Tests UL Flashcards
O’Brian test
SLAP lesion.
Patient hand out in front, internal rotation.
Apply resistive force down @ wrist + stabilise shoulder.
Pain relief in ext rot = +ve.
Speeds test
Bicipital tendinopathy.
Arm out, supinated, slight extension.
Stabilise shoulder, apply down force at hand.
Gerber’s/lift off test
Subscapularis.
Hand behind back.
they pull their hand off back, I apply resistance at wrist.
Jobs’ can test
Supraspinatus
Arm out to side: ext rot, int rot.
Push down on wrist against them.
RIC tests
Abduction, adduction
Int, ext rotation in neutral
Int, ext rotation in 90˚ abduction
BIceps
Hawkins kennedy test
subacromial
rest hand on their shoulder to stabilise.
their arm resting in my elbow crest.
Pull humerus into int rotation at wrist.
move shoulder position around.
Neer’s test
subacromial
in situ, arm up in full shoulder flexion.
stabilise scap and push arm post at elbow.
Crank test
glenoid labrum (SLAP)
In supine, shoulder elevated 160˚, elbow flx 90˚
Hand under side to stabilise scap, push my trunk against their elbow to compress humeral head in glenoid fossa.
grab humerus to add int/ext rotation when compressing to pinch torn labrum
Biceps load tests
glenoid labrum/biceps tendon, prog from speed’s.
supine, shoulder 90˚abd, elbow 90˚ flx, off EOB.
One hand under humerus other pulling wrist away, they try to pull their hand in.
position 2: same but shoulder flxed 120˚
Anterior draw test
anterior stability of gleno-humeral structure.
Supine, arm abducted off EOB.
one hand stabilising under scap with thumb on coracoid process.
Moving hand as prox as possible to humeral head, PA on humeral head.
Apprenhension/relocation test
Gleno-humeral stability.
in supine, shoulder abducted off side of bed, elbow flexed 90˚.
push arm down @ wrist while stabilising elbow - look for facial expression.
THEN, apply AP on humeral head and externally rotate arm more. if there can be more external rotation or pain decrease= +ve ant instability
surprise test by removing AP
Posterior instability test
posterior gleno-humeral.
Supine, arm flexed over to opp side, elbow to ceiling.
Pull humerus laterally, AP through humeral axis, at elbow with other hand.
listen for “clunk”
Sulcus test
inferior stability.
Sitting, elbow flexed infront, support under elbow with one hand, other hand’s thumb on humeral head.
Apply caudal on humeral head with thumb.
Valgus test/MCL
MCL
supine, arm extended out to side
stabilise humerus and push elbow into body
try at different elbow flexions
Varus test/LCL
supine, arm extended out to side
stabilise humerus and push elbow away from body
try at different elbow flexions
Tinel’s sign
neural symptoms of ulnar N.
supine, Arm bent over head to other side, elbow to ceiling.
hold at elbow crease and tap ulnar nerve at olecranon.
tickling/prickling = +ve test
Functional Hand Tests (7)
pinch grip
key grip
fist
grasp
oppening door/jar
thumb opposition
grip strength
Physicological mvmt of radiocarpal joint (active + passive)
flxn, extn
radial, ulnar deviation
Physiological mvmt of inf + sup radioulnar joint (active + passive)
supination - bent elbow, supine
pronation
Physicological mvmt of fingers - MCP, PIP, DIP joints (active + passive)
MCP flxn, extn, abdn, addn
PIP flxn, extn
DIP flxn, extn
Physicological mvmt of thumb (active + passive)
MCP flxn
IP flxn
MCP extn + IP extn
ab/dduction
Passive accessory - inferior radio-ulnar
PA, AP
wrap hand on each side of bones with thumbs on top.
stabilise one and push through thenar emminence on other.
Accessory movement - Radio-carpal joint
Lateral glide: squeeze distal forearm from one side, hold opp side of hand with U grip and push.
Medial glide: switch
Accessory movements - intercarpal
AP
PA
accessory movements - 1st Carpo-Metacarpal joint
AP
PA
Carpal bones
scaphoid lunate triquitrium pisiform,
trapezium trapezoid capitate hamate
RIC - digits
flexor digitorum prof + sup
extensor digitorum
lumbricals - flex MCP
flexor pollicis longus
extensor pollicis longus
abductor pollicis longus
opponens pollicis
RIC - wrist
flexor carpi ulnaris
flexor carpi radialis
extensor carpi radialis longus + brevis
extensor carpi ulnaris
Special test - muscle/tendon test
grip thumb in own hand and ulnarly deviate
eg: for de quervain’s tenovaginitis (AbPL + EPB tendons)
Special test - median nerve
Phalen’s test
overpressure in elbow extension + wrist flexion
eg: carpal tunnel syndrome
hold 30secs
Tennis elbow
extensors
hand under elbow other at hand
in supine, flexed elbow, pronate forearm, flex wrist and fingers and slowly extend arm
lack of extension + pain/symptoms
RIC - middle phalanx extension, += pain in extensor origin
OR resist all fingers OR grip one of my fingers
Golf elbow
flexors
hand under elbow other at hand
supine, elbow flexed, supinate and extend wrist and fingers
slowly extend
lack of extension + pain/symptoms
RIC - gently cupped fingers, try to open them, +ve= pain on flexor origin
Watson’s test
scapho-lunate instability
find palmaris longus by askign to touch thumb to middle finger to place finger on anterior tubercule of lunate.
use other hand to rotate into radial and ulnar deviation with AP. pain/clunck = +ve.
trying to sublax scaph off back of radial articular surface, will clunck when let go = instability
TFCC test - stability
elbow on towel/table, hand up
one hand around dorsum of radius
other hand’s pisiform on theirs, apply AP
compare to other side for pain/more laxity.
TFCC test - articular surface integrity
grasp arm and hold hand pisiform to theirs
ulnar deviate and circumduct with compression
special test - ulnar collateral lig of thumb (skiers thumb)
valgus force (thumb away from palm)
Yergason
resist supination in neutral shoulder and elbow flexion, in pronation .
ask for pain in bicipital groove, palpate for tendon sublaxation.
