicitis
○ Draw a line from the ASIS to umbilicus, find the midpoint, go two inches inferior to this, palpate McBurney Point for local tenderness. Any pain?
○** No tenderness with palpation**
Describe Rovsing sign for appendicitis
○ Palpate deeply and evenly in the LLQ and quickly let go
○ Any pain here? tap on right lower quadrant
○** No tenderness in RLQ or referred rebound pain, Rovsing sign is absent**
Describe Psoas sign for appendicitis
○ Have patient flex Right hip against your resistance on the R thigh. Ask abt pain.
No pain with flexion, psoas for appendicitis is negative
Describe Obturator sign for appendicitis
○Flex patient’s right leg at hip and with knee bent, rotate leg internally
○No rt hypogastric pain, obturator’s sign is negative
Describe Murphy’s sign for cholecystitis
○ Palpate under R costal margin as the patient inspires, ask if any tenderness with inspiration
○ No arrested breathing or increased tenderness with inspiration, Murphy’s sign for cholecystitis is absent.
List the 2 rotator cuff tear tests
1) Drop arm test
2) Empty can test
Describe the drop arm test for rotator cuff tear
○Have pt abduct arm laterally until horizontal
○Patient slowly adducts arm
○Drop after 90 degrees= positive = RC tear
Describe the empty can test for rotator cuff tear
Have pt put arms out w palms facing outward; you try to push down and they try to resist
Describe Tinel’s sign for carpal tunnel
Tingling with tapping over the median nerve as it enters the carpal tunnel.
No pain in the distr. of the median nerve, negative for carpal tunnel
Describe Phalen’s sign for carpal tunnel
Have pt press backs of hands together in acute flexion for 60 seconds
No numbness or tingling, negative
Describe straight leg raise (for radicular pain/ sciatica)
Raise pt’s leg for them to flex hip to 30-70 degrees, then ask abt pain.
Straight leg test is negative for radicular pain and sciatica
List the 2 carpal tunnel tests
Phalen’s and Tinels
List the 2 tests for ACL
Lachman’s and anterior drawer
Describe Lachman’s test for ACL tear
With knee in slight flexion, stabilize femur with one hand and pull tibia forward with other.
No excessive anterior translation bilaterally, Lachman’s for ACL tear is negative
Describe anterior drawer test for ACL tear
With knee flexed, firmly grasp proximal tibia and pull toward you.
No excess anterior translation bilaterally, anterior drawer is neg. for ACL tear
Describe posterior drawer test for PCL tear
With knee flexed, firmly grasp proximal tibia and push away from you.
No excess posterior translation compared to other knee, posterior drawer is neg. for PCL tear
Describe Valgus test for MCL tear
With knee at both 0 and 30 degree flexion, firmly grab ankle and apply inward force from lateral knee.
No significant laxity bilaterally, Valgus is negative for MCL tear
Describe Varus test for LCL tear
With knee at both 0 and 30 degrees, firmly grab ankle and apply outward force from medial knee.
No significant laxity bilaterally, Varus is negative for LCL tear
Describe McMurray’s test for lateral and medial meniscal injuries
Flex knee, and:
1) Medial meniscus: Externally rotate ankle while extending knee
2) Lateral meniscus: Internally rotate ankle while extending knee
1) What does a 30 degree valgus test test?
2) What abt 0 degree?
1) Medial ligament
2) Medial ligament and ACL
1) What does a 30 degree varus test test?
2) What abt 0 degree?
1) Lateral ligament
2) Ligament and ACL
Describe Thompson test for Achilles tendon rupture
With pt lying prone, squeeze their calf.
Plantar flexion is intact, no Achilles tendon rupture
What are the 3 meningitis tests?
1) Nuchal rigidity
2) Brudzinski’s
3) Kernig
Describe nuchal rigidity test for meningitis
Have pt flex their neck ; resistance to flexion/ moving legs up to relieve pressure is (+)
Describe Brudzinski’s for meningitis
Flexion of neck = hips and knees react in pain if (+)
Describe the Kernig test for meningitis
Flex pt’s hip and knee, then extend knee
No pain w knee extension, negative for meningitis
What is Clonus positive for?
Hyperreflexia or CNS disease
Describe the Clonus test for CNS disease
Loosen pt’s ankle, then sharply point pt’s foot upwards and keep pressure. Feel for twitching.
No clonus felt, negative for CNS disease
How do you perform the Asterixis test for metabolic encephalopathy?
Ask patient to “stop traffic” holding for 1-2 minutes
No sudden brief (nonrhythmic) flexion of the hands, negative for metabolic encephalopathy
Describe Babinski reflex for corticospinal tract lesion in CNS
Using back of reflex hammer, lightly stroke lateral aspect of sole from heel to ball of foot, curving medially across the ball.
No dorsiflexion of the big toe, Babinski for corticospinal tract lesion in CNS is absent
Describe Romberg Test for cerebellar ataxia
Ask pt to stand with feet together, and then to close their eyes while doing so. Look for losing balance entirely/ not correcting movements.
No loss of balance, cerebellar ataxia is negative
What are the two corticospinal tract lesion tests? What part does each specifically test for?
1) Babinski = CNS corticospinal tract
2) Pronator drift = contralateral corticospinal tract
Describe the pronator drift test for contralateral corticospinal tract lesion
Have pt stand with eyes closed and both arms forward w. palms up, and tap their arms briskly downward
No spontaneous pronation or supination and arms return to horizontal position, so pronator drift for contralateral corticospinal tract lesion is negative
What is McMurray’s test for?
Lateral and medial meniscal injuries
What test is for cerebellar ataxia?
Romberg
Describe the Neer test for shoulder impingement
Internally rotate arm, stabilize scapula, move arm up to 90⁰ ask about pain
Hawkins-Kennedy test for shoulder impingement
Flex shoulder at 90, flex elbow and have arm in front of chest. Push down on pts forearm. Pain in shoulder = pos
