Tissue Diff Testing Flashcards
Roos test
thoracic outlet syndrome; pt: arms in 90/90, open/close hands for 3 mins; +: = inability to maintain the test position, weakness of arms, sensory loss of ischemic pain
Adson’s test
thoracic outlet; p: arm by side, pt asked to rotate head away from arm; +: absence of radial pulse after 1 min
Allen’s test (shoulder)
thoracic outlet; p: positioned with arm in 90deg abduction, ER, elbow flexion & asked to rotate head away from arm; +: diminished radial pulse
apprehension test for anterior disolcation
P: supine with arm in 90deg abduction, laterally rotate arm; +: look of apprehension/facial grimace
apprehension for posterior dislocation
p: supine with arm 90deg abduction, medially rotate: +: look of apprehension/grimace
Ludington’s test
Biceps tendon pathology; p: clasp hands behind back and alternately contract/relax the biceps; +: absence of movement in tendon = rupture
Speed’s test
Biceps tendon pathology; p: elbow extended with arm supinated, resist shoulder flexion while palpating bicipital groove; +: pain or tenderness = tendonitis
Yergason’s test
Biceps tendon pathology; P: elbow in 90deg flexion with arm pronated, pt actively supinates against resistance wit PT palpating bicipital groove; +: pain or tenderness = tendonitis
What tests are used for biceps pathology
Ludington’s (rupture); Speeds, Yergason’s (tendonitis)
Drop arm test
RTC; p: arm in 90deg abduction & asked to slowly lower arm to side; +: pt unable to slowly lower or severe pain = tear in the RTC
Hawkin’s Kennedy Impingement
RTC pathology; p: PT flexes arm to GH 90 then medially rotates; +: pain = impingement of supraspinatus
Neer impingement test
RTC pathology (supraspinatus); p: PT stabilizes posterior scap and elbow and passively moves pt arm through flexion; +: pain/facial grimace = supraspinatus impingement
Supraspinatus test
RTC pathologyl p: arm in 90deg abduction and 30deg horizontal adduction with thumb down (empty can), PT resists arm; +: weakness or pain = tear of supraspinatus tendon, impingement, or suprascpular N involvement
what tests are used for RTC pathology
Drop arm (tear); hawkin’s kennedy, neer, supraspinatus (impingement of supraspinatus)
costoclavicular syndrome test
thoracic outlet; p: assumes military posture, PT monitors pulse; +: absent/diminished radial pulse due to first rib & clavicle compressing the subclavian A.
wright test (hyperabduction test)
thoracic outlet; p: PT moves pt arms into abduction; +: dec radial pulse likely due to compression in the costoclavicular space
what tests are used for thoracic outlet? which test is the only one NOT to measure radial pulse?
Adson’s, Allen, Costoclavicular, Roos, Wright; Roos does NOT measure radial pulse, only movement
glenoid labrum tear test
p: supine, PT passively abductions and laterally rotates arm over head with anterior force to humerus; +: clunk or grinding
ULTT 1 - median N
median N, anterior interosseous; 110deg GH abduction, supination, wrist extension, thumb extension
ULTT 2 - median N
median N, mulsculocutaneous N, axillary N; supination, wrist ext, thumb extension, shoulder ER
ULTT 3 - radial N
radial N, pronation, wrist flexion, finger/thumb flexion, ulnar dev, shoulder IR
ULTT 4 - ulnar N
ulnar N; elbow flexion, supination, wrist ext, radial dev, finger ext, shoulder ER
which limb tension tests are basically opposites? AND have you do the opposite motion than you would think?
radial & ulnar (radial = ulnar deviate, ulnar = radially deviate)
varus/valgus stress test
LCL/MCL respectively; p: 20-30deg flexion
Cozen’s test
lateral epicondylitis; p: pt in slight elbow flexion, asked to make fist, pronate, radially deviate, and extend wrist against resistance: +: pain to lateral epicondyle or muscle weakness
lateral epicondylitis test
p: extend 3rd digit against resistance; +: pain or weaknesses
medial epicondylitis test
p: PT supinates arm, extends wrist and elbow while palpating medial epicondyle; +: pain
Mill’s test
lateral epicondyle; p: PT pronates arm, flexes wrist, and extends elbow; +: pain in lateral epicondyle
what tests are used for lateral epicondylitis? what tests are mirror opposites of each other?
Cozen’s, lateral epicondylitis, Mill’s test; Mill’s and medial epicondylitis are opposites
Tinel’s sign
ulnar nerve compression; tap between olecranon procress and medial epicondyle; +: tingling
ulnar collateral ligament instability test
p: valgus force to MCP of thumb; +: excessive valgus movement = tera of ulnar collateral and accessory collateral lig = gamekeeper/skier’s thumb
Allen’s test (hand)
vascular insufficency of radial or ulnar A; pt open/closes hand with arteries compressed; +: delayed or absent flushing when arteries are released = occlusion
bunnel-littler test
intrinsic hand tightness; if PIP doesn’t flex with MCP extended = muscle or capsule tightness BUT if it fully flexes with slight MCP flexion = muscle tightness but no capsular tightness
tight retinacular ligament test
PT attempts to flex DIP, if it can flex with PIP in flexion = tight retinacular but not tight capsule
Froment’s sign
ulnar N compromise; p: hold a piece of paper between thumb and index finger; +: distal phalanx flexed (adductor pollicis paralysis); if the MCP extends too = Jeanne’s sign
Phalen’s test
carpal tunnel (median n compression); p: standing with dorsum of wrists compressed and wrist in flexion for 60sec; +: tingling in thumb, index finger, middle finger, and lateral half of ring finger
Tinel’s sign (wrist)
carpal tunnel (medial N compression); tap over the volar aspect of pt’s wrist; +: tingling in median N distruibution - thumb, index finger, middle finger, lat half of ring finger
Finkelstein test
thumb tenosynovitis (de Quevain’s dx); p: makes fist with thumb tucked in, PT ulnarly deviates wrist; +: pain over abductor pollicis longus and extensor pollicis brevis
Grind test
OA of thumb CMC joint; p: PT applies compression and rotation through thumb metacarpal; +: pain
Murphy’s test
dislocated lunate; p: makes a fist; +: third metacarpal level with the second and first
Ely’s test
rectus femoris contracture; p: prone, passively knee flexion +: hip flexion occurs too
Ober test
TFL contracture; p: sidelying, PT moves leg into hip extension and abduction, then down; +: inability for test leg to adduct and touch table
Piriformis test
piriformis tightness or sciatic compression; sidelying with hip flexed to 60deg, PT applied adduction force at knee. +: pain or tightness
Thomas test
+; straight leg raise from table = hip flexion contracture
Tripod sign
tight hamstrings; pt sitting EOB with knees 90, PT passively extends 1 knee, +: tightness of hamstrings or extension of trunk to limit hamstring
90-90 Straight leg raise
hamstring tightness; p: alternately extends ea knee as much as possible with hips in 90deg flexion; +: knee remaining 20deg or more of flexion
Craig’s Test
femoral anteversion; p: pt prone, medially and laterally rotate hip until greater trochanter is parallel with the table; anteversion should be between 8-15deg
Patrick’s test (FABER)
iliopsoas, sacroiliac, hip joint abnormalities; pt supine with leg flexed, abducted and laterally rotated; +: failure of leg to abduct below the level of the opposite leg
Quadrant scouring test
arthritis, AVN, osteochondral defect; pt in supine, passively adduction and flex hip with compressive force; +: grinding, catching, or crepitation
Trendelenburg test
weakness of glut med on weight bearing side; p: asked to stand on one leg for ~10sec, +: drop of pelvis
Anterior drawer test
ACL; p: knee flexed to 90deg with hip at 45 deg, P>A force on tibia; +: excessive translation, with diminished or absent end point
Lachman test
ACL; p: knee flexed to 20-30deg with P>A force on tibia; +; excessive translation
anterior drawer vs lachman, which one has less knee flexion?
lachman’s (20-30 vs. 90deg)
Lateral pivot shift test
ACL; p: medially rotate tibia with valgus force while knee is slowly flexed; +:shift or clunk indicating anteriolateral rotatory instability - reduction of tibia on femur
What tests are used for ACL
lateral pivot shift, anterior drawer, lachman’s
posterior drawer test
PCL; pt supine with knee flexed to 90deg and hip at 45deg, A>P force on tibia +: excessive posterior translation with diminished or absent end point
Posterior sag sign
PCL; p: supine with kne flexed to 90deg and hip flexed to 45deg; +: tibia sagging
Slocum test
anteriolateral OR anteriomedial knee instability; p: supine, knee flexed to 90deg and hip at 45deg, pt foot rotated 30deg medially with lower leg stabilized then P>A force on tibia; +: excessive instability on lateral aspect of tibia; OR rotate foot laterally and look for medial translation
Valgus/varum stress test
MCL/LCL respectively. performed with knee in 20-30deg flexion. if positive with knee in full extension: MCL, PCL, posterior oblique ligament and posterior medial capsule OR LCL, PCL, arcuate complex and posteriolateral capsule
Apley’s compression test
meniscus; pt prone with knee flexed to 90deg, compress and medially/laterally rotate tibia; +: clicking or pain
Bounce home test
meniscal lesion; pt in supine, maximally flex knee then extend passively; +: incomplete extension or rubbery end feel
McMurray test
posterior mensical lesion, clicking or pronounced crepitation
Brush test
effusion in the knee - proximally stroke medial surface of patella +: wave of fluid just below the distal border
Patellar tap test
effusion; slight tap over the patella; +: if the patella appears to be floating
Clarke’s sign
patellofemoral dysfunction; slight distal pressure to superior pole of patella then pt contracts quads - +: failure to complete contraction without pain
Hughston’s plica test
medial plica dysfunction: pt supine, PT flexes knee and medially rotates tibia while attempted to move patella medially to feel medial femoral condyle; +: popping sound over medial plica
Noble compression test
ITB friction syndrome; hand over the lateral epicondyle of the femur with pressure over lateral epicondyle, pt extends knee +: pain over lateral femoral epicondyle ~30deg
Patellar apprehension test
patellar subluxation or dislocation; lateral directed force to patella; +: look of apprehension or attempt to contract quadriceps
Anterior drawer test for ankle
ATLF; tib fib stabilized with ankle in 20deg PF, +: excessive anterior translation of talus
Talar tilt
calcaneofibular ligament sprain, tib fib stabilized with pt in sidelying, tilts talus into abduction and adduction +: excessive tranlation
Thompson test
Achilles tendon rupture; pt prone, squeeze muscle belly of gastroc/soleus +: absence of PF
Tibial torsion test
excessive tibial rotation; pt sitting EOB, PT thumbs on B malleoli, measure the acute angle formed by axes of knee and ankle; normal = 12-18deg in adults
True leg length discrepancy
greater than 1cm; lying supine with legs 15-20cm apart; measure from ASIS to distal point of medial malleoli
Foraminal compression test
nerve root compression in C spine; p: in sitting with head laterally flexed, inferior force through top of head; +: pain radiating into arm toward flexed side
Vertebral artery test
compression of vertebral artery; pt in supine, C spine extension, lateral flexion, rotation to ipsilateral side; +: dizziness, nystagmus, slurred speech, loss of consciousness
Sacroiliac joint stress test
SIJ dysfunction; supine, downward and lateral force to pt ASIS; +: unilateral pain in SIJ or gluteal area
Sitting (or standing) flexion test
articular SIJ dysfunction; pt sitting wtih knees 90, pt bends forward with thumbs of inferior margin of PSIS; +: PSIS moves farther in cranial direction than the other; for standing pt stands with feet 12in apart
