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PCM Midterm > Specialty Tests > Flashcards

Specialty Tests Flashcards

1
Q

Apprehension Test

A

Patient is seated/supine. Shoulder is abducted to 90 and elbow flexed to 90. Stabilize shoulder with one hand and force arm into external rotation

+: patient apprehensive of repeat dislocation
Pathology indicated: Glenohumeral instability

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2
Q

Sulcus Sign

A

Grasp patient’s elbow and apply inferior traction

+: indent appears in area beneath acromion
Pathology indicated: glenohumeral instability

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3
Q

Yergason’s Test

A

Patient’s arm at side with elbow flexed to 90. Physician uses one hand to palpate bicipital groove and monitors there. Other hand grasps wrist. Patient will supinate and externally rotate against physicians force

+: pain/tendon subluxation out of groove
Pathology indicated: unstable bicipital tendon

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4
Q

Speed’s test

A

patient’s arm flexed at the shoulder with hand supinated. slightly flex patients elbow, resist at forearm while patient flexes shoulder

+: pain in bicipital groove
pathology indicated: bicipital tendonitis of longhead biceps

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5
Q

Empty can test

A

flex patients shoulders to 90 while horizontally abducting to 45. Then internally rotate both arms so thumbs are pointing down. Press down on forearms while patient resists

+: pain or weakness
Pathology indicated: Rotator cuff pathology (specifically supraspinatus)

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6
Q

Drop-Arm Test

A

Patient abducts arm to 90 then slowly drops arm

+: arm will drop or gentle tap on wrist will cause arm to drop
Pathology indicated: Full thickness tear of supraspinatus

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7
Q

Painful arc test

A

Patient abducts arm starting at their side

+: pain is elicited within 60-120 degrees of shoulder abduction
Pathology indicated: subacromial impingement and/or rotator cuff injury

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8
Q

Neer Impingement

A

Stabilize patient’s shoulder. With forearm pronated, passively flex shoulder to fully flexed position

+: pain
Pathology indicated: subacromial bursa or rotator cuff impingement

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9
Q

Hawkins Test

A

Flex shoulder to 90, flex elbow to 90, and passively rotate the humerus into internal rotation.

+: Pain
Pathology indicated: rotator cuff or subacromial bursa impingement

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10
Q

Lift Off Test

A

Place patient’s arm into internal rotation and extension. Patient pushes arm into further internal rotation as physician resists

+: weakness
Pathology indicated: subscapularis weakness

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11
Q

Cross Arm Test

A

Physician passively adducts patients arm across the chest and rests patient’s hand on their opposite shoulder

+: Pain in the AC join with end range adduction
Pathology indicated: AC joint pathology

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12
Q

Apley Scratch Test

A

Physician shoulder make note of how far the patient can reach

Pathology indicated: ROM

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13
Q

Valgus Stress test of Elbow

A

Arm slightly abducted and externally rotated, Forearm supinated and flexed to apex. 30 degrees. Slight medial directed value stress is applied

+: pain/tenderness w/ palpation and increased laxity
Pathology Indicated: Sprained Medial (Ulnar) collateral ligament

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14
Q

Varus Stress Test of elbow

A

Arm slightly abducted and internally rotated. elbow flexed to approx. 15 degrees. A slight lateral stress is applied to elbow joint

+: pain/ increased laxity
Pathology indicated: Sprained lateral collateral (radial) ligament

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15
Q

Tinel Test (elbow)

A

Tap between olecranon and medial epicondyle in ulnar groove

+: test causes tingling sensation down forearm within ulnar nerve distribution
Pathology indicated: ulnar nerve entrapment/cubital tunnel syndrome

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16
Q

Golfer’s elbow test

A

Patient’s elbow is flexed to 90 degrees and forearm is placed in supination. Physician placed one hand under proximal forearm for stabilization and the other over the patient’s wrist to resist movement. Patient is instructed to flex

+: Pain/tenderness around medial epicondyle
Pathology indicated: Medial epicondylitis

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17
Q

Tennis Elbow test (Cozen’s Test)

A

Patient’s elbow is flexed at 90 degrees and arm is placed into pronation. Examiner places one hand under proximal forearm for stabilization and the other hand over the patient’s hand to resist movement. Instruct patient to extend wrist

+: pain/tenderness around lateral epicondyle, may radiate down lateral forearm
Pathology indicated: Lateral epicondylitis

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18
Q

“OK” Sign

A

Patient is unable to make the “O” with thumb and forefinger pinched together

Pathology indicated: anterior interosseous nerve

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19
Q

Tinel’s Sign (hand)

A

tap over the transverse carpal ligament/flexor retinaculum

+: numbness/tingling/pain radiating to thumb, index and middle finger
Pathology indicated: Carpal Tunnel Syndrome

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20
Q

Phalen’s Sign

A

Place dorsal aspects of patient’s hands together and force into wrist flexion. Hold for 60 seconds

+: numbness/tingling/pain radiating to thumb, index and middle finger
Pathology indicated: Carpal Tunnel syndrome

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21
Q

Finkelstein Test

A

Ask patient to make a fist and then ulnar deviate the wrist

+: increased pain in 1st dorsal compartment
Pathology indicated: DeQuervain’s tenosynovitis

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22
Q

Log Roll

A

Roll the patient’s leg into internal and external rotation

+: pain
Pathology indicated: central or peripheral compartment pathology

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23
Q

C-Sign

A

Patient points to the source of pain with 2 fingers or cups just above the trochanter with the thumb and index finger

Pathology indicated: Labral pathology

24
Q

Labral Loading

A

Flex the patient’s knee and hip to 90, load into the femur towards the innominate (push down)

+: pain
Pathology indicated: labral or cartilaginous pathology

25
Q

Labral Distraction

A

Distract patient’s femur day from innominate

+: Improvement of pain
Pathology indicated: labral or cartilaginous pathology

26
Q

Scour

A

Flex and externally rotate patient’s hip. Load into socket and articulate through annular range of motion

+: Pain
Pathology indicated: labral or articular cartilage pathology

27
Q

Apprehension: FABER (1 or 3)

A

Patient’s hip is flexed, abducted and externally rotated, physician induces further into external rotation by applying a posterior force at the knee

+: anterior subluxation of hip or apprehension/pain
Pathology indicated: Labral pathology

28
Q

Rectus Femoris Test

A

Patient supine. One hip is flexed up to the chest. The other leg is bent over the edge of tablet

+: Knee flexion is less than 90
Pathology indicated: Rectus Femoris contraction

29
Q

Jump sign

A

Patient seated. Pressure is applied to greater trochanter

+: patient withdraws or jumps with pressure
Pathology indicated: Trochanteric Bursitis

30
Q

Straight Leg Raise Test

A

Patient supine. Passively flex patient’s ipsilateral hip with knee extended

+: pain over lateral leg, especially at more than 15 degrees
Pathology indicated: IT band contracture
30-60 degrees: lumbosacral radiculopathy/ sciatic neuropathy
>70: muscle strain/joint disease of low back

31
Q

Piriformis Test

A

Patient is supine with hip and knee flexed, one ankle cross over contralateral knee. Patient abducts against resistance

+: Pain over posterior aspect of greater trochanter
Pathology indicated: Piriformis spasm or pathology

32
Q

Patrick’s: FABER (2 of 3)

A

Patient’s hip is flexed, abducted and externally rotated, physician braces contralateral ASIS, patient externally rotates/abducts against resistance

+: pain or weakness
Pathology indicated: gluteus medius pathology

33
Q

Patricks: FABER (3 of 3)

A

Patient’s hip is flexed, abducted and externally rotated. Physician braces contralateral ASIS, patient internally rotates/adduct against resistance

+: anterior or medial groin pain/weakness
Pathology indicated: Iliopsoas insufficiency/pathology

34
Q

Thomas Test

A

Patient is supine and pulls knee to chest. One leg is lowered to the table to test the flexibility of the hip flexors

+: instability to fully extend or extended leg raises off table
Pathology indicated: hip flexor contraction

35
Q

Valgus test (of knee)

A

Patient supine with knee flexed to 30 degrees. Physician supports the lower leg with one hand and other placed on the lateral aspected of the patient’s knee. Apply a medial force to the proximal tibia while abducting the lower leg
Done at 30 degrees flexion and 0

+: increased laxity, soft or absent endpoint, pain
Pathology indicated: medial collateral ligament (MCL) disruption

36
Q

Varus Test (of knee)

A

Patient supine with knee flexed to 30 degrees. Physician supports the lower leg with one hand and other is placed on medial aspect of patient’s knee. Apply a lateral force to the proximal tibia while adducting the lower leg
Done at 30 degrees flexion and 0

+: increased laxity, soft or absent endpoint, pain
Pathology indicated: Lateral Collateral Ligament (LCL) disruption

37
Q

Anterior Drawer Test

A

Patient supine with knee flexed to 90. Examiner sits on the patient’s foot and grasps the proximal tibia with both hands, pulling the tibia anteriorly

+: excessive translation
Pathology indicated: ACL injury/tear

38
Q

Lachman’s Test

A

Patient supine. Examiner places cephalad hand on the distal thigh, superior to the patella. Caudad hand grasps the proximal tibia. Flexing the knee to 10-30, the examiner uses his caudal hand to pull the tibia anteriorly while the cephalad hand stabilizes the thigh
More sensitive

+: increased laxity, soft or absent end point
Pathology indicated: ACL injury/tear

39
Q

Posterior Drawer Test

A

Patient supine with knee flexed to 90. Examiner sits on the patient’s foot and grasps the proximal tibia with both hands, moving tibia posteriorly

+: excessive translation
Pathology indicated: PCL injury/tear, posterior capsular injury or disruption

40
Q

Reverse Lachman’s test

A

Patient supine. Examiner places cephalad hand on the distal thigh superior to the patella. Caudad hand grasps the proximal tibia, flexing the knee to 10-30. Proximal hand stabilizes the femur while the distal hand pushes the tibia posterior
More sensitive test

+: increased laxity, soft or absent end point
Pathology indicated: PCL/ posterior capsule injury/tear `

41
Q

McMurray’s Test

A

Patient is supine with hip and knee flexed. Examiner uses caudal hand to control the ankle and caphalad hand placed on distal femur. Examiner will rotate tibia into internal rotation and apply a varus stress then continue the leg into extension OR rotate tibia into external rotation and apply a values stress and continuation into rotation

+: Pain or a palpable click
Pathology indicated:
internal rotation/varus- lateral meniscus
external rotation/valgus- medial meniscus

42
Q

Apley’s Grind test- compression test

A

Patient is prone with knee flexed to 90. Examiner uses downward force on the foot to provide a compressive force on the meniscus while rotating the foot internally and externally

+: Pain with rotation and/or compression
Pathology indicated: Possible meniscal injury, collateral ligament injury, or both

43
Q

Apley’s Grind test- Distraction test

A

Patient is prone with knee flexed to 90. Examiner stabilizes thigh then applies upward traction to the leg while rotating it

+: pain with distraction and rotation
Pathology indicated: possible collateral ligament damage

+: relief of pain with distraction
Pathology indicated: possible meniscus injury

44
Q

Patellar laxity and Apprehension Test

A

Laxity: one hand above and one hand below the joint, thumbs placed against the medial side of the patella. Examiner pushes the patella laterally, assessing ROM

Apprehension: when testing laxity to the point of restriction, ask the patient if the maneuver provokes any discomfort or sense of instability

+: sense of apprehension or instability
Pathology indicated: possible previous patellar dislocation or severe instability

45
Q

Patellar compression (grind) test

A

Patient supine and knee extended. Provide compressive load to the patella with one hand while moving the patella medial and lateral

+: pain with compression
Pathology indicated: possible inflammation, chondromalacia, or injury to the patellofemoral articular surface

46
Q

Patella-femoral grinding test

A

Compress patella caudally into trochlear groove and instruct patient to tighten quadriceps against resistance

+: crepitus or pain
Pathology indicated: roughness of articulating surfaces

47
Q

Patellar-Glide Test

A

Patient site or supine will slowly extend and flex the knee, while physician notes quality of the articular motion. Place hand lightly over the patella can increase sensitivity of this test

+: palpable/audible crepitus pain or catching of patella

48
Q

Anterior Drawer Test (Foot)

A

Grasp posterior calcaneus with one hand and distal tibia/fibular with the other hand, monitoring anteriorly at the anterior talus, provide anterior force on calcaneus while stabilizing the distal tibia/fibula. Normal springing back to neutral should occur.

+: pain, no springing, excessive motion/laxity
Pathology indicated: ATF ligament pathology/tear (lateral ankle sprain)

49
Q

Talar Tilt Test

A

Grasp distal tibia/fibular with one hand and inferior calcaneus with the other, blocking motion of the calcaneus of the talus. Invert talus to evaluate ROM

+: laxity, increased ROM, pain
Pathology indicated: Calcaneofibular ligament pathology/tear, also tests some ATF

50
Q

Eversion Test

A

Grasp the distal tibia/fibula with one hand and plantar surface of the mid-foot with the other hand. Evert the foot to evaluate ROM

+: Laxity, increased ROM or pain
Pathology indicated: Deltoid ligament pathology (medial ankle sprain)

51
Q

Squeeze Test

A

Wrap hands around leg proximal to the ankle, contracting distal tibia/fibula with both thenar eminences. Squeeze for 2-3 seconds then rapidly release

+: pain
Pathology indicated: syndesmosis pathology (high ankle sprain)

52
Q

Cross Leg Test

A

Patient crosses affected ankle over opposite knee. Apply pressure to distal fibular of affected leg

+: pain at distal ankle
Pathology indicated: syndesmosis pathology (high ankle sprain)

53
Q

Thompson Test

A

Patient prone with foot off table, squeeze patient’s calf. Observe for plantar flexion

+: absence of plantar flexion
Pathology indicated: achilles tendon rupture

54
Q

Homan’s Sign

A

Patient laying or seated with knee extended. Dorsiflex the patient’s foot. Can apply lateral compression to calf

+: pain with dorsiflexion
Pathology indicated: DVT

55
Q

Moses Sign

A

Patient seated or supine with knee slightly flexed or extended, induce an anterior compression on the gastrocnemius muscle into the poster aspect of the tibia

+: pain with anterior compression
Pathology indicated: DVT

PCM Midterm (3 decks)

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