Tests Flashcards
simmonds
achilles tendon rupture
rest knee on side of bed/chair and squeeze body of gastrocnemius, positive test is when foot does not move in concordance
perthes
The Perthes test is a clinical test for assessing the patency of the deep femoral vein prior to varicose vein surgery.
The test is done by applying a tourniquet at the level of the sapheno-femoral junction to occlude the superficial pathway, and then the patient is asked to move in situ. If the deep veins are occluded, the dilated veins increase in prominence.
modified schober test
While the patient is in a standing position the examiner makes a mark approximately at the level of L5 (fifth lumbar vertebra). Two points are marked: 5 cm below and 10 cm above this point (for a total of 15 cm distance). Then the patient is asked to touch his/her toes while keeping the knees straight. If the distance of the two points do not increase by at least 5 cm (with the total distance greater than 20 cm), then this is a sign of restriction in the lumbar flexion. [1] This can be useful in examining a patient suspected of ankylosing spondylitis.
lachmans
The Lachman test is a clinical test used to diagnose injury of the anterior cruciate ligament (ACL).
The knee is flexed at 20–30 degrees with the patient supine. The examiner should place one hand behind the tibia and the other grasping the patient’s thigh. It is important that the examiner’s thumb be on the tibial tuberosity. The tibia is pulled forward to assess the amount of anterior motion of the tibia in comparison to the femur. An intact ACL should prevent forward translational movement (“firm endpoint”) while an ACL-deficient knee will demonstrate increased forward translation without a decisive ‘end-point’ - a soft or mushy endpoint indicative of a positive test. More than about 2 mm of anterior translation compared to the uninvolved knee suggests a torn ACL (“soft endpoint”), as does 10 mm of total anterior translation.
mcmurrays
The McMurray test, also known as the McMurray circumduction test is used to evaluate individuals for tears in the meniscus of the knee.
To perform the test, the knee is held by one hand, which is placed along the joint line, and flexed to complete flexion while the foot is held by the sole of the foot with the other hand. The examiner then places one hand on the medial side of the knee to pull the knee towards varus position, pulling the knee laterally (bow legged). The other hand rotates the leg internally while extending the knee. If pain or a “click” is felt, this constitutes a “positive McMurray test” for a tear in the lateral meniscus.
anterior/posterior drawer test
The drawer test is used in the initial clinical assessment of suspected rupture of the cruciate ligaments in the knee.
The patient should be supine with the hips flexed to 45 degrees, the knees flexed to 90 degrees and the feet flat on table. The examiner positions himself by sitting on the examination table in front of the involved knee and grasping the tibia just below the joint line of the knee. The thumbs are placed along the joint line on either side of the patellar tendon. The index fingers are used to palpate the hamstring tendons to ensure that they are relaxed as contracted hamstring muscles may inhibit forward movement of the tibia, even when the anterior cruciate ligament (ACL) is deficient, thus producing a ‘false negative’ result. The tibia is then drawn forward anteriorly. An increased amount of anterior tibial translation compared with the opposite limb or lack of a firm end-point may indicate either a sprain of the anteromedial bundle or complete tear of the ACL. If the tibia pulls forward or backward more than normal, the test is considered positive. Excessive displacement of the tibia anteriorly suggests that the ACL is injured, whereas excessive posterior displacement of the tibia may indicate injury of the posterior cruciate ligament.
tourniquet/trendelenburg test
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trendelenburg
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rotator cuff tests
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femoral nerve stretch test
the patient lies prone, the knee is passively flexed to the thigh and the hip is passively extended; the test is positive if the patient experiences anterior thigh pain.
straight leg raise
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allens
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phalens
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tinels
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finkelsteins
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