Special Tests Descriptions UE Flashcards
1
Q
Apprehension Test for Anterior Shoulder Dislocation
A
- Patient positioned in supine
- Shoulder Abduction 90, Elbow Flexion 90
- Therapist laterally rotates patient’s shoulder
- Positive test indicated by look of apprehension or a facial grimace prior to reaching an end point
2
Q
Apprehension Test for Posterior Shoulder Dislocation
A
- Patient supine
- Shoulder in 90 of Flexion and Medial Rotation
- Therapist applies posterior force through long axis of the humerus
- Positive test indicated by look of apprehension or a facial grimace prior to reaching an end point
3
Q
Speed’s Test
A
Biceps Tendon Pathology
- Patient in sitting or standing
- Elbow Extended and Forearm Supinated
- Therapist palpates bicipital groove and places the other hand on volar surface of forearm
- Therapist resists active shoulder flexion
- Positive test indicated by pain or tenderness in the bicipital groove region
4
Q
Yergason’s Test
A
Biceps Tendon Pathology
- Patient in sitting
- Elbow Flexed 90 and forearm pronated, humerus stabilized against patient’s thorax
- Therapist palpates bicipital groove and places the other hand on the patient’s forearm
- Patient instructed to actively supinate and laterally rotate against resistance
- Positive test indicated by pain or tenderness in bicipital groove
5
Q
Drop Arm Test
A
Rotator Cuff Pathology/Impingement
- Patient in sitting or standing
- Shoulder Abducted to 90
- Patient instructed to slowly lower arm to side
- Positive test indicated by patient failing to slowly lower the arm or by the presence of sever pain
6
Q
Hawkins-Kennedy
A
Rotator Cuff Pathology/Impingement
- Patient in sitting or standing
- Therapist flexes patient’s shoulder to 90 and then medially rotates the arm
- Positive test indicated by pain. May involve the supraspinatus tendon
7
Q
Infraspinatus Test
A
Rotator Cuff Pathology/Impingement
- Patient in standing
- Elbow Flexed to 90 and Shoulder in 45 of Medial Rotation
- Patient resists as therapist applies medial pressure to forearm
- Positive test indicated by pain or weakness, suggesting infraspinatus strain/tear
8
Q
Neer Impingement Test
A
Rotator Cuff Pathology/Impingement
- Patient in sitting or standing
- Therapist puts one hand on posterior aspect of scapula and other hand stabilizing elbow
- Therapist takes arm through flexion
- Positive test indicated by facial grimace or pain, and may indicate impingement of supraspinatus tendon
9
Q
Supraspinatus Test
A
Rotator Cuff Pathology/Impingement
- Patient has arm in 90 of Abduction, and 30 of Horizontal Adduction with the thumb downward
- Therapist resists patient’s attempt to abduct arm
- Positive test indicated by weakness or pain, may indicate tear of the supraspinatus tendon, impingement or suprascapular nerve involvement
10
Q
Adson Maneuver
A
Thoracic Outlet Syndrome
- Patient in sitting or standing
- Therapist monitors radial pulse, asks patient to rotate head to face the test shoulder. Then asked to extend head while therapist laterally rotates and extends the patient’s shoulder
- Positive test indicated by absent or diminished radial pulse
11
Q
Allen Test (1)
A
Thoracic Outlet Syndrome
- Patient in sitting or standing
- Test arm in 90 of abduction, lateral rotation, and elbow flexion
- Patient rotates head away from the test shoulder
- Therapist monitors radial pulse
- Positive test indicated by an absent or diminished pulse when head rotates away
12
Q
Roos Test
A
Thoracic Outlet Syndrome
- Patient in sitting or standing
- Arms positioned in 90 of abduction, lateral rotation, and elbow flexion
- Patient opens/closes hands for 3 minutes
- Positive test indicated by inability to maintain test position, weakness of arms, sensory loss or ischemic pain
13
Q
Varus Stress Test
A
Ligamentous instability
- Patient in sitting
- Elbow in 20 to 30 degrees of flexion
- Therapist places one hand on elbow, and one proximal to the patient’s wrist
- Therapist applies a varus force to test the Lateral Collateral Ligament while palpating lateral joint line
- Positive test indicated by increased laxity in the LCL when compared to the contralateral limb, apprehension, or pain
14
Q
Valgus Stress Test
A
Ligamentous Instability
-Same as Varus Test, but therapist applies a valgus force to test the Medial Collateral Ligament
15
Q
Cozen’s Test
A
Epicondylitis
- Patient in sitting
- Elbow in slight flexion
- Therapist places thumb on lateral epicondyle and stabilizes elbow joint
- Patient asked to make a fist, pronate, radially deviate and extend wrist against resistance
- Positive test indicated by pain in lateral epicondyle region or muscle weakness
16
Q
Lateral Epicondylitis Test
A
Epicondylitis
- Patient in sitting
- Therapist stabilizes elbow and other hand on dorsal aspect of patient’s hand distal to PIP
- Patient asked to extend 3rd digit against resistance
- Positive test indicated by pain or muscle weakness in lateral epicondyle region
17
Q
Medial Epicondylitis Test
A
Epicondylitis
- Patient in sitting
- Therapist palpates medial epicondyle region and supinates the patient’s forearm, extends the wrist, extends the elbow
- Positive test indicated by pain in medial epicondyle region
18
Q
Tinel’s Sign (elbow)
A
Neurological Dysfunction
- Patient in sitting
- Therapist taps between the olecranon process and medial epicondyle
- Positive test indicated by tingling sensation in the ulnar nerve distribution of the forearm, hand, fingers.
- May indicate ulnar nerve compression or compromise
19
Q
Ulnar Collateral Ligament Instability Test
A
Ligamentous Instability - “Gamekeeper’s thumb” or “Skier’s Thumb.”
- Patient in sitting
- Therapist holds patient thumb in extension and applies valgus force to the MCP joint of thumb
- Positive test indicated by excessive valgus movement
- May indicate tear of the Ulnar collateral and accessory ligaments
20
Q
Allen Test
A
Vascular Insufficiency
- Patient in sitting or standing
- Patient opens / closes hand several times in succession, then maintains hand in closed
- Therapist compresses radial and ulnar arteries
- Patient relaxes hand and therapist releases pressure on one of the arteries while observing hand color
- Positive test indicated by delayed or absent flushing of the radial or ulnar half of the hand
- May indicate radial or ulnar artery occlusion
21
Q
Froment’s Sign
A
Neurological Dysfunction
- Patient in sitting or standing
- Patient holds piece of paper between thumb and index finger
- Therapist attempts to pull paper away from patient
- Positive test indicated by patient flexing distal phalanx of the thumb due to adductor pollicis muscle paralysis.
- If at the same time, the patient hyperextends the MCP joint of the thumb, it is termed Jeanne’s Sign
- Both findings may indicate ulnar nerve compromise or paralysis
22
Q
Phalen’s Test
A
Neurological Dysfunction
- Patient in sitting or standing
- Therapist flexes patient’s wrist maximally and asks the patient to hold the position for 60 seconds
- Positive test indicated by tingling in thumb, index, middle fingers and lateral half of the ring finger
- May indicate carpal tunnel syndrome due to median nerve compression
23
Q
Tinel’s Sign (wrist/hand)
A
Neurological Dysfunction
- Patient in sitting or standing
- Therapist taps over volar aspect of the wrist
- Positive test indicated by tingling of thumb, index, middle fingers, lateral half of the ring finger distal to the contact site
- May indicate carpal tunnel syndrome due to median nerve compression
24
Q
Finkelstein Test
A
Miscellaneous
- Patient in sitting or standing
- Asked to make a fist with the thumb tucked inside the fingers
- Therapist stabilizes patient’s forearm and ulnar deviates wrist
- Positive sign indicated by pain over abductor pollicis longus and extensor pollicis brevis tendons at the wrist
- May indicate tenosynovitis in the thumb (de Quervain’s disease)
