UE Special Tests Flashcards
Apprehension test for anterior shoulder dislocation
Supine with arm abducted to 90 deg
PT laterally rotates shoulder
+= look of apprehension or facial grimace before EROM
Apprehension test for posterior shoulder dislocation
Supine with arm in 90 deg of flexion and medially rotated
PT applies posterior force through humerus
+= look of apprehension or facial grimace before end point
Ludington’s Test
Sitting with hands clasped behind head with fingers interlocked
Asked to alternately contract and relax biceps
+= absence of movement at biceps tendon, may indicate rupture of long head of biceps
Speed’s Test
Sitting or standing with elbow extended and forearm supinated
PT has one hand over bicipital groove and other on volar surface of forearm while resisting shoulder flexion
+= pain or tendernessin bicipital groove, may indicate biceps tendonitis
Yergason’s Test
Sitting with 90 degrees of elbow flexion and forearm stabilized against thorax
PT places one hand on bicipital groove and other on pt. forearm while resisting supination and lateral rotation
+= pain or tenderness in bicipital groove, may indicate bicipital tendonities
Drop Arm Test
Sitting or standing with arms elevated to 90 deg of shoulder abd
Pt. slowly lowers arms
+= pt unable to slowly lower arm(s) or presence of severe pain, may indicate tear in rotator cuff
Hawkins-Kennedy Impingement Test
Sitting or standing with shoulder flexion at 90 deg and elbow flexed
PT applies medial rotation
+= pain, may indicate shoulder impingement involving supraspinatus tendon
Neer Impingement Test
PT has one hand on posterior border of scap and other underneath pt. elbow
Arm is elevated through flexion
+= facial grimace or pain, may indicate shoulder impingement involving supraspinatus tendon
Supraspinatus Test
Pt. arm placed in 90 deg of abd and 30 deg of horizontal add with thumb pointing downward
PT resists abduction
+= weakness or pain, may indicate tear of supraspinatus tendon, impingement, or suprascapular nerve involvement
Adson maneuver
PT monitors radial pulse as pt. rotates head toward involved shoulder and extends head while PT laterally rotates and extends shoulder
+= absent or diminished radial pulse, may indicate thoracic outlet syndrome
Allen Test
Arm in 90 deg abd, lateral rotation, and elbow flexed
Pt. rotates head away from involved shoulder as PT monitors radial pulse
+= absent or diminished pulse, may indicate thoracic outlet syndrome
Costoclavicular Syndrome Test
While sitting, PT monitors radial pulse and places pt into military posture
+= absent or diminished radial pulse, may indicate thoracic outlet syndrome via compression of subclavian artery b/w 1st rib and clavicle
Roos Test
Arms in 90 deg of abd, lateral rotation, and elbow flexion
Pt opens and closes hands for 3 min
+= inability to maintain test position, weakness of arms, sensory loss or ischemic pain, may indicate thoracic outlet syndrome
Wright (hyperabduction) Test
While sitting or supine, PT moves pt arm overhead in the frontal plane while monitoring radial pulse
+= absent or diminished radial pulse, may indicate compression of costoclavicular space
Glenoid Labrum Test
Supine with PT placing one hand on posterior aspect of humeral head while other hand stabilizes humerus proximal to elbow
PT passively abducts and laterally rotates arm over head while applying anterior force
+= clunk or grinding sound, may indicate glenoid labrum tear
ULLT Test: Radial nerve
Shoulder depression with 10 deg abduction Elbow extension Forearm pronation Wrist flexion & ulnar deviation Finger & thumb flexion Shoulder medial rotation
ULLT Test: Ulnar nerve
Shoulder depression 10-90 deg of shoulder abduction Elbow flexion Forearm supination Wrist extension & radial deviation Finger and thumb extension Shoulder lateral rotation
ULLT Test: Median nerve, anterior interosseous nerve
Shoulder depression with 100 deg abduction Elbow extension Forearm supination Wrist extension Finger & thumb extension
ULLT Test: median nerve, axillary nerve, musculocutaneous nerve
Shoulder depression with 10 deg abduction Elbow extension Forearm supination Wrist extension Finger & thumb extension Shoulder lateral rotation
Varus stress Test
Sitting with elbow flexed 20-30 deg
PT has one hand on proximal elbow and other proximal to pt wrist while applying varus force
+= increased laxity in lateral collateral ligament, apprehension or pain, may indicate tear of lateral collateral ligament
Valgus stress Test
Sitting with elbow flexed 20-30 deg
PT has one hand on proximal elbow and other proximal to pt wrist while applying valgus force
+= increased laxity in medial collateral ligament, apprehension or pain, may indicate tear of medial collateral ligament
Cozen’s Test
Sitting with elbow in slight flexion
PT stabilizes elbow while palpating lateral epicondyle
Pt fights resistance while making a fist, pronating forearm, extending wrist and radial deviation
+= pain @ lateral epicondyle or muscle weakness, may indicate lateral epicondylitis
Lateral epicondylitis Test
PT stabilizes elbow with one hand and places other on dorsal aspect of pt hand distal to PIP
Pt extends middle finger against resistance
+= pain @ lateral epicondyle, may indicate lateral epicondylitis
Medial epicondylitis Test
PT palpates medial epicondyle and supinates pt forearm and extends wrist and elbow
+= pain @ medial epicondyle, may indicate medial epicondylitis
Mill’s Test
PT palpates lateral epicondyle, pronates forearm, flexes wrist, and extends elbow
+= pain @ lateral epicondyle, may indicate lateral epicondylitis
Ulnar collateral ligament instability Test
PT holds thumb in extension while applying valgus force @ MCP of thumb
+= excessive valgus movement, may indicate tear of ulnar collateral ligamentand accessory collateral ligaments
Gamekeepers or skiers thumb
Allen Test
Pt asked to open and close hand several times and then keep hand closed
PT compresses radial and ulnar arteries then pt relaxes hand and PT releases pressure on one artery while observing color of hands and fingers
+= delayed or absent flushing of radial and ulnar half of hand, may indicate occlusion in radial or radial artery
Bunnel-Littler Test
MCP joint held into slight extension as PT moves PIP into flexion
If PIP is unable to flex with MCP extension, may be tight intrinsic muscle or capsular tightness
IF PIP fully flexes with MCP in slight flexion, may be intrinsic muscle tightness WITHOUT capsular tightness
Tight retinacular ligament Test
PIP is held in neutral while PT tries to flex DIP
If unable to flex DIP, retinacular ligaments or capsule may be tight
If able to flex DIP with PIP flexion, may be tight retinacular ligaments and capsule may be normal
Froment’s Sign
Pt holds piece of paper b/w thumb and index finger as PT tries to pull away
+= pt flexes distal phalanx of thumb due to adductor pollicis muscle paralysis
If pt hyperextends MCP of thumb= Jeanne’s sign
Both may indicate ulnar nerve compromise or paralysis
Phalen’s Test
Pt maximally flexes wrist and holds them together for 60s
+= tingling in thumb, index finger, middle finger, and lateral half of ring finger, may indicate carpal tunnel syndrome due to median nerve compression
Tinel’s Sign
Elbow in slight flexion as PT taps with index finger b/w medial epicondyle and olecranon process
+= tingling in ulnar nerve distribution, may indicate ulnar nerve compression or compromise
Finkelstein Test
Pt makes fist while thumb tucked inside fingers
PT stabilizes forearm and ulnarly deviates wrist
+= pain over abductor pollicis longus and extensor pollicis brevis tendon, may indicate tenosynovitis in thumb aka deQuervain’s disease
Grind test
PT stabilizes pt hand and grasps along thumb at MCOP and applies compression and rotation
+= pain, may indicate degenerative joint disease
Murphy Sign
Pt asked to make a fist
+= pt 3rd MCP remains level with 2nd and 4th MCPs, may indicate dislocated lunate
Tinel’s Sign
Pt taps over volar aspect of pt wrist
+= tingling in thumb, index finger, middle finger, and lateral half of ring finger, may indicate carpal tunnel syndrome due to median nerve compression
