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Upper Extremity Special Tests Flashcards

1
Q

Acromion types

A
  1. Type I - (flat) least likely to cause impingement
  2. Type II - (curved) more likely to cause impingement
  3. Type III - (beaked) most likes to cause impingement
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2
Q

Functional shoulder articulations

A
  1. Scapulothoracic
  2. Acromioclavicular
  3. Sternoclavicular
  4. Glenohumeral
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3
Q

Neural flexion of shoulder

A

150-170 degrees

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4
Q

Neutral extension of shoulder

A

60 degrees

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5
Q

Neutral external rotation of shoulder

A

60 degrees

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6
Q

Neutral internal rotation of shoulder

A
  1. Stage 1 = 70

2. Stage 2 = -95 (hand behind back)

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7
Q

Adduction of shoulder

A

20-40 w/ arm in front of body

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8
Q

Abduction of shoulder

A

180 along coronal plane

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9
Q

Horizontal flexion of shoulder

A

130-160 from coronal plane

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10
Q

Horizontal extension of shoulder

A

40-50 from coronal plane

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11
Q

Horizontal internal rotation of shoulder

A

70 from coronal plane

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12
Q

Horizontal external rotation of shoulder

A

90 from coronal plane

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13
Q

Boa’s sign

A
  1. Pain in right shoulder/upper back
  2. Referred pain from abdominal organs on right
  3. Indicates possible cholecystitis, pyloric stenosis, duodenal ucler
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14
Q

Kehr’s sign

A
  1. Pain in left shoulder/upper back
  2. Referred pain from abdominal organs on left
  3. Indicates possible plenty injury, gastritis, gastric ulcer, renal stone
  4. Possible cardiac etiology
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15
Q

Elbow flexion

A

145

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16
Q

Elbow extension

A

0

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17
Q

Forearm pronation

A

90 from thumb up (neutral position)

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18
Q

Forearm supination

A

90 from thumb up (neutral position)

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19
Q

Carrying angle

A 
Angle abduction from trunk
1. Males: 5-10
2. Females 10-15
3. Abnormal
  A. >15 (cubitus valgus)
  B. <5-10 (cubitus varus)
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20
Q

Wrist flexion

A

80-90

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21
Q

Wrist extension

22
Q

Adduction (ulnar deviation)

23
Q

Abduction (radial deviation)

24
Q

Apley scratch test

A
  1. Test for: shoulder general ROM
  2. Technique:
    A. pt reaches behind head to touch sup medial scapula w/ both arms
    B. Pt reaches behind back to touch inferior angle opposite scapula
    C. Compare both arms
25
AC joint dysfunction test
1. Test for: AC joint dysfunction 2. Technique: pt crossed arm across chest to put hand on opposite shoulder A. Shoulder and elbow flex 90 B. Pt resist downward force *pain = +
26
Drop arm test
1. Test for: supraspinatus (rotator cuff tear) 2. Technique: pt abducts arms above head, slowly lowers them * sudden drop = +
27
Empty can/jobe test
1. Test for: supraspinatus weakness 2. Technique: pt abduct shoulder 90 w/ 30 horizontal flexion ant, pronate arm A. Pt resist downward force *pain = +
28
External rotation and lag test
1. Test for: supraspinatus, infraspinatus, teres minor weakness 2. Technique: A. External rotation: elbow flex 90 w/ arm at side, pt ext rotates against dr. *pain = + B. Lag: same position, dr externally rotates arm and released *arm returns to normal = +
29
Subscapularis lift off test
1. Test for: subscapularis weakness 2. Technique: pt internally rotates arm behind back on lumbar spine A. Pt resists dr trying to pull hand away from back
30
Hawkin’s test
1. Test for: impingement between greater tuberosity of humerus against coracoid-humeral ligament 2. Technique: pronated arm flex 90, internally rotated A. Stabilize scapula *pain = +
31
Neer’s test
1. Test for: impingement between greater tuberosity humerus and inferior acromion process 2. Technique: pronated arm passively flexed while stabilizing scapula A. Impingement at 90 *pain = +
32
Apprehension/relocation test
1. Test for: unstable shoulder w/ ligamentous laxity 2. Technique: A. Apprehension: abduct arm 90 w/ elbow flexed 90, slowly externally rotate arm *pain/apprehension = + B. Relocation: same as apprehension but stabilize glenohumeral joint *pt feels improvement = +
33
Yergason’s test
1. Test for: long head biceps/transverse humeral ligament 2. Technique: pt starts elbow flex 90 and forearm pronated A. Pt tries flex arm and supinate against resistance B. 3rd time, dr externally rotates arm while resisting *pain/tendon popping out of groove = +
34
Speed’s test
1. Test for: long head biceps tendon, bicipital tendonitis 2. Technique: arm flex 90 and sup A. Pt resists downward force at wrist *pain ant shoulder = +
35
O’Brian’s test
1. Test for: bicipital-labral complex 2. Technique: arm flex 90 and adducted to medial line, elbow extended, forearm pronated A. Pt resist downward/medial force B. Repeated w/ forearm sup *pain/clicking = +
36
Roo’s test
1. Test for: thoracic outlet syndrome 2. Technique: shoulder abd 90 and externally rotated, elbows flex 90 A. Pt opens and closes hands 3 min *parasthesia = +
37
Adson’s test
1. Test for: thoracic outlet syndrome 2. Technique: shoulder slight extension and abduction, elbow extended, head toward affected side A. Dr. Feels radial pulse before put in position and monitors while in position *weakened pulse or parasthesia = +
38
Wright’s test
1. Test for: thoracic outlet syndrome 2. Technique: hyperabduct arm above head, head turned away A. Radial pulse felt before put in position and monitored after *weakened pulse or parasthesia = +
39
Tinel’s test at elbow
1. Test for: Cubical tunnel syndrome (ulnar nerve) 2. Technique: hyperflex elbow and extend wrist in forearm pronation A. Percuss between olecranon and medial epicondyle *numbness/tingling on medial hand = +
40
Resisted supination test
1. Test for: extensor carpi radialis brevis (lateral epicondylitis) 2. Technique: stablilze elbow, resisted supination * pain lateral epicondyle = +
41
Maudley’s test
1. Test for: lateral epicondylitis 2. Technique: forearm prone, pt resist downward force on middle finger * lateral epicondyle pain = +
42
Mill’s test
1. Test for: lateral epicondylitis 2. Technique: forearm prone, pt resist downward force at wrist * pain lateral epicondyle = +
43
Resisted pronation test
1. Test for: flexor carpi radialis origin, medial epicondylitis 2. Technique: stabilize elbow, forearm sup, pt tries to pronate against resistance * pain medial epicondyle = +
44
Resisted wrist flexion test
1. Test for: medial epicondylitis 2. Technique: stabilize elbow, forearm sup, dr resists wrist flexion * medial epicondyle pain = +
45
Tinel’s test
1. Test for: carpal tunnel (median nerve) 2. Technique: percuss flexor retinaculum * numbness/tingling along median nerve distribution = +
46
Phalen’s test
1. Test for: carpal tunnel syndrome 2. Technique: hyperflexion wrists by pressing dorsum hands together 30-60 sec, arms at 90 abduction and parallel to floor * numbness/tingling = +
47
Reverse Phalen’s test
1. Test for: carpal tunnel syndrome 2. Technique: hyperextension wrists w/ palms together 30-60 sec * numbness/tingling = +
48
Finkelstein’s test
1. Test for: De Quervain’s tenosynovitis (extensor pollicis brevis and abductor pollicis longus) 2. Technique: flex MCP and IP of thumb and place in fist, ulnar deviation at wrist * pain of ant snuff box = +
49
Allen’s test
1. Test for: collateral blood supply in hand 2. Technique: fist held 20-30 sec until blanching, pressure distal ulnar and radial arteries A. Fist released, one artery released B. Repeat other artery *blood flow doesn’t return in blocked side in 5-7 sec = +
50
Supraspinatus
1. Prox: supraspinatus fossa 2. Distal: sup facet greater tuberacle 3. Innervation: suprascapular (C4-C6) 5. Fxn: initiates and assists abduction
51
Subscapularis
1. Prox: anterior scapula 2. Distal: lesser tuberosity humerus 3. Innervation: upper (C5) and lower (C6) subscapular n. 4. Fxn: internal rotation
52
Infraspinatus
1. Prox: infraspinus fossa 2. Distal: middle facet greater tubercle humerus 3. Innervation: suprascapular (C5-C6) 4. Fxn: external rotation

OMM (16 decks)

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