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Special Tests Flashcards

1
Q

Lump special tests

A

Transillumination

Ascultate

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2
Q

Ulcer special tests

A

Peripheral pulses

light touch and pressure sensation

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3
Q

Upper limb neurological special tests

A

Pronator drift

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4
Q

How do you test pronator drift

A

Patients arms outstretched and supinated
Examiner gently taps on one of the outstretched arms
This should be corrected

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5
Q

What is a positive for pronator drift

A

Patient’s arms start to pronate and drift downwards

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6
Q

What does a positive pronator drift test suggest

A

Collateral upper motor neurone lesion

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7
Q

Lower limb neurological special tests

A

Rombergs test

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8
Q

How do you perform Rombergs test

A

Patient stands with feet together, arms outstretched in front of the them, hands suppinated

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9
Q

What is are abnormal Romberg test results

A

Patient cannot perform test with their eyes open. Or when eyes closed the patient rocks and sways

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10
Q

What does inability to perform Romberg test with eyes open suggest

A

Cerebellar lesion

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11
Q

What does rocking and swaying when the eyes are closed suggest in Romberg test

A

Loss of proprioception

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12
Q

Hip special tests

A

Thomas’ test
Assess gait
Trendelenburgs test

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13
Q

How do you perform Thomas’s test

A

Place hand between lumbar spine and bed. Flex the ipsilateral hip and look for correction of lumbar lordosis

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14
Q

What is an abnormal Thomas’s test

A

The contralateral leg (hip you are testing (not touching)) will raise off the bed

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15
Q

What does an abnormal Thomas’s test suggest

A

Fixed flexion deformity

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16
Q

How do you assess gait

A

Watch the patient walking

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17
Q

What is an abnormal gait in a hip examination

A

Waddling gait

Antalgic gait

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18
Q

What does an abnormal gait in a hip examination suggest

A 
Waddling= hip pain or proximal muscle weakness
Antalgic= pain on weight bearing
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19
Q

How do you perform trendelenburgs test

A

Ask the patient to stand on one leg

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20
Q

What is an abnormal trendelenburgs test result

A

The pelvis will dip on the contralateral side (sound side sags)

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21
Q

What does an abnormal trendelenburgs test result suggest

A

Reduced abductor muscle strength

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22
Q

What are the abductors of the hip

A

Gluteus medius, gluteus minimus, tensor fascia latae and sartorius

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23
Q

Cranial nerve examination special tests

A

Rinnes Test

Webers Test

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24
Q

How do you perform Rinnes test

A

Hold 512Hz tuning fork on the mastoid and then immediately move it to the external acoustic meatus.

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25
What is an abnormal Rinnes test result
The tuning fork will sound louder when on the mastoid
26
What does an abnormal Rinnes test result suggest
Conductive hearing loss | sensorineural=quitter at both
27
How do you perform Webers test
Hold 512Hx tuning fork on the forehead in the midline
28
What is an abnormal Webers test
Sound is louder in one of the ears
29
What does an abnormal Webers test suggest
``` Conductive= louder in affected ear Sensorineural= louder in normal ear ```
30
Knee examination special tests
Lachmans test | McMurrays test
31
What is an abnormal gait, knee examination
Abnormal toeing angle or antalgic gait
32
How do you perform Lachmans test
Flex knee to 20 degrees. One hand behind tibia and thumb on tuberosity. Pull thigh anteriorly with other hand.
33
What is an abnormal lachmans test
A soft end point of the tibia on the femur
34
What does an abnormal Lachmans test suggest
ACL damage
35
How do you perform McMurrays test
Flex hip to 90 degrees and maximally flex the knee. Externally rotate the knee whilst grandually extending. Repeat during internal rotation.
36
What is an abnormal McMurrays test
Palpable, audible or painful click over the medial joint line
37
What does an abnormal McMurrays test suggest
Meniscal tear
38
Spine examination special tests
Straight leg raise Bowstring test Femoral stretch test
39
How do you perform a straight leg raise
Patient lies flat Passively flex their thigh with their leg extended Lower the leg gradually and then dorsiflex foot (that makes it worse= Lasegue's sign)
40
What is an abnormal straight leg raise
Back or leg pain | Paraesthesia or pain in a nerve root distribution
41
What does an abnormal straight leg raise suggest
Back pain= central disc prolapse Leg pain= lateral protrusion Paraesthesia or pain in a nerve root distribution= nerve root irritation
42
How do you perform a Bowstring test
Perform straight leg raise If pain, flex knee slightly Apply pressure with thumb in the popliteal fossa to stretch tibial nerve
43
What is an abnormal Bowstring test
Radiating pain and paraesthesia
44
What does an abnormal Bowstring test suggest
Nerve root irritation
45
How do you perform a femoral stretch test
With patient prone and anterior thigh fixed to couch | Flex each knee in turn
46
What is an abnormal femoral stretch test
Pain in the skin of the anterior compartment of the thigh
47
What does an abnormal femoral stretch test suggest
Protrusion of a vertebral disc at L2-4
48
Shoulder examination special tests
``` Rotator cuff -resisted active abduction -resisted active external rotation -resisted active interal roatation Acromioclavicular joint pathology ```
49
How do you test resisted active abduction
Abduct the arm.
50
What is an abnormal resisted active abduction
Painful between 60 and 120 degrees
51
What does an abnormal resisted active abduction suggest
Supaspinatus injury
52
How do you test resisted active external rotation
Resist external rotation, with the elbow flexed at 90 degrees
53
What does an abnormal active external rotation suggest
Infraspinatus and teres minor injury
54
Which muscle initiates abduction
Supraspinatus
55
Which muscle abducts up to 90 degrees
Deltoid
56
Which muscle causes abduction beyond 90 degrees
Trapezius and serratus anterior
57
How do you test active internal rotation
Lift off test. Place hand in small of back push dorsum of hand off the back
58
What is an abnormal test of active internal rotation
Inability to move the dorsum of the hand off the back
59
What does an abnormal test of active internal rotation suggest
Subscapularis rupture or dysfunction
60
How do you test acromioclavicular joint pathology
Scarf test. Place arm in forced adduction across body at 90 degrees of flexion at the shoulder.
61
What is an abnormal test of acromioclavicular joint pathology
Pain or tenderness across the ACJ
62
What does abnormal test of acromioclavicular joint pathology suggest
Acromioclavicular joint pathology
63
Elbow examination special tests
Medial epicondylitis | Lateral epicondylitis
64
How do you test for medial epicondylitis
In supinated position ask patient to make a fist and flex their wrist against resistance
65
What is an abnormal test for medial epicondylitis
Pain at the medial epicondyle
66
How do you test for lateral epicondylitis
In pronated position, ask patient to extend their wrist against resistance.
67
What is an abnormal test for lateral epicondylitis
Pain at the lateral epicondyle (extensor muscle origin)
68
Hand examination special tests
``` Tinels test Phalens test Median nerve function Ulnar nerve function Radial nerve function ```
69
How do you perform tinels test
Tapping strongly but not too fast over the median nerve as it crosses under the flexor retinaculum via the carpal tunnel
70
What is an abnormal tinels test
Pain, numbness or tingling in the cutaneous distribution of the median nerve
71
What does an abnormal tinels test suggest
Carpal tunnel syndrome
72
How do you perform phalens test
Hold both wrists of the patient;s in palmar flexion for one minute. Compress carpal tunnel with thumbs.
73
What is an abnormal phalens test
Pain, numbness or tingling in the cutaneous distribution of the median nerve
74
What does an abnormal phalens test suggest
Carpal tunnel syndrome
75
How do you test median nerve function
Test palmar abduction of the thumb against resistance | Median nerve distribution sensation
76
What is an abnormal median nerve function test
Reduced power and sensation
77
How do you test the ulnar nerve function
Ask the patient to cross their index and middle fingers | Test sensation in ulnar nerve distribution
78
What is an abnormal ulnar nerve function
Reduced power and sensation
79
How do you test radial nerve function
Test wrist dorsiflexion against resistance | Test sensation in the anatomical snuffbox

2b (28 decks)

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