Special tests

Question 1

List all the psych special test questions (5)

Answer 1

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?

Question 2

Describe the two hearing special tests

Answer 2

• 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

Question 3

List the 4 special tests for appendicitis

Answer 3

1) McBurney’s pt
2) Rovsing sign
3) Psoas sign
4) Obturator sign

Question 4

Describe McBurney’s pt for appendicitis

Answer 4

○ 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**

Question 5

Describe Rovsing sign for appendicitis

Answer 5

○ 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**

Question 6

Describe Psoas sign for appendicitis

Answer 6

○ Have patient flex Right hip against your resistance on the R thigh. Ask abt pain.
No pain with flexion, psoas for appendicitis is negative

Question 7

Describe Obturator sign for appendicitis

Answer 7

○Flex patient’s right leg at hip and with knee bent, rotate leg internally
○No rt hypogastric pain, obturator’s sign is negative

Question 8

Describe Murphy’s sign for cholecystitis

Answer 8

○ 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.

Question 9

List the 2 rotator cuff tear tests

Answer 9

1) Drop arm test
2) Empty can test

Question 10

Describe the drop arm test for rotator cuff tear

Answer 10

○Have pt abduct arm laterally until horizontal
○Patient slowly adducts arm
○Drop after 90 degrees= positive = RC tear

Question 11

Describe the empty can test for rotator cuff tear

Answer 11

Have pt put arms out w palms facing outward; you try to push down and they try to resist

Question 12

Describe Tinel’s sign for carpal tunnel

Answer 12

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

Question 13

Describe Phalen’s sign for carpal tunnel

Answer 13

Have pt press backs of hands together in acute flexion for 60 seconds
No numbness or tingling, negative

Question 14

Describe straight leg raise (for radicular pain/ sciatica)

Answer 14

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

Question 15

List the 2 carpal tunnel tests

Answer 15

Phalen’s and Tinels

Question 16

List the 2 tests for ACL

Answer 16

Lachman’s and anterior drawer

Question 17

Describe Lachman’s test for ACL tear

Answer 17

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

Question 18

Describe anterior drawer test for ACL tear

Answer 18

With knee flexed, firmly grasp proximal tibia and pull toward you.
No excess anterior translation bilaterally, anterior drawer is neg. for ACL tear

Question 19

Describe posterior drawer test for PCL tear

Answer 19

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

Question 20

Describe Valgus test for MCL tear

Answer 20

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

Question 21

Describe Varus test for LCL tear

Answer 21

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

Question 22

Describe McMurray’s test for lateral and medial meniscal injuries

Answer 22

Flex knee, and:
1) Medial meniscus: Externally rotate ankle while extending knee
2) Lateral meniscus: Internally rotate ankle while extending knee

Question 23

1) What does a 30 degree valgus test test?
2) What abt 0 degree?

Answer 23

1) Medial ligament
2) Medial ligament and ACL

Question 24

1) What does a 30 degree varus test test?
2) What abt 0 degree?

Answer 24

1) Lateral ligament
2) Ligament and ACL

Question 25

Describe Thompson test for Achilles tendon rupture

Answer 25

With pt lying prone, squeeze their calf.
Plantar flexion is intact, no Achilles tendon rupture

Question 26

What are the 3 meningitis tests?

Answer 26

1) Nuchal rigidity
2) Brudzinski’s
3) Kernig

Question 27

Describe nuchal rigidity test for meningitis

Answer 27

Have pt flex their neck ; resistance to flexion/ moving legs up to relieve pressure is (+)

Question 28

Describe Brudzinski’s for meningitis

Answer 28

Flexion of neck = hips and knees react in pain if (+)

Question 29

Describe the Kernig test for meningitis

Answer 29

Flex pt’s hip and knee, then extend knee
No pain w knee extension, negative for meningitis

Question 30

What is Clonus positive for?

Answer 30

Hyperreflexia or CNS disease

Question 31

Describe the Clonus test for CNS disease

Answer 31

Loosen pt’s ankle, then sharply point pt’s foot upwards and keep pressure. Feel for twitching.
No clonus felt, negative for CNS disease

Question 32

How do you perform the Asterixis test for metabolic encephalopathy?

Answer 32

Ask patient to “stop traffic” holding for 1-2 minutes
No sudden brief (nonrhythmic) flexion of the hands, negative for metabolic encephalopathy

Question 33

Describe Babinski reflex for corticospinal tract lesion in CNS

Answer 33

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

Question 34

Describe Romberg Test for cerebellar ataxia

Answer 34

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

Question 35

What are the two corticospinal tract lesion tests? What part does each specifically test for?

Answer 35

1) Babinski = CNS corticospinal tract
2) Pronator drift = contralateral corticospinal tract

Question 36

Describe the pronator drift test for contralateral corticospinal tract lesion

Answer 36

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

Question 37

What is McMurray’s test for?

Answer 37

Lateral and medial meniscal injuries

Question 38

What test is for cerebellar ataxia?

Answer 38

Romberg

Question 39

Describe the Neer test for shoulder impingement

Answer 39

Internally rotate arm, stabilize scapula, move arm up to 90⁰ ask about pain

Question 40

Hawkins-Kennedy test for shoulder impingement

Answer 40

Flex shoulder at 90, flex elbow and have arm in front of chest. Push down on pts forearm. Pain in shoulder = pos