Tests Flashcards
Know which tests test what
Knee flexion supine angle
140-150 degrees
Knee flexion prone angle
135 degrees (rectus femoris limiting)
Knee extension angle
prone; minus 2 degrees, plus or minus 3 degrees
Medial/lateral knee rotation
legs off bed; stabilise femur and externally/internally rotate tibia
Testing knee extension
legs off bed; resist them extending; ask to “kick leg out”
Testing knee flexion
prone; stabilise femur; ask pt to flex whilst providing extension force on achilles
Testing knee flexion without gravity
Pt on side; hold upper leg abducted; stabilise femur; ask pt to flex lower leg
Patellar mobility test
Testing: passive glide of patella ROM
Detects: tightness of vastus lateralis and medialis
Performed: supine; knees 20-30 degrees flexed; quads relaxed (pillow under knees if necessary); move patella up down left right
Clark’s sign
push down and inferior on patella; ask pt to contract quads
positive: pain with movement of patella or inability to complete test
Patellar tracking test
legs off bed; actively extend knee from 90 degrees
normal = straight movement with slight lateral shift near full extension
abnormal = sudden lateral movement at full extendion; inverted J shape path
Apprehension test
determine previous history of lateral dislocation/subluxation
gently push patella laterally
positive: pt feels like patella will laterally dislocate
Anterior drawer test (knee)
testing: ACL integrity
injury: blow to hyperextended knee or twisting, non-contact injury
pt supine; hip and knee flexed; feet flat (sit on pt foot); anterior force to tibia
positive = soft end feel/excessive anterior movement of tibia
Slocum test
knee anterior drawer test
Lachman test
anterior drawer test with knee in 15 degrees flexion and external hip rotation (foot planted)
posterior drawer test
anterior drawer test but push instead of pull
Valgus (abduction) stress test
pt supine; knee slightly flexed
push knee in, pull ankle out
medial opening of joint = medial instability of ligament
pain = acute injury
varus (adduction) stress test
pt supine; knee slightly flexed
pull knee out, push ankle out
lateral opening of joint = lateral instability of ligament
uncommon injury (mostly sport related)
McMurry’s test
knee meniscal tears
1) leg externally rotated, varus (outward) stress to test MEDIAL MENISCUS
2) leg internally rotated, valgus (inward) stress to test LATERAL MENISCUS
Knee extension lag
also called quadriceps lag
often of functional relevance in knee rehab
inability to actively move joint to its passive limit
pt supine; knees hanging off bed; flex one knee up and leg other leg hang; passively extend extended knee, then ask pt to do it actively
if can’t complete, is positive
femoral pulse location
midway between pubic tubercles and anterior superior iliac spine
Anterior internal rotators
Iliopsoas
Posterior internal rotators
g. medius
g. minimus
adductors
Anterior external rotators
sartorius
deep anterior fibres
posterior external rotators
g. maximus
piriformis
deep posterior fibres
<45 degrees motion internal rotation with hip extended
Tight anterior external rotators - sartorius and deep anterior fibres
<45 degrees motion internal rotation with hip flexed
Tight posterior external rotators - g. maximus, piriformis and deep posterior fibres
<45 degrees motion external rotatation with hip extended
Tight anterior internal rotators - iliopsoas
<45 degrees motion external rotation with hip flexed
Tight posterior internal rotators - g. medius, g. minimus, adductors
Thomas test
Testing: hip flexion contracture and psoas syndrome
Hip flexion contracture associated with what kind of people?
runners, dancers and gymnasts
Thomas test - knee higher than hip
tight psoas
Thomas test - hip abducts
tight tensor fasciae latae
Thomas test - knee extension
tight rectus femoris
Thomas test - lateral rotation of tibia
tight biceps femoris
FABER test also called
Patrick test
FABER test
test: pathology of hip joint or sacroiliac joint
pt supine
FABER test - posterior pain
sacroiliac joint dysfunction
FABER test - ipsilateral anterior hip pain
early sign of osteoarthritis in hip joint
Piriformis syndrome
irritation of sciatic nerve by compression of nerve within buttock by piriformis muscle
Piriformis syndrome pain increased by
contraction of piriformis muscle; prolonged sitting; direct pressure to muscle
Piriformis syndrome causes
difficulty walking
one cause of sciatica
Percentage of people with sciatic nerve through piriformis
15%
Piriformis test also called
FAIR test
FAIR test also called
piriformis test
FAIR test
Hip passively flexed to 60 degrees
Knee passively flexed to angle of 60-90 degrees
stabilising hip, internally rotate and adduct hip
apply downward pressure to knee
positive: reproduce pain
Signs of piriformis tightness
relaxed supine; ipsilateral external rotation is positive sign
prone, knees flexed; one leg unable to fall as far towards ground is positive sign
Obers test
test for tight ITB Pt on side abduct and flex leg 90 degrees attempt to adduct upper leg positive: leg remains abducted (won't drop) --> ITB contracture
Nobles compression test
pt supine knee flexed 90 degrees
apply pressure over lateral femoral epicondyle while passively extending knee
positive: pain at 30 degrees flexion
indicates: ITB irritation or inflammation
Ely test
tight rectus femoris
flex knee and try to touch butt
positive: heel does not touch butt
if rectus tight, will cause hip to passively flex (buttock rises)
LLD
ASIS to medial malleolus
umbilicus to medial malleolus
frontal plane: tibia longer
sagittal plane: femur longer
Percussion test
pt supine
strike heel
positive: reproduce pt worst pain
Homan’s test
detect DVT
forceful abrupt ankle dorsiflexion with knee extended
positive: pain in calf
Peroneal subluxation test
detect subluxation/dislocation of peroneus brevis and longus behind lateral malleolus
pt actively dorsiflex and evert; feel for subluxation
Squeeze test also called
Thompson test
Simmond’s test also called
Thompson test
Thompson test
detect complete rupture of achilles tendon
pt prone; squeeze calf where girth widest
positive: foot doesn’t plantarflex (complete rupture)
Anterior drawer test (ankle)
detect ATFL integrity
pt supine with knee flexed and foot resting off couch
stabilise lower leg and pull heel/talus anteriorly
positive: increased posterior movement of lateral malleolus –> laxity or rupture
dimple sign/suction sign produced with which test
anterior drawer test (ankle)
Talar tilt test
test integrity ATFL, CFL, inferior syndesmosis
long sitting; rt hand, left calcaneus
other hand dorsum of foot
foot dorsiflexed and inverted
positive:
CFL/ATFL - increased excursion of talus (combined rupture)
Syndesmosis - reproduction of high ankle sprain; increased talus excursion, apprehension, painful clunk
External rotation stress test
assess integrity of inferior tibiofibular syndesmosis
forearm on medial arch, foot plantargrade, stabilise femur, externally rotate
positive: high ankle sprain
Calcaneofibular ligament stress test
test CFL ligament long sitting; rt foot, left hand other hand on dorsum of foot foot plantagrade invert calcaneum positive: pain over lateral ankle/limited range of motion
medial collateral ligament stress test
stress deltoid ligament long sitting right hand, left ankle other hand on medial dorsum of foot valgus calcaneum then gradual eversion and dorsiflexion
Calcaneocuboid ligament stress test
Stress calcaneocuboid ligament long sitting right hand/right ankle calcaneus fixed neutral other hand combines adduction and inversion to forefoot
ATFL stress test
long sitting cup ankle (right hand, right ankle) other hand dorsum move calcaneum plantarflexed and inverted
varus/valgus stress test MTP
long sitting
stabilise proximal bone
left to right movement
positive: increased pain/laxity (collateral ligament sprain)
Intermetatarsal glide test
long sitting grasp 2 met heads opposite directions pain or increased glide deep transverse metatarsal ligament/interosseous ligament trauma
tinel’s sign
supine hip externally rotated and foot everted tap tarsal tunnel radiating pain in foot and toes tarsal tunnel syndrome
metatarsal squeeze test
detect morton’s neuroma or intermetatarsal plantar digital nerve
long sitting
squeeze mets together and palpate with other hand
pain or mulder’s click
Squat
torso vertical
femur horizontal
knees aligned over feet (2nd ray); not valgus
toes forward
Single leg squat
be straight up
hop test also called
single leg squat
lunge - hip flexion can’t descend far enough for trailing knee to be near floor
Front leg: tight adductor magnus
Back leg: weak adductor magnus, weak gluteus maximus
lunge - ankle dorsiflexion front heel raises
soleus inflexibility front leg
lunge- hip extension - hip of trailing leg not completely extended at lowest point
rectus femoris inflexibility
dynamic instability of hip/knee/ankle?
lunge - hip abductors sudden drop of hip of step leg while stepping (on one leg before planting heel)
weak hip abductors:
g. med
g. min
Romberg’s test
pt stands with eyes closed and tries to balance
trendelenburg
stand on one leg - if nwb drops is positive for weak hip abductors on stance side (glutes)
ankle ROM functional test
lunge test
