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NPTE > Special Tests > Flashcards

Special Tests Flashcards

1
Q

Shoulder Dislocation

A
  • Apprehension Test Anterior Dislocation
  • Apprehension Test Posterior Dislocation
  • Sulcus sign
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2
Q

Apprehension Test Anterior Dislocation

A
  • Patient: Supine, Shoulder Abduction 90, Elbow Flexion 90
  • Therapist: ER pt’s shoulder
  • (+) Apprehension or grimace
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3
Q

Apprehension Test Posterior Dislocation

A
  • Patient: Supine, 90 shoulder flexion, IR and flex pt shoulder until hand touches their own chest
  • Therapist: supports scapula, applies downward lateral force through the elbow
  • (+) Apprehension or grimace
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4
Q

Sulcus Sign

A
  • Patient: standing, shoulder abduction 20-50
  • Therapist: grasps pt’s elbow and pulls inferiorly
  • (+) inferior instability = depression seen between the acromion and humeral head; 1+ = <1cm, 2+ = 1-2cm, 3+ >2cm
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5
Q

Biceps Tendon Pathology Tests

A
  • Ludington’s Test
  • Speed’s Test
  • Yergason’s Test
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6
Q

Ludington’s Test

A
  • Patient: sitting with arms placed overhead and elbows pointing towards the ceiling
  • Have the patient contract and relax biceps
  • (+) absence of mvmt in the biceps tendon = rupture of long head of biceps
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7
Q

Speed’s Test

A
  • Patient: sitting or standing, shoulder flexion 90, elbow extension, supination
  • Therapist: one hand on bicipital tendon and the other at patient’s wrist; resists pt’s active shoulder flexion
  • (+) pain or tenderness in the bicipital groove; may indicate bicipital tendonitis
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8
Q

Yergason’s Test

A
  • Patient: Sitting with elbow flexed to 90, forearm pronation, humerus against thorax
  • Therapist: one hand on bicipital groove, and one hand on pt’s forearm; patient supinates and ER arm against resistance
  • (+): pain or tenderness in the bicipital groove
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9
Q

Rotator Cuff Pathology/Impingement Tests

A
  • Drop Arm Test
  • Hawkins-Kennedy Impingement Test
  • Infraspinatus Test
  • Lateral Rotation Lag Sign
  • Lift Off Sign ( Medial Rotation Lag Sign)
  • Neer Impingement Test
  • Supine Impingement Test
  • Supraspinatus Test
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10
Q

Drop Arm Test

A
  • Patient: Sitting or standing, shoulder abduction 90; patient is asked to slowly lower their arm to their side
  • (+): severe pain, failing to slowly lower arm = Rotator cuff tear
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11
Q

Hawkins-Kennedy Impingement Test

A
  • Patient: sitting or standing 90 degrees shoulder flexion, 90 degrees of elbow flexion, IR
  • Therapist: stabilizes at the elbow and IR the arm
  • (+): pain = impingement of supraspinatus
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12
Q

Infraspinatus Test

A
  • Patient: stands, elbow flexion 90 and IR 45
  • Therapist: applies resistance at the forearm in the direction of IR and the patient presses into ER
  • (+):pain or weakness = infraspinatus strain/tear
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13
Q

Lateral Rotation Lag Sign

A
  • Patient: standing or sitting, shoulder scaption 20, elbow flexion 90, end-range ER; patient holds position
  • (+): infraspinatus and teres minor = cannot hold position [ can vary elevation level]
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14
Q

Lift Off Sign (Medial Rotation Lag Sign)

A
  • Patient: stands, dorsum of hand on back; patient is asked to move handoff back
  • (+): inability to hold position = subscapularis lesion
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15
Q

Neer Impingement

A
  • Patient: sitting or standing
  • Therapist: one hand on pt’s scapula and on patient’s extended elbow; Therapist elevates patient’s arm into flexion
  • (+): facial grimace or pain = shoulder impingement
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16
Q

Supine Impingement

A
  • Patient: supine,
  • Therapist: passively flex pt’s arm into flexion and ER; then ADD arm until arm touches ear; then IR rotates the arm
  • (+) a significant increase in pain with IR
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17
Q

Supraspinatus Test

A
  • Patient: standing, shoulder abduction 90, horizontal adduction 30 with the thumb pointing down
  • Therapist: resists pt’s attempt to abduct
  • (+): weakness or pain = supraspinatus tear
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18
Q

Thoracic Outlet Syndrome Tests

A
  • Adson Maneuver
  • Allen Test
  • Costoclavicular Syndrome Test
  • Roos Test
  • Wright Test
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19
Q

Adson Maneuver

A
  • Patient: sitting or standing, extension, ER shoulder, abduct; rotates head to face the extended arm
  • Therapist: monitors radial pulse
  • (+): radial pulse diminishes or absent = thoracic outlet syndrome
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20
Q

Allen Test

A
  • Patient: sitting or standing, test arm 90 abduction, 90 ER, and 90 elbow flexion (pitcher position); patient rotates face to opposite shoulder
  • Therapist: monitors radial pulse
  • (+): absent or diminished radial pulse when the head is rotated
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21
Q

Costoclavicular Syndrome Test

A
  • Patient: sitting, patient extends chest to ceiling (military posture) by depressing and retracting shoulders; humerus extended and abducted 30 degrees
  • Therapist: monitors radial pulse
  • (+): absent or diminished pulse = thoracic outlet syndrome by compression of the subclavian artery btwn rib and clavicle
22
Q

Roos Test

A
  • Patient: sitting or standing, shoulder 90 abduction, 90 ER, 90 flexion (pitcher position); patient is asked to open and close hands for 3 minutes
  • (+): inability to maintain test position, weakness of the arms, sensory loss or ischemic pain; may indicate TOS
23
Q

Wright Test (Hyperabduction Test)

A
  • Patient: sitting or supine,
  • Therapist:
  • (+): absent or diminished radial pulse = compression in the costcoclavicular space
24
Q

Acromioclavicular Crossover

A
  • Patient: 90 flexion and full adduct patients arm
  • Therapist: applies overpressure
  • (+): pain over acromioclavicular joint
25
Q

Active Compression Test (O’Brien’s Test)

A
  • Patient: stands with shoulder flexed to 90, horizontally adducts to 10-15 degrees, and medially rotates so the thumb points down
  • Therapist: applies overpressure to resist shoulder flexion
  • (+): superior labral tear = pain with medial rotation and relief with lateral rotation
26
Q

Glenoid Labrum Tear Test

A
  • Patient: supine, abduct and laterally rotates the arm over the head
  • Therapist: hand on posterior aspect of the humeral head, stabilize at the elbow; the therapist applies an anterior directed force on the humerus
  • (+): clunk or grinding sound = glenoid labral tear
27
Q

Jerk Test

A
  • Patient: sitting, shoulder abducted to 90, medial rotation with elbow bent
  • Therapist: axial compression force through the patient’s elbow while horizontally adducting the shoulder
  • (+): sudden clunk or jerk as the humeral head subluxes posteriorly and clunks/jerks again when back to starting position OR P = posterior labral tear
28
Q

Upper Limb Tension Test

A
  • ULTT 1: Median
  • ULTT 2: Median
  • ULTT 3: Radial
  • ULTT 4: Ulnar
29
Q

ULTT1

A
  • Median
    1. shoulder depression
    2. shoulder abduction 110
    3. flex elbow to 90
    4. ER shoulder
    5. Ext wrist and fingers
  • confirm neurological take-off tension; ask pt to LF to opp side whcih should increase tension again
30
Q

ULTT2

A
  • Median
    1. Depress pt’s shoulder with your hip
    2. abduct the arm to 10
    3. flex elbow to 90
    4. supinate forearm
    5. extend fingers and wrist
    6. slowly extend pt’s elbow until sx are provoked
31
Q

ULTT3

A
  • radial nerve
    1. depress pts shoulder with hip
    2. Arm 10 abduction and flex elbow to 90 degrees
    3. Pronate the forearm and flex the fingers
    4. extend the elbow
32
Q

ULTT 4

A
  • Ulnar
    1. depress pts shoulder
    2. 90 degrees of shoulder abduction
    3. supinate forearm
    4. extend fingers and wrist
    5. ER of shoulder
    6. bring fingers to ear
33
Q

Elbow Ligamentous Instability Tests

A
  • Valgus Stress Test

- Varus Stress Test

34
Q

Elbow Valgus Stress Test

A
  • Patient: Sitting with 20-30 elbow flexion
  • Therapist: one hand on the elbow and other hand on proximal wrist; apply a valgus force
  • (+) increased laxity, apprehension, or pain = MCL sprain
35
Q

Elbow Varus Stress Test

A
  • Patient: Sitting with 20-30 elbow flexion
  • Therapist: one hand on the elbow and other hand on proximal wrist; apply a varus force
  • (+) increased laxity, apprehension, or pain = LCL sprain
36
Q

Epicondylitis Tests

A
  • Cozen’s Test
  • Lateral Epicondylitis Test
  • Medial Epicondylitis Test
  • Mill’s Test
37
Q

Cozen’s Test

A
  • Patient: sitting with elbow slightly flexed, makes a fist, pronates forearm, radially deviates, and extends the wrist against resistance
  • Therapist: applies resistance
  • (+) P or mm weakness
38
Q

Lateral Epicondylitis Test

A
  • Patient: sitting with the arm on the table with a slight bend in the elbow; hand pronates on table
  • Therapist: stabilizes the elbow with one hand and places the other hand on the dorsal aspect of the patient’s hand distal to the PIP joint. The patient is asked to extend the 3rd digit against resistance.
  • (+) indicated by pain in the lateral epicondyle region or mm weakness = lateral epicondylitis
39
Q

Medial Epicondylitis Test

A
  • Patient: sitting
  • Therapist: palpates the medial epicondyle and supinates the patient’s forearm, extends the wrist, and extends the elbow
  • Patient will try to extend 3rd digit as therapists pins down at the 3 rd PIP jt
  • (+) P = medial epicondylitis
40
Q

Mill’s Test

A
  • Patient: sitting
  • Therapist: palpates the lateral epicondyle, pronates the patient’s forearm, flexes the wrist and extends the elbow
  • (+) Pain in the lateral epicondyle
41
Q

Neurological Dysfunction Tests

A
  • Elbow Flexion Test
  • Pinch Grip Test
  • Tinel’s Sign
42
Q

Ulnar Collateral Ligament Instability Test

A
  • Therapist: applies a valgus force to the thumb

- (+) excessive valgus = tear (Gamekeeper’s thumb or skier’s)

43
Q

Allen Test (Vascular Insufficiency)

A
  • Patient: supinated, fight tist
  • Therapist: compresses radial and ulnar arteries; therapist then asks pt to relax hand while the therapist releases one of the arteries
  • (+) delayed or absent flushing of the radial or ulnar half of the hand and may indicate occulsion
44
Q

Bunnel-Littler Test

A
  1. Patient extension of MCP and therapist flexes PIP
    If the PIP does not flex there might be intrinsic mm or capsular tightness
  2. flexion of MCP and flexion PIP
    If the PIP it fully flexes with MCP flexion, there may be intrinsic mm tightness without capsular tightness
45
Q

Tight Retinacular Ligament Test

A
  • Therapist: 1. PIP stabilized and flex DIP 2. flex PIP and Flex DIP
  • (+) If the therapist is unable to flex the distal DIP jt, the retinacular ligaments or capsule may be tight
  • (+) If the therapist is able to flex the DIP with PIP flexion, the retinacular ligaments may be tight and the capsule may be normal
46
Q

Carpal Compression Test (Median Nerve Compression Test)

A
  • Patient: supinates and relaxes hand on table
  • Therapist: place thumbs over the median nerve for 30 seconds
  • (+) P or paraesthesia = carpal tunnel syndrome
47
Q

Froment’s Sign

A
  • Patient: hold’s piece of paper btwn thumb and index finger
  • Therapist: attempts to pull the paper away
  • (+) patient flexes distal phalanx of the thumb and hyperextends the metacarpophalangeal joint of the thumb (Jeanne’s sign) = Ulnar nerve compression or paralysis
48
Q

Phalen’s Test

A
  • Patient: flexes wrist by touching dorsal hands together pointing down; hold for 60 secs
  • Therapist:
  • (+) tingling in fingers 1-3 and 1/2 = median nerve compression
49
Q

Tinel’s Sign

A
  • Patient:
  • Therapist:
  • (+)
50
Q

Finkelstein Test

A
  • Patient: make a fist with thumb tucked inside the fingers
  • Therapist: stabilizes forearm; grab pt’s fist and slowly ulnarly deviate wrist
  • (+) P over the and policies longus and extensor policies brevis tendon - de Quervain’s disease
51
Q

Grind Test

A
  • Patient:
  • Therapist: grabs pt’s thumb and applies compression and rotation to the metacarpal
  • (+) grinding or P = degenerative joint disease
52
Q

Murphy’s Sign

A
  • Patient: makes a fist

- (+) 3rd metacarpal remaining level with the 2nd and 4th metacarpals. May indicate dislocation of lunate

NPTE (3 decks)

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