Special Tests Flashcards
Apprehension test ant dislocation
pt. Supine should abducted to 90 deg elbow flexed to 90deg, PT lat rotates shoulder, positive = look of apprehension
Apprehension test post dislocation
Pt supine shoulder flexed to 90 w/ medial rotation, PT applies post force through long axis, positive = look of apprehension
Sulcus sign
pt. Standing PT pulls arm inferiority at elbow, positive = depression between acromion and humeral head
Ludigntons test
Sitting hands interlocked behind their head, pt contracts and relaxs bicep muscle, positive = absence of bicep tendon indicating rupture of long head
Speeds test
Pt elbow extended and shoulder flexed to 90 w/ SUPINATION, PT resists active shoulder flex while palpating bicipital groove, positive = pain or tenderness in bicipital groove indicating bicipital tendinitis
Yergasons test
Pt elbow flexed to 90 w/ fore arm pronated, PT resists active forearm supination and shoulder ER, while palpating bicipital groove, p! Or tenderness indicates bicipital tendinitis
Drop arm
Pt arm abducted to 90degrees, pt asked to slowly lower arm to side, presence of pain or instability to lower arm slow = RTC tear
Hawkins-Kennedy
PT moves shoulder into 90 degrees of flexion w/ elbow flexed to 90 and medially rotates shoulder, positive = pain indicating shoulder impingement of supraspinatus
Infraspinatus test
Pt standing elbow flexed to 90 shoulder IR to 45, pt. Resists PT medially directed force, positive = pain or weak indicated Infraspinatus tear
Lateral rotation lag sign
Elbow flexed to 90, PT move shoulder into 20 deg of caption and near end range ER PT asks pt. To hold here, inability to hold position or arm moves into more IR indicates Infraspinatus and/or supraspinatus pathology
Lift off sign (medial rotation lag sign)
Pt. Stand w. Dorsal of hand on low back, asked to move hand away form back, if unable PT moves hand away and sees if they can hold it, inability = positive indicating Subscapularis lesion
Neer Impignment test
Stabilizing posterior aspect of scap, PT moves shoulder through full elevation in scapular plane w/ medially rotated arm, positive = pain or facial grimace indicating shoulder impingement involving supraspinatus
Supine impingement test
Pt. Supine PT moves shoulder into full flexion and ER, adducts and IR shoulder, positive = increase in p! W/ IR, indicating impingement of RTC tenons
Supraspinatus test
pt. Standing shoulder abduction 90 then horizontally adducts 30, thumb down. Pt resists should abduction, p! Or weak indicates supraspinatus tear or impignment of suprascapular nerve
Adsons maneuver
PT monitoring radial pulse, pt. Rotates head toward test side extending neck while PT extends and ER shoulder, absent or diminished pulse indicates TOS
Allen’s TOS test
pt. 90deg abduction and ER and elbow 90deg flex, pt. Rotates head away from test while PT monitors radial pulse, absent or diminished pulse positive TOS
Costoclavicular test
Pt. Sitting, pt. Assumes military posture PT monitoring radial pulse, absent or diminished pulse indicates TOS from compression of subclavian artery between first rib and clavicle
Roos test
Pt. Both shoulder abducted and ER to 90 w/ elbows flexed to 90, pt. Opens and closes hands for 3 mins, weakness, sensory loss, ischemic pain or inability to hold test position indicates TOS
Wrights test TOS
PT moves pt.s arm overhead in frontal plan monitoring radial pulse, absent or diminished pulse indicates compression in costoclacviular space TOS
Acromioclavicular crossover test
PT moves shoulder into 90deg flex, then full horizontally adducts shoulder, p! Over acromioclavicular joint indicates AC injury
Active compression test o’brians test
Pt. Standing shoulder flexed 90, horizontally adducts 10-15, and IR thumb pointed down. Pt. Resists PT applied downward force on arm shoulder ER and same downward force applied, positive = p! With shoulder IR that decreased with ER, indicating superior lateral tear
Glenoid labrum tear test
Pt. Supine, PT places hand on posterior aspect of humeral head, other hand stabilizes humerus proximal to elbow. PT abducts and ER arm over pt’s head and plies anteriorly directed force to humeral head, positive = clunk or grinding indicating glenoid labrum tear.
Jerk test
Pt. Sitting shoulder elevated 90 and IR with elbow flexed to 90. PT provides axial compression force through elbow and horizontally adducting shoulder. Positive = sudden clunk jerk or pain as humeral head subluxes posterior. Indicating shoulder instability or posterior lateral lesion
Elbow cozens test
Pt. Sitting with elbow slight flexion PT places thumb on lateral epicondyle and stabilizes elbow joint. Pt. Makes a fist with pronated arm radially deviated and extended wrist against resistance. Positive = pain or weakness near lateral epicondyle, indicating lateral epicondyle
Maudsleys test
Pt. Sitting forearm pronated, PT stabilizes elbow one hand and resists active third digit extension distal to PIP joint. Positive = weakness or pain near lateral epicondyle
Medial epicodylitis test
PT supinates pt. Forearm extends wrist and extends elbow while palpating medial epicondyle, positive = pain near medial epi.
Mills test
PT pronates pt.s forearm flexes wrist and extends elbow palpating lateral epicondyle, pain near lateral epicondyle
Elbow flexion test
Pt. Fully flexes both elbows and extends both wrists, holding for 3-5mins. Presence of tingling or parenthesis in ulnar nerve distribution indicating curtail tunnel syndrome.
Pinch grip test
Pt. Asked to pinch tips of index finger and thumb together, positive = inability to pinch tip-to-tip instead pressing pads together, indicative of anterior interosseous nerve pathology
Elbow tinels sign
Pt. Elbow slightly flexed PT taps between medial epicondyle and olecranon process, tingling sensation in ulnar nerve distribution indicating ulnar nerve compression
Ulnar collateral ligament instability
PT holds pt.’s thumb in extension applying vagus force to MCP joint, positive = excesssive vagus movement indicating a tread of ulnar collateral and accessory collateral ligament
Gunnel-Littler test
pt. MCP in slight extension, PT attempts to move PIP into flexion,
If PIP doesn’t flex with MCP extended indicates tight intrinsic muscle or capsular tightness.
If PIP flexes fully with MCP in slight flexion indicates muscle tightness without capsule tightness
Tight retinacular ligament test
PIP neutral, PT flexes DIP, positive = inability to flex DIP indicates retinacular ligament or capsule tight, if able to feel DIP with PIP flexed indicates retinacular tightness normal capsule
Capsular compression test (median nerve compression test)
PT hold patients wrist with both hands applying pressure over median nerve in carpal tunnel for 30 seconds, positive = presence of pain or paresthesia in median nerve distribution
Froments sign
Pt. Holds piece of paper between thumb and index finger while PT attempts to pull paper
Positive = pt. Flexing DIP thumb to hold onto paper indicating adductor pollicis muscle paralysis, possibly from secondary to ulnar nerve compression, if pt. Also Hyperextends MCP of thumb termed Jeanne’s sign
Phalens test
Pt. Presses dorsal aspect of both hands against another wrists maximally flexed for 30sec, positive = tingling in thumb, index , middle or lateral half of ringer finger. Inducted carpal tunnel syndrome
Tinels sign wrist/hand
PT taps volar aspect of wrist, tingling in median nerve distribution into hand indicates carpal tunnel syndrome
