Special Tests Flashcards
Specific Manual Dexterity tests
- Jebson Taylor Hand Function Test
- Minnesota Rate of Manipulation Test
- Purdue Pegboard Test
- Moberg’s Pickup Test
- Nine-Hole Peg Test
Manual Dexterity Tests
Specific (5)
Functional (these will be the most important)
Jebson Taylor Hand Function Test includes what
Writing
Card turning
Picking up small objects
Stacking checkers
Picking up large, light objects and placing them
Picking up large, heavy objects and placing them
Minnesota Rate of Manipulation Test includes what
Placing Turning Displacing One hand turning and placing Two hand turning and placing
Description of Minnesota Rate of Manipulation Test
Brings in gross motor too because brings in shoulder, elbow, and forearm
Given a board that specific cut outs will fit into
Different tests that can do - unilateral time test, bilateral test…
Purdue Pegboard Test description
Assembly fine motor dexterity - good for people that need to do repetitive fine motor
Is timed
Different tests can be performed - just place pins in holes, or the assembly one where they put a pin, then washer, then collar and so on
Mobergs Pickup test - description
Pick up different shaped items
Times test
Nine-hole peg test
Most common
Take pins from bowl and put them into holes and then take them out
Sensory - Sensation Testing
Two point discrimination
Light touch
Vibration
Temperature
Sensory testing can include
Sensation
Proprioception and Kinesthesia
Stereognosis
Proprioception
Knowing where you are in space
Can place thumb in flexion and ask them to mimic it on other side (eyes closed)
Kinesthesia
Sense of motion or movement
Move them and then have them describe in what direction you moved them (eyes closed)
Varus and Valgus Stress Testing - what are they testing
Dorsal collateral ligaments
Describe varus and valgus stress testing
Can do it at MCP, PIP, DIP
Pos. if excessive asymmetrical mobility
Ulnar gap = valgus
Radial gap = varus
TFCC load test - test for what
Triquetrum and/or disc integrity
TFCC load test - description
Active = patient pushes against armrest
Passive = ROM with axial loading
Have them hold hands out as if hand shake with them - palpate the disc, u. styloid, and triquetrum - have them push into your hand and can add the axial rotation
Thumb UCL Testing - stress placed where
On the UCL of the thumb MCP joint
Thumb UCL testing - description
Place a radial directed force (valgus) to the MCP
If more than 30 mvmnt = rupture
Murphy’s Sign - looking for what
Dislocation of the lunate
Murphy’s Sign - description
Patient makes a fist
Positive if 3rd MC is level with the 2nd and 4th MC
Watson’s Test - looking at what
Scaphoid shift
Scapholunate ligament stability
Watson’s Test - Description
Palpate the scaphoid
Passively move the patients wrist from ulnar deviation and ext into radial deviation and flexion
Positive if painful and scaphoid shifts
Finkelstein’s Test - what is it assessing
1st extensor compartment tenosynovitis
Finkelstein’s Test - description
Patient makes fist with thumb enclosed in palm
Patient ulnar deviates thumb
Positive if pain present in snuff box
Trigger Finger Test - testing what
flexor tenosynovitis
Trigger Finger Test - how to
Therapist palpate volar surface of PIP
Patient flexes and extends their PIP
Positive if snapping occurs
Tap Test - what is it assessing
Possible digital fracture
Tap test - how to
With digit extended, therapist taps on end of the finger
Positive if painful
Tinel’s test- for median nerve - where do you do it
Tap over volar aspect of carpal tunnerl
Pos if tingling under point of contact with radiatin
Tinel’s test - for ulnar nerve- where do you do it
Tap over Guyon’s tunnel (pisiform hook of hamate)
Pos tingling under point of contact with radiation
Phalen’s test - for what nerve and how to
Median
Patient flexes elbows to 90 and then fully flexes wrists for 60 sec (gets ulnar too though - so to take it out have them extend elbows and do it)
Pinch test - for what nerve and how to
Median
Patient attempts a tip to tip pinch between thumb and 2nd digit
FDP, FPL
Pos if end up in pulp to pulp pinch
Fromet’s test - for what nerve and how to
Ulnar
A piece of paper held in lateral apprehension grip
Therapist tries to pull paper away
Pos if paper easily pulled away
Wartenberg’s Sign - for what nerve and how to
Ulnar
Therapist passively spreads patients fingers apart and patient tries to adduct fingers
Pos if patient can’t bring 5th finger to midline
Allen’s test - what for
Circulation - radial and ulnar arterial supply
Allen’s test - what is it
Patient makes a fist and relaxes repetitively and then squeeze hand tightly
Therapist compress both radial and ulnar arteries
Patient opens hand
Therapist releases pressure over one artery and watches for flush in hand and then releases the other artery
Pos if delayed flush to portion of hand
Digital blood flow - what is it
Therapist compresses nail bed and then notes time for blood to return to nail (flush)
Pos if delayed (avg 3 sec)
Joint accessory mobility testing - Radiocarpal arthrokinematics
Open chain - convex carpals on concave radius
Opposite
Joint accessory mobility testing - Radiocarpal - movement with extension
Roll dorsal
Glide palmarly
So to inc ext glide palmarly
Joint accessory mobility testing - Radiocarpal - movement with flexion
Roll palmarly
Glide dorsal
So to inc flex glide dorsally
Joint accessory mobility testing - Radiocarpal - to increase ulnar deviation you can do
a radial glide
Ulna rolls, radius glides
Stabilize radius and move carpals in radial direction and distally too (rotary component)
Joint accessory mobility testing - radiocarpal - to increase radial deviation you can do
an ulnar glide
Radius rolls, ulna glides
Stabilize radius and move carpals in ulnar direction and distally too (rotary component)
Joint accessory mobility testing - midcarpal - arthrokinematics
Convex distal row on concave proximal row - Opp
But not that clear in every person so you will want to mobilize volarly and dorsaly
Joint accessory mobility testing - midcarpal - what happens with extension arthrokinematically
Roll - dorsal
Glide - palmar
What percents happen from radiocarpal and midcarpal joints with flex/ext
60% radiocarpal
30-40% midcarpal
