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BOARDS: Musculoskeletal > UE special tests > Flashcards

UE special tests Flashcards

1
Q

What two tests can be used to identify biceps tendonopathy? Tell how to do them.

A

yergasons: pt’s arm at belly, move out to resist you while completing ER/supinatin
- can feel tendon pop out if transverse lig not good
- 70s SN, 50s SP

speeds: UE held out straight, supinated
- push down so they resist arm descending into ext.
- 90s SN, 10s SP

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2
Q

What is neer’s impingement test?

A

neer to ear: pt sitting -> you stabilize the scapula, then passively internally rotate his shoulder, then elevate it

  • check neutral elevation first
  • SN 88, SP 30

USED FOR SOFT TISSUE IMPINGEMENT aka supraspinatus, long head of biceps

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3
Q

What’s the difference between the empty can and the drop arm test?

A

empty can = identifies tear or impingement of supraspinatus

  • resist abduction at neutral 90deg elevation
  • then resist abduction at IR position with 30deg forward from horizontal (empty can position)

vs

drop arm = testing for tear or full rupture of rotator cuff
- passively abduct pt’s arm to 120, tell pt to slowly bring it down to side

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4
Q

What are the anterior/posterior apprehension sign tests?

A

anterior: pt supine, shoulder at 90deg abd
- slowly take shoulder into ER -> pt doesn’t like it
- can tell you about previous shoulder dislocations

posterior: pt supine with shoulder abducted 90deg
- bring shoulder into IR and horizontal adduction while giving posterior force at humerus -> pt doesn’t like it

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5
Q

What is the clunk test used for?

A

identifying labral tear

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6
Q

How do you do the clunk test?

A

pt supine, shoulder in full abduction

  • push humeral head anterior while externally rotating humerus
  • audible “clunk” is heard
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7
Q

What is the posterior impingement test? What structures may be impinged if this is positive (vs neer)?

A

posterior impingement

  • pt supine: move shoulder into 90deg abd, max ER, 15-20deg horizontal adduction
  • pain in posterior shoulder

identifies impingement between rotator cuff/greater tuberosity or posterior glenoid/labrum

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8
Q

What is the AC shear test?

A

clasp your two hands together: one heel of hand is on spine of scap, one heel of hand is on clavicle

  • you press them together and compress AC
  • positive for reproducible pain in AC
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9
Q

What does Adson’s test look at?

A

identifies pathology of structures that run through thoracic inlet

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10
Q

How do you do adson’s test?

A

pt sitting
- you find radial pulse on testing arm -> slightly extend and ER straight arm, then extend/rotate head towards tested side

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11
Q

What are the three tests you can use for thoracic outlet, and how are they differentiated?

A

1) Adson’s (extend arm, extend/turn head)
2) Roos (arms in 90/90, open/close hands for 3min)
3) Allen’s maneuver (pt’s arm supported in 90/90, look away, monitor radial pulse for diminished/gone)

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12
Q

How do you perform Hawkins-Kennedy?

A

pt’s shoulder put into 90deg shoulder flexion with elbow bent to 90deg
- therapist passively IRs arm, positive for subacromial impingement if pain

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13
Q

When extending your whole arm down to fingers, supinated, and then side bending away with head, what nerve are you putting on tension?

A

median

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14
Q

How do you test the radial nerve?

A

elbow extended, wrist pronated, wrist flexed/ulnar dev, fingers flexed, IR at shoulder -> side bend away

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15
Q

What is the rent sign test for? How do you perform?

A

Used to identify RTC tear or impingement

  • in seated, bring arm into extension with elbow bent; rotate into IR/ER
  • palpate anterior to anterior acromion, looking to feel prominent greater tuberosity and depression of 1 finger width if a tear
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16
Q

What’s the difference between the crank test and clunk test?

A

clunk test = looks for labrum tear

  • put shoulder in full abd, prop up anterior humeral head
  • externally rotate shoulder listening for clunk

crank test = looking at instability and/or labral tear
- abduct arm to 160deg, axial load, crank into ER/IR listening for click or pain

17
Q

What’s the bear hug test for? What other test looks at the same thing?

A

subscap tear

  • cross arm over body, hand on opposite shoulder
  • “compress your shoulder and press down with your hand, keeping elbow in the air”

belly press also tests for subscap tear

18
Q

What does the horizontal adduction test look at?

A

ac joint dysfunction or subacromial impingement

- supposed to be a passive test

19
Q

What tests are used for impingement?

A

Neer, Yocum, Hawkins-Kennedy, horizontal adduction

20
Q

What tests are used to identify a labral tear?

A

clunk (prop up anterior humeral head)
active compression (IR arm push down, ER arm push dwn)
biceps load (arm 120/90 and pulling bicep in)
crank (axial load)

21
Q

What tests are used for bicipital tendonopathy/osis?

A

yergasons

speed’s

22
Q

What is the active compression test used for? how do you do it?

A

straight arm out in 90deg flexion, 10 adduction

  • IR arm, resist push down
  • ER arm, resist push down

If pain with IR but relief with ER -> AC joint dysfxn
If pain/click with IR but reduced/eliminated with ER -> SLAP

23
Q

What is tennis elbow? How do you test for it?

A

lateral epicondylosis -> test with Cozens

  • pt sitting with elbow in 90deg flexion, supported on table
  • resist wrist ext, radial dev, and forearm pronation with fingers flexed into a fist (all at same time)

*can also be tested with Mills: passive flexion of wrist and fingers and all that

24
Q

What muscle is commonly indicated in lateral epicondylosis?

A

ECRB

25
Q

What is the golfer’s elbow test?

A

pt’s arm supported on table, supinate arm, extend elbow then wrist

  • pain occurs over medial epicondyle
  • indicates potential medial epicondylosis
26
Q

You suspect your patient may have pronator teres syndrome. How would you test for this? What nerve do you think is implicated?

A

pts sitting, arm supported w/ elbow at 90

  • resist elbow extension and forearm pronation simultaneously
  • reports of tingling/parasthesias over MEDIAN nerve distribution indicate positive
27
Q

What does Finklesteins test look for?

A

de Quervain’s tenosynovitis (paratendonitis of APL and or EPB)

EPB = extensor pollicis brevis
APL = abductor pollicis longus
28
Q

What is the Bunnel-Littler test?

A

looks at intrinsic tightness at the PIP joints

  • MCP joint stabilized in slight ext. while PIP is flexed
  • then MCP is flexed and PIP joint is flexed
29
Q

During Bunnel-Littler test, if you flex the MCP and get more range in the PIP, what does this mean?

A

intrinsic muscles are tight vs capsule tightness

capsule tightness wouldn’t change with MCP flexion, PIP range would remain same

30
Q

How do you test for tight retinacular?

A

PIP stabilized in neutral, flex DIP
- then flex PIP then DIP

increased range with flexion? retinacular ligaments are tight (if both limited, capsule tight)

31
Q

What nerve innervates the thenar emminence? How do you test for it?

A

hold piece of paper between fingers and try to pull it out

- froment’s sign: seeing flexion of distal IP of thumb as compensation

32
Q

How do you perform phalen’s?

A

FLEX both wrists, hold for 1 minute

33
Q

What is Allen’s test? (note test, not maneuver)

A

test: have pt open/close hand quickly for several reps, block ulnar artery and then have them make a fist
- hold for a second then observe filling when they open
- do same for radial a.

34
Q

What tests can be used to look for median nerve compression in carpal tunnel?

A

phalen’s
tinel’s
flick test: flick hands, can relieve parasthesias

35
Q

Where can you test for compression of the ulnar n.?

A

tinel’s sign in cubital tunnel

BOARDS: Musculoskeletal (10 decks)

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