Tests

Question 1

Spurling’s

Answer 1

Tests for: cervical nerve root impingement
Test: slightly extend the cervical spine with rotation and sidebending toward involved side and apply axial compression
Positive: reproduction of neck, shoulder, or arm pain

Question 2

Straight leg raising test

Answer 2

Tests for: nerve root irritation or lumbar disk herniation at L4, L5, S1 levels
Test: supine, support foot around calcaneus and lift leg
Positive: pain extends down the whole leg

Question 3

Bragard stretch test

Answer 3

Tests for: used to confirm positive straight leg raise
Test: lower flexed hip until just below where pain was, dorsiflex foot
Positive: reproduction of pain

Question 4

Femoral stretch test

Answer 4

Tests for: nerve root compression of L1-3
Test: prone, extend hip while supporting knee
Positive: pain

Question 5

Yergason

Answer 5

Tests for: stability of biceps tendon, tendonitis
Test: palpate long head, flex patient’s elbow at right angle, have patient externally rotate shoulder with resistance against forearm; for tendonitis: repeat but supinate forearm instead of externally rotating
Positive: tendon pops out of groove; tenderness at groove is positive for tendonitis

Question 6

Drop arm test

Answer 6

Tests for: rotator cuff tear (suprasinatus)
Test: abduct patient’s arm to 90, ask him/her to slowly lower their arm»while they do that, push the arm
Positive: patient cannot hold arm and it drops

Question 7

Neer test

Answer 7

Tests for: rotator cuff inflammation, impingement, or tear
Test: have patient internally rotate shoulder and flex patient’s shoulder up to 150
Positive: shoulder pain

Question 8

Hawkins test

Answer 8

Tests for: rotator cuff impingement or tear
Test: flex elbow to 90, abduct arm to 90, internally rotate humerus
Positive: pain

Question 9

Supraspinatus test

Answer 9

Tests for: supraspinatus tendonitis or rotator cuff tear
Test: have patient abduct 90 and flex his/her arm 30 followed by internal rotation of shoulder (empty can)
Positive: weakness and pain

Question 10

Apprehension test

Answer 10

Tests for: anterior subluxing humerus
Test: have patient flex elbow, abduct their shoulder 90 and externally rotate it»push shoulder from posterior side while further externally rotating the arm
Positive: patient exhibits apprehension

Question 11

Jerk test

Answer 11

Tests for: posterior subluxing humerus
Test: flex elbow and shoulder 90 and internally rotate the shoulder»push humerus posteriorly while externally rotating the shoulder
Positive: clunk

Question 12

Sulcus test

Answer 12

Tests for: inferior subluxing humerus
Test: place one hand on lateral acromion and pull down on arm relaxed at patient’s side
Positive: widening of sulcus between humerus and acromion

Question 13

Ligamentous stability test

Answer 13

Tests for: stability of medial and lateral collateral ligaments of the elbow
Test: cup posterior elbow with one hand and hold supinated forearm during the test»provide valgus stress then varus stress to the lateral side
Positive: gapping

Question 14

Tinel’s sign at the elbow

Answer 14

Tests for: irritation or entrapment of ulnar nerve
Test: locate ulnar groove and tap several times
Positive: tingling sensation down the forearm to ulnar distribution of hand

Question 15

Tennis elbow test (Cozen’s test)

Answer 15

Tests for: lateral epicondylitis
Test: have patient pronate forearm with elbow bent, ask patient to make fist and extend upwards»examiner holds elbow and attempts to flex wrist while patient resists
Positive: severe pain at lateral epicondyle

Question 16

Tinel’s sign at wrist

Answer 16

Tests for: carpal tunnel syndrome
Test: tap at median nerve at wrist above flexor retinaculum
Positive: paresthesias of 1-3 and 1/2 of 4th digit

Question 17

Phalen’s test

Answer 17

Tests for: carpal tunnel syndrome
Test: flexing patient’s wrists to maximum degree and holding it for at least one minute
Positive: paresthesias in 1-3 and 1/2 of 4th digits

Question 18

Thomas test

Answer 18

Tests for: Flexion contractures of the hip
Test: have patient lay supine and flex one leg as far as it will go
Positive: normal flexion of raised leg and 15+ degrees of flexion in opposite hip

Question 19

Trendelenburg test

Answer 19

Tests for: weak hip abductor muscles
Test: Ask patient to stand and balance on one foot. Observe patient from behind
Positive: Iliac crest drops on side of lifted leg, then hip abductors on opposite hip are weak

Question 20

Patrick/Faber test

Answer 20

Tests for: pathology in the hip and SI joint
Test: Have patient lie supine on table and place foot of involved side on their opposite knee; to stress SI joint, place one hand on flexed knee and other on ASIS of opposite side
Positive: presence of muscle spasm, limitation of motion, or pain in groin, anterior thigh, or trochanteric region of bent leg indicates hip joint pathology; pain in ipsilateral SI joint indicates SI joint disorder

Question 21

Lateral/medial ligament stability testing

Answer 21

Tests for: stability of LCL/MCL
Test: Have patient supine with knee nearly extended, stabilize lower leg against your body and apply varus then valgus force
Positive: Abnormal gapping on either side

Question 22

Drawer tests for the knee

Answer 22

Tests for: ACL/PCL tear
Test: With patient supine, have them flex knee to 45-90, stabilize leg by sitting gently on patient’s foot, grasp leg just below knee with both hands and jerk tibia forward/backward
Positive: abnormal forward/backward mobility of 2 cm or more

Question 23

Lachman test

Answer 23

Tests for: ACL tear
Test: Have patient supine with knee at 20-30 degrees of flexion, with one hand stabilize the distal femur and with the other hand, grasp the proximal tibia, apply pressure attempting to translate tibia anteriorly
Positive: abnormal forward mobility

Question 24

McMurray test

Answer 24

Tests for: meniscal tear
Test: Supine with legs flat, flex knee with one hand on their heel and the other on their knee, apply valgus force to knee while simultaneously externally rotating the lower leg as you lower it»then do varus force while internally rotating and lowering the leg
Positive: palpable or audible click or pain, grinding, and/or lack of extension

Question 25

Apley compression test

Answer 25

Tests for: meniscal tear
Test: prone with knee flexed at 90, hold plantar surface of patient’s heel and apply compressive force while internally and externally rotating the lower leg
Positive: pain in knee

Question 26

Apley distraction test

Answer 26

Tests for: MCL and LCL injury
Test: prone with knee at 90, cup one hand around posterior heel and place your knee at distal end of thigh, pull up while preventing the femur from rising»externally and internally rotate the leg
Positive: pain in knee on either joint line

Question 27

Thompson-Doherty squeeze test

Answer 27

Tests for: ruptured Achilles
Test: Have patient kneel on exam table with their feet off the edge»squeeze calf and notice motion of foot (should be plantar flexed)
Positive: little or no motion

Question 28

Ankle drawer test

Answer 28

Tests for: disruption of anterior talofibular ligament
Test: Have patient sitting with ankle at 10-20 plantar flexion»place one hand around anterior distal tibia, place other hand on medial surface of the foot, wrapping your hand around the calcaneus»pull forward on heel while pushing posteriorly on tibia
Positive: obvious extreme forward displacement of foot on tibia

Question 29

Whisper pectoriloquy test

Answer 29

Tests for: consolidation
Test: have patient whisper “1,2,3” as you listen to the lungs
Positive: clear sounds

Question 30

Bronchophony

Answer 30

Tests for: consolidation
Test: have patient say “99” as you listen to lung sounds
Positive: clear sounds

Question 31

Egophony

Answer 31

Tests for: consolidation
Test: have patient say “E,E,E” while you listen
Positive: you hear “A,A,A”

Question 32

Brudzinski

Answer 32

How: Doctor forward bends patient’s head and neck

Positive Sign: involuntary flexion of hips and knees (pt may report nuchal pain or resist neck flexion)

Tests for: meningeal irritation

Question 33

Kernig

Answer 33

How: Flex the hip and the knee to 90°, then extend the knee

Positive Sign: low back pain and resistance to flexion.

Tests for: meningeal irritation

Question 34

Finger nose finger

Answer 34

-Bilateral
How: 1. Patient extends arms out with fingers pointed > touches their nose with one finger, then the other and alternates a few times 2. patient touches their nose then doctor’s finger > doctor moves finger each time
-Abnormal signs: poor tracking and/or past pointing
-Tests: cerebellar function

Question 35

Heel to shin

Answer 35

-How: patient supine or sitting > heel to opposite knee > run heel down shin to ankle
Abnormal sign: deviation from midline
Tests: cerebellar function

Question 36

Rapid alternating movements

Answer 36

How: 1. pat knees with palms of hands then back of hands 2. rapid touching of each finger to thumb in sequence from index to pinky and back
Abnormal: tremors, inability to maintain speed and/or rhythm
Tests: cerebellar function

Question 37

Tandem gait

Answer 37

How: walk heel to toe
Abnormal: poor balance, swaying, falling over
Tests for: cerebellar function

Question 38

Romberg test

Answer 38

How: have patient standing feet together, arms at sides > close eyes
Positive: loss of balance
Tests for: implies cerebellar ataxia, proprioceptive defect, or vestibular defect