special tests Flashcards
yergason’s test
Purpose: test the integrity of the transverse ligament/biceps tendinopathy. Exam:patient sitting with shoulder neutral and elbow at 90 with forearm pronated. Resist forearm supination and shoulder ER. Positive if: you feel biceps pop out, or pain in LHB
Speed’s Test
Purpose: Biceps tendinopathy. Exam: Upper limb either in full extension and supination resisting flexion or at 90 and resist extension for eccentric contraction. Positive if: reproduces pain in biceps
Neer’s Impingement Test
Purpose: impingement of LHB / supraspinatus. Exam: sitting; shoulder is passively IR and then brought into full ABD. Positive if pain in the shoulder region
Supraspinatus (empty can) test
Purpose: identifies tear and/or impingement of supraspinatus tendon or possible supra scapular nerve neuropathy. Exam: patient seated and bring to 90 and resist ABD; then bring to IR and 30 degrees horizon. ADD and resist ABD. Positive if there is pain or weakness in the empty can position
Drop Arm Test
Purpose: Identifies a tear or full rupture of the rotator cuff. Exam: seated with shoulder passively ABD to 120. Patient instructed to lower arm to their side. Positive if patient is unable to perform the task
Posterior internal impingement test
Purpose: identify an impingement between the rotator cuff and the greater tuberosity or the posterior glenoid and labrum. Exam: Supine: passive ABD to 90, fully ER and horizon. ADD 15-20 degrees. Positive if reproduces pain in posterior shoulder
Clunk Test
Purpose: identifies a labral tear. Exam:supine with shoulder in full ABD, push the humeral head anterior while rotating the humerus into ER. Positive if there is an audible clunk.
Anterior Apprehension Sign
Purpose: hx of anterior shoulder dislocation. Exam: patient is supine and move into 90 ABD. Slowly move into ER. Positive: pt is apprehensive to the movement
Posterior Apprehension Sign
Purpose: hx of a posterior dislocation. Exam: pt is supine and you move the shoulder to 90 ABD, put a posterior force through the shoulder by pushing on elbow and then move the shoulder into IR and horizon. ADD. Positive if: patient is apprehensive
Acromioclavicular Shear Test
Purpose: identify dysfunction of the AC joint. Exam: patient is seated. examiner places heel of one hand on the spine of scapula and the other heel of hand on the clavicle: push them together. Positive if there is pain to the AC joint.
Adson’s Test
Purpose: identify pathology of structures in the thoracic inlet. Exam: Patient seated. palpate the radial pulse. Then patient rotates head toward the testing side, extend and ER the shoulder and extend the head and again assess radial pulse. Positive if: neurological, vascular symptoms, disappearance of pulse
Costoclavicular Syndrome (military brace) test
Purpose: thoracic outlet. Exam: patient seated. find the radial pulse and move the shoulder down and back and reassess pulse. Positive if: neurological or vascular symptoms
Wright (hyperabduction test)
Purpose: Thoracic Outlet. Exam: patient is seated, find the radial pulse and move the shoulder into max ABD and ER. Patient rotates their head opposite this arm and takes deep breaths. Positive if: reproduction of neurological/vascular symptoms
Roos Elevated Arm Test
Purpose: thoracic outlet. Exam: Shoulder ABD to 90, full ER and slight horizontal ADD. elbow to 90 and open and closes hands for 3 minutes. Positive if: reproduction of neuro/vascular symptoms
ULTT1 biases
Median Nerve, Anterior interosseous nerve
ULTT1 arm positions
Shoulder: Depression and ABD to 110. Elbow: extended. Forearm: supinated. Wrist: Extended. Fingers and thumb: extended Cervical: contralateral side bend
ULTT2 biases
Median, axillary, and musculocutaneous nerves
ULTT2 arm positions
Shoulder: depression and ABD to 10. Elbow: extended. Forearm: supinated. Wrist: extended, Shoulder: ER, Cervical: contralateral side flexion
ULTT3 Radial nerve arm positions
Shoulder: depression and ABD 10. Elbow: extension. Forearm: pronation. Wrist: Flexion and ulnar deviation. Fingers and thumb: flexion. Shoulder: IR Cervical: opposite side bend
ULTT4 Ulnar nerve positions
Shoulder: depression and ABD 10-90. Elbow:flexion, Forearm: supination. Wrist: extension and Radial deviation. Fingers: Extension. Shoulder: ER. Cervical: opposite side bend
Elbow ligament stability testing
Elbow placed in 0-20 of flexion and place values force to assess ulnar collateral ligament and varus force to assess radial collateral ligament.
Lateral epicondylitis or tennis elbow test
place elbow at 90, and pronated and radially deviated. resist wrist extension. Positive if there is pain at lateral epicondyle
Medial epicondylitis or golfer’s elbow test
seated with elbow at 90. Passively supinate, extend elbow and extend wrist. Positive if pain over medial epicondyle
Pronator Teres syndrome test
Purpose: to identify a median Nerve entrapment. Exam: resist forearm pronation and elbow extension at the same time. Positive if there is tingling or paresthesia in median nerve distribution.
Finkelstein’s Test
Purpose: identify de Quervian’s tenosynovitis (ABD pollicis longus and Extensor pollicis Brevis). Make a fist with thumb tucked, move the wrist into ulnar deviation. Positive in pain in the wrist - must compare to other side
Bunnel-Littler Test
Purpose: identify tightness in the structures surrounding the MCP joints.Exam: Start with MCP stabilized in slight EXT. Then PIP is flexed. Then MCP is flexed with PIP flexed. If the two are equal this is capsular tightness. If flexion is increased with the MCP in flexion then there is intrinsic muscular tightness
Tight retinacular test (fingers)
Purpose: identify tightness around the PIPs. Exam: PIP stabilized in neutral and DIP is flexed. The PIP flexion with DIP is performed. IF they are equally tight, it is scapular tightness. IF there is more DIP flexion with PIP flexion then the retinaculum is tight.
Froment’s Sign
Purpose: identify ulnar nerve dysfunction. Exam: Patient grasps a piece of paper between the first and second finger. Pull paper out and look for IP flexion of the thumb: this indicates weakness of ADD pollicis muscle that is innervated by ulnar nerve.
Phalen’s Test
Purpose: identify carpal tunnel. Exam: upside down prayer position for 1 minute. Positive if there is tingling/paresthesia into median nerve distribution.
Two point discrimination test for the hand is normally
generally less than 6mm
Allen’s Test
Purpose: identify vascular compromise of ulnar/radial arteries. Exam: identify both arteries, have patient open and close fingers several times then close fist. Occlude ulnar after and have patient open hand: observe palm of hand, then release and assess vascular filling. Positive is abnormal filling: normal is white color to normal color
FABER test
Identifies: hip mobility dysfunction. Exam: figure 4 position and lower the leg down towards the table. Positive if patient is unable to assume relaxed position or reproduction of pain.
Grind/Scour Test
Purpose: Hip DJD. Exam: supine, hip to 90 flexion and knee maximally flexed. Apply compressive force through the femur. Positive if there is pain in hip or referred pain