Special Tests - Musculoskeletal Flashcards
how is the type of test determined
nature of the chief complaint
sxs
previous physical examination results
tests may be
specific to areas of involvement
allen test
pt opens and closes fist several time
on the fifth time they hold it close while the PT occludes the radial and ulnar arteries w/ pressure
hand is then opened
one artery is released
tinnel sign
vigorous tapping of the ulnar nerve b/w the olecranon and medial epicondyle
what is tinnel sign looking for
neuroma or neuritis
will send a sensation of “pins and needles” down the forearm
phalens test
attempts to reproduce sxs of carpal tunnel
how do we do the phalens test
pt places the dorsal aspects of both hands against each other
push wrists into maximum flexion
lateral epicondylitis test could be performed
passively and actively
active lateral epicondylitis test
pt makes a fists and then extends the wrist
while stabilizing the forearm, PT attempts to force the wrist into flexion
if pathology is present –> lateral epicondylitis test
pain will be felt over the lateral epicondyle and the wrist extensors
supraspinatus or drop arm test indicates
tear in the rotator cuff muscle
specifically the supraspinatus
drop arm test procedure
pt arm is passively ABD to 90
then ask the pt to slowly lowe rit down to their side
if pathology is present –> drop arm test
pt will be unable to hold the arm up or lower it slowly to their side
if pt is able to hold arm up –> drop arm test
gentle tap at 90 will cause arm to fall to side if pathology is present
dural sign
pt is in the supine position and passively flexes their neck
LE can also be flexed to increase the dural stretch
positive sign –> dural sign
pt experiencing radiating pain across the back
normally the radiation will be down the middle of the back along the vertebral column
ober test
tests for ITB contracture or tightness
ober test procedure
pt positioned in side lying with affected side up
knee is flexed while the therapist extends and ABD the involved hip with 1 hand
stabilization –> ober test
pelvis is stabilized with the other hand as the limb is allowed to lower
if there is tightness –> ober test
limb will not lower to meet the other leg
the ITB will be tighter w/ knee in flexion
thomas test
test for tightness of the hip flexors, rectus femoris and ITB
position of pt –> thomas test
pt at the very end of the table
have them lay spine and draw both LE up tightly to their chest
maximum knee and hip flexion
pt is required to hold position w/ both hands
thomas test procedure
act pt to lower one leg towards the table while the other leg remains in maximum hip and knee flexion
thigh rises up and stays off the table –> thomas test
hip flexors are tight
regardless of knee being flexed or extended
if thigh drops down to the table when the knee is extended –> thomas test
rectus femoris is tight
LE ABD when leg is flexed–> thomas test
ITB is tight
90/90 test –> pt position
supine
asked to grasp one leg behind the thigh to position the hip in 90 flexion
90/90 test procedure
pt is required to extend their knee as far as possible
thompson test
squeeze the calf while pt is in prone and feet hanging off the table
if normal the foot will PF
SLR test pt position
supine
SLR test procedure
therapist passively flexes the pt’s hip w/ knee extended
if pathology is present –> SLR test
pt will complain of radiating pain into the LE
extremity girth measurements
measured to asses for muscle atrophy, hypertrophy or swelling
how should the circumference of a limb be measured
regular intervals
along the long axis of the body part
extremity girl measurement techniques
bony prominence is used as a reproducible landmark for reassessment of the pt’s status
