Upper Extremity Special Tests

Question 1

Apley’s Scratch Test

Answer 1

Patient asked to reach overhead and touch opposite shoulder blade on their back.
Patient reaches behind back as far up the back as they can.
Patient asked to reach across and touch the back of the opposite shoulder

Compare both sides

Question 2

Apley’s Scratch Test Documentation

Answer 2

Comparing position for each side.
R/L overhead:T4/C5
R/L behind back: L1/L4
R/L cross body: posterior opposite shoulder/lateral opposite shoulder

Not a positive or negative result

Question 3

Hawkins-Kennedy Test

Answer 3

Patient stands
Examiner- moves patients UE to 90 degrees flexion and 90 degrees elbow flexion
Resists shoulder internal rotation (push down on wrist when applying resistance)

Question 4

Hawkins-Kennedy test Documentation

Answer 4

Positive if painful
Usually resulting in impingement

R+, L-

Question 5

Empty Can Test

Answer 5

Evaluate patient’s arm in neutral rotation to 90 degrees abduction
Then internally rotate and put in scapular plane
*thumb points to floor
*resist at wrist

Question 6

Empty Can Test Documentation

Answer 6

Positive if pain is present with test

R+/L-

Question 7

If Empty Can Test is positive what is most likely the cause ?

Answer 7

Shoulder impingement, supraspinatus might be torn or rotator cuff injury

Question 8

Lateral Epicondylitis Test

Answer 8

Resist 3rd digit at finger tip

Question 9

Lateral Epicondylitis Test Documentation

Answer 9

Pain over the lateral epicondyle is a positive test

R+/L-

Question 10

Lateral Epicondylitis is also known as?

Answer 10

Tennis Elbow

Question 11

Medial Epicondylitis Test

Answer 11

Palpate medial epicondyle
Passively supinate forearm and extend wrist

Resist at the fingers

Question 12

Medial Epicondylitis Documentation

Answer 12

Positive if pain over medial epicondyle

R+/L-

Question 13

Medial Epicondylitis is also known as?

Answer 13

Golfer’s Elbow

Question 14

Varus Instability Test

Answer 14

Position patients elbow slightly flexed and humerus stabilized by the examiner
Apply adduction force distal to elbow (may need to apply several times) *push medially

Palpate the lateral collateral ligament at joint line
as it is stretched you should feel increased tension

Question 15

Varus Instability Test with pain would indicate?

Answer 15

Change in pain or motion may indicate sprain or instability

Question 16

Valgus Stress Test

Answer 16

Elbow flexed at 90 degrees and arm supinated

Stabilize distal humerus while palpating the medial collateral ligament at the joint
* HUMERUS DOES NOT ROTATE
Apply a valgus or abduction force

Question 17

Valgus stress test with pain would indicate?

Answer 17

Pain or reproduction of symptoms may indicate MCL tear

Question 18

Valgus Stress test is also referred to as?

Answer 18

milking maneuver

Question 19

Tinel’s Special Test

Answer 19

Tap the carpal tunnel
Medial- hamate and pisoform
Lateral- scaphoid and trapezium

Question 20

Tinel’s postive test results in?

Answer 20

tingling or paresthesia in the thumb, index finger, middle and lateral half of the ring finger

Question 21

Phalen Special Test

Answer 21

Wrist flexion, both hands

hold for 1 minute

Question 22

If phalen test is positive results will be?

Answer 22

tingling or parethesia the median nerve distribution

Question 23

Reverse Phalen

Answer 23

Wrist extension, both hands together palms touching
applies pressure over carpal tunnel
Hold for 1 minute

Question 24

Positive results for Reverse Phalen will be?

Answer 24

Tingling or paresthesia in the median nerve distribution

Question 25

How are special tests documented?

Answer 25

Name of test
Side
Result (positive or negative)