Special Tests UL (Quiz 2) Flashcards
What does Apley’s Scratch Test Assess
Triplanar shoulder movements in a functional manner
Apley’s Scratch Test Maneuver
patient attempts to touch their fingers together behind their back
Top arm: flexion, abduction, ext rotation
Bottom: extension, adduction, int rotation
Apley’s Scratch Test Results
normal test would allow the patient to touch the spine of the scapula reaching superiorly or the inferior angle reaching inferiorly
What does load and shift assess for
atraumatic instability issues with the glenohumeral joint
load and shift maneuver
grasp humeral head and palpates posteriorly and anteriorly
force is applied anterior and posteriorly
Load and shift results
25% translation or less: normal
26-50% translation: grade I
50% translation: grade II or II
What does Sulcus sign assess for
presence of multidirectional instability
Sulcus Sign Maneuver
examiner applies a downward pull at the elbow/forearm
Sulcus Sign Results
if found bilaterally and equal, this is not clinically significant
What does Hawkins-Kennedy Impingement Assess
presence of sub-acromial impingement
Hawkins-Kennedy Impingement Maneuver
examiner flexes shoulder to 90 deg and internally rotates patient’s shoulder
Hawkins-Kennedy Impingement Results
pain and/or apprehension = positive test
Speeds Test Assessment
biceps tendonitis at proximal attachment
Speeds Test Maneuver
patients should 90 deg of flexion, examiner applies downard force while patient actively flexes
what does supraspinatus (empty can) assess
supraspinatus or suprascapular nerve injury
supraspinatus (empty can) results
weakness and/or pain on in GH joint on the side being tested
supraspinatus (empty can) maneuver
patients shoulders abducted 90 degrees and set to 30-45 degrees of horiziontal adduction
what does Milking maneuver assess
UCL injury
Milking maneuver maneuver
patients elbow flexed to 90 degrees and supinated
holds patients thumb and pulls it to impart a valgus stress `
Ligamentous Varus Instability Assessment
radial collateral ligament
Tinel’s Sign at elbow assess
ulnar nerve entrapment
tinels sign at the elbow results
tingling along the ulnar nerve distribution in the forearm, hand and fingers
Thumb ulnar collateral ligament laxity test
applies valgus stress to thumb
UCL sprain
Finkelstein’s Test assess
dequervains tenosynovitis
Finkelstein’s Test maneuver
with the patient making a fist holding the thumb, the examiner passively ulnar deviates the patient’s wrist
Finkelstein’s Test results
pain along the course of the abductor pollicis and extensor pollicis brevis
Tinel’s sign at wrist assess
compression of median nerve carpal tunnel syndrome
Tinel’s sign at wrist results
compaints of tingling/numbness or pain distribution of median nerve (fingers 1-2 and radial 1/2 ring finger)
Phalen’s Test Assessment
compression of median nerve/carpal tunnel
Froment’s Sign assessment
ulnar nerve lesion and/or paralysis of adductor pollicis
Froment’s Sign results
IP of thumb flexes to maintain grip on paper (+)
Suclus sign grading
+1 = less than 1 cm
+2 = 1 to 2 cm
+3 = more than 2 cm
Grade I sprain
mild
few fibers are torn
firm end feel
Grade II sprain
moderate
1/2 fibers torn
firm but delayed or possibly soft end feel
Grade III Sprain
severe
all fibers torn
empty end feel
movement constrained only by surrounding structures
