Specialty Tests - Fall Flashcards
+ve log roll test
posterior pain
anterior/groin pain
clicking
posterior pain - piriformis syndrome with TTP in sciatic notch
anterior/groin pain: Intra-articular pathology (SCFE, FAI, AVN)
clicking: acetabular labral tear
+ve Jumpsign test
trochanteric bursitis
patient jumps/withdraws with pressure
+Trendelenburg (single leg stance)
+ve: a downward drop in the level/height of the iliac crest on the side of the lifted leg
indicates: weakness in hip abductor muscles (gluteus medius and minimus ) on the planted leg side
pathology is on the planted leg
+FAbER test
Groin pain = Intraarticular disorders
- labral tears, FAI (Femoral Acetabular impingement)
- OA
- Iliopsoas, bursitis/strain
+Ober Test
pain at greater trochanter or inability to adduct
+ Scour Test
labral/articular cartilage pathology
Valgus Test is for:
+ve indicates
Medial Collateral Ligament
+ve: laxity/soft/absent endpoint/pain
= MCL Disruption: sprain/tear
Valgus Test is for:
+ve indicates
Lateral Collateral Ligament
+ve: laxity/soft/absent endpoint/pain
= LCL Disruption: sprain/tear
Lachman’s Test is for:
+ve indicates
ACL
+ve: laxity/soft/absent endpoint/pain
= ACL Disruption: insufficient -partial or complete sprain/tear
+ Anterior and Posterior Drawer Test
Anterior: ACL
post: PCL
+ve: laxity/soft/absent endpoint/pain
McMurray’s Test is for
+ve tests
Meniscus Tear
medial meniscus: tibia ER while applying valgus
lateral meniscus: tibia IR while applying varus
+ve test: palpable click / pain during extension = meniscus tear/injury
+Bounce Home Test
normal: knee should fully extend and bounce back at the end point
+ve: failure to extend
indicates: meniscus injury/ effusion/ both
+ve Apley’s grind compression/distraction
pain with distraction/rotation or relief of pain with distraction/rotation
collateral ligament damage
+ Patella-femoral Grind
+ve : crepitus/pain
roughness of articulating surface -> patella-femoral pain syndrome aka chondromalacia patella
+ Bulge sign
+ fluid wave toward lateral aspect or bulge on medial side
+ Talar Tilt Test / inversion test
+ve: laxity, increased ROM, PAIN
Main
Anterior Talofibular ligament injury
Calcaneofibuklar ligament pathology /tear
maybe
Medial ankle sprain
+Eversion test
deltoid ligament pathology (medial ankle sprain)
+Ankle anterior drawer test
ATF ligament pathology/tear (lateral ankle sprain)
+Squeeze Test
Syndesmosis Pathology (high ankle sprain)
+Thompson Test
squeeze patients calf and expect plantarflexion
+ve: Absence of plantarflexion
Achilles Tendon Rupture
+Homan’s Sign
+ve pain with dorsiflexion
acute DVT/ Thrombophlebitis
proceed with caution to minimize embolism risk esp if calf shows edema
DVT will be confirmed with an ultrasound
+ straight leg raise (SLR)
- pain over lateral leg at 30-60
- pain at 30-60
- pain >70
+resisted SLR
- IT band contracture
- Neurologic pain (lumbar disc herniation at L4-S1 nerve roots, lumbosacral radiculopathy, sciatic neuropathy)
- mechanical low back pain due to muscle strain or joint disease —- pathology of hip/SI joints, tight hamstrings, gluteus maximus
+resisted: SCFE, FAI
+ adam’s Forward Bend
- resolution of rib hump with sidebending - functional
- persistence of rib hump with sidebending - structural
Angle of Trunk Rotation
COBB Angle
Angle of Trunk Rotation > 7degrees
COBB Angle >10 degrees …send for X-Ray
+ Low Midline sill (step-off sign)
+ve if there’s an observable/palpable anterior displacement of superior segment compared to pathologic segment
lumbar spondylolisthesis or lumbar instability
+ Thomas Test
patient in supine, hugs one knee to the chest and extends one leg
+ve: inability to full extend or leg raises off the table
indicates: tight hip flexor muscle
Deep tendon reflexes for Biceps, Triceps, Brachioradialis
Biceps C5, C6,
Triceps, C6,C7
Brachioradialis C5,6
+Apprehension test
GH Instability
+ empty can test and Drop Arm test
supraspinatus pathology
+painful arc test (btwn 60 and 120 Abduction)
+ Neer impingement
+ Hawkins Test
Both indicate:
subacromial bursa
impingement/injury of rotator cuff
+ Cross Arm Test
AC Joint pathology
pain with resisted wrist flexion with elbow in full extension
medial epicondylitis
pain with resisted wrist extension with elbow in full extension
lateral epicondylitis
+tinel test
ulnar nerve entrapment/cubital tunnel syndrome
(tap between olecranon and medial epicondyle in ulnar groove) - tingling sensation down forearm within ulnar nerve distribution
+ tinel sign, Phalen’s sign
Carpal Tunnel Syndrome
+Finkelstein Test
DeQuervain’s tenosynovitis
nerve tested by swallowing, phonation and gag reflex
glossopharyngeal (9)
nerve tested by soft palate, uvula, phonation and gag reflex
Vagus
Rhomberg test + with eyes open or closed
open: cerebellar pathology
closed: proprioceptive/vestibular lesion
+ve Babinski
UMN lesion (dorsiflexion of big toe)
normal : plantarflexion
+Nuchal rigidity -> resistance to neck flexion
+ Brudzinski -> hips and knees flex when neck is passively flexed
+ Kernig’s sign -> pain and increased resistance to extension of knee after passive knee flexion
meningeal sign
