Special Tests Flashcards
Spurling Test
extend, side bend C spine to side tested, push down
positive - pain radiates to ipsilateral arm
help localize affected nerve root
Wallenberg’s Test
tests vertebral artery insufficiency
flex neck and hold for 10 seconds, extend neck and hold for 10 sec
Positive test = dizziness, visual changes, lightheadedness, eye nystagmus
Underberg test
neck bent backward and head fully rotated to either side
vascular or neuro sx = HVLA contraindicated
Adson Test
Thoracic outlet sn d/t tight scalene muscles
monitor pulse
extend elbow, shoulder is extended, externally rotated, slightly abducted
Deep breath and turn head toward ipsilateral arm
Positive if severely decreased or absent radial pulse
Wright’s test
Thoracic outlet sn d/t pec minor and coracoid process compression
hyperabduct arm above head w/t some extension, positive if severely decreased or absent radial pulse
Costaclavicular syndrome test (Military posture test)
thoracic outlet sn d/t clavicle and first rib compression
radial pulse monitored while depressing and extending shoulder
positive if severely decreased or absent radial pulse
Apley’s scratch test
ROM of shoulder
Look for asymmetry or any limitations
Drop arm test
abduct shoulder 90 then slowly lower arm
positive if can’t lower smoothly or drops at 90 degrees
Speed’s test
bicep tendon in bicipital groove
extend elbow, flex shoulder and supinate forearm
Resist flexion of shoulder
positive if tenderness in bicipital groove
Yergason’s test
biceps tendon in bicipital groove
flex elbow 90
pull down on elbow, externally rotate forearm while patient resists motion
Pain as biceps tendon pops out of bicipital groove
Allen’s test
tests adequacy of blood supply to hand by radial and ulnar a.
occlude both arteries, pt makes fist
release one artery watch for flushing of the hand, and repeat with other artery
Positive if not adequately supplying hand
Finkelstein Test
tests tenosynovitis in abductor pollicis longus and extensor pollicis brevis tendons at wrist
De Quervain’s disease
First with thumb tucked inside finger
physician deviates wrist ulnarly while stabilizing forearm
Positive - pain over tendons at wrist
Phalen’s test
flex wrist, old for 1 minute
Tingling sensation in thumb, index, middle, lateral ring indicates carpal tunnel syndrome
Reverse Phalen’s Test (Prayer’s test)
pt extends wrist, gripping the physician’s hand
Tingling sensation in thumb, index, middle, lateral ring indicates carpal tunnel syndrome
Tinel’s test
tap volar aspect of patients transverse carpal ligament
Tingling sensation in thumb, index, middle, lateral ring indicates carpal tunnel syndrome
Also can use to check ulnar nerve entrapment at elbow, peroneal compression at fibular head, posterior tibial nerve entrapment at ankle
Hip drop test
sidebending ability of lumbar spine and thoracolumbar junction
Straight leg Raising test (Lasegue’s test)
Tests sciatic nerve compression
Knee extended and stabilized, lift upward, flexing hip until pt feels discomfort.
back off then dorsiflex foot (Braggard’s test) - stretches sciatic
If no pain: tight hamstrings
If pain: sciatic origin -> positive straight leg
Pelvic side shift test
Determines if sacrum is in midline
stabilize shoulder and push opposite hip, and switch
positive on site of freer translation
Seen in flexion contracture of iliopsoas (psoas syndrome)
Flexion contracture of right iliopsoase -> positive pelvic shift test to the left
Trendelenberg test
tests gluteus medius strength (hip abductor)
Lumbosacral spring test
tests if sacral base is tilted posterior
backward bending test (Sphinx test)
positive if sacral base moves posterior
If thumbs become more symmetric w/ lumbar extension, part of sacral base moved anterior
If more asymmetric, part of the base has moved posterior
Ober’s test
tight tensor fascia lata and IT band
flex knee to 90, abduct hip, slightly extend (IT over greater trochanter)
slowly allow thigh to fall to table
Positive if thigh remains abducted
Patrick’s test
SI and hip joint
FABER - figure 4
Thomas test
psoas test
flex one hip up causes contralateral knee to raise off table
Anterior drawer - knee
ACL - tibia slides out under femur = positive for ACL tear
Posterior drawer - knee
PCL - tibia moves backward under femur = positive PCL tear
Apley’s compression and distraction tests
Compression: meniscal tear
- prone, knee 90, compress down through heel, add internal and external rotation of tibia
- positive if pain
Distraction: MCL or LCL
- distract and internal and external rotation added
- pain
McMurray’s Test
Posterior aspect of medial meniscus
- fully extend knee, esternally rotate, add valgus stress
- positive if palpable or audible click
Posterior aspect of Lateral meniscus
-internal rotation of tibia, Varus stress on knee
Patellar grind test
assess posterior articular surface of patella - chondromalacia patellae seen in patello-femoral syndrome
Supine, extended knee. Push patella distally, have patient contract quads
roughness of articular surface will grind
palable and painful when quads contract and move patella
Positive if pain with contraction
Valgus and varus stress test of knee
Valgus stress test - lateral force, assess medial
-gapping = MCL tear
Varus stress test - medial force, assess lateral
-gapping = LCL tear
Anterior draw test of ankle
assess ATF, some deltoid
hold 20 degrees of dorsiflexion as pulling foot forward
excessive motion positive
if b/l injury - excessive motion of talus
Deviation to one side - ligament to opposite side of foot are damaged
