Ms 2

Front 1

Apley

Back 1

Position: Prone with knee bent to 90 deg.

Test: Examiner stabilizes thigh with their knee. Mediall and Laterally rotates tibia with distraction (ligamentous)and then compression (meniscus)

Result: Postive if pain or changes in amount of movement results.

Front 2

Mcmurray

Back 2

Position:Supine with knee flexed.

Test: Examiner rotates the tibia medially (Lateral meniscus)and extends the knee. This is then repeated with lateral rotation of tibia.(Medial Meniscus)

Result: Snap or click along with the feeling of pain is positive result.

Front 3

Bounce Home

Back 3

Position: supine with heel cupped in examiners hand with knee fully flexed

Test:examiner then allows the knee to quickly fully extend

Result:Positive test is lack of full extension due to springy block with possible sharp pain on the joint line.

Front 4

Plica Exam

Back 4

Position: Seated on the edge of the table with both knees flexed to 90 degrees

Test: Examiner places one finger over the patella and asks patient to extend the knee

Result: Positive if examiner feels patella stutter or jump between 60 and 45 degrees of flexion.

Front 5

Mediopatellar Plica Exam

Back 5

Position: Supine with knee flexed to 30 degrees with leg resting on examiners arm.

Test:Examiner pushes patella medially with their thumb

Result: Pain or click indicates pinching of plica between patella and medial femoral condyle.

Front 6

Patellar Tap

Back 6

Position: supine, Examiner places on hand at inferior portion of the patella with thumb and forefinger on each
side of the patella

Test: Examer then pushes fluid down with other hand from 10cm above patella. Then taps the lpatella

Result: floating or dancing of patella will be felt if fluid is present.

Front 7

Q-Angle

Back 7

Position: Supine with knee straight

Test:Measure angle of lines from ASIS to patella and tibial tubercle to patella

Result: Q-angle Normal is 13=male and 18=female

Front 8

Noble Compression Test

Back 8

Position: supine with knee in 90 degrees of flexion

Test: Pressure is applied with examiners thumb on lateral femoral condyle or just proximal to it. Examiner then extends patients knee while maintianing pressure

Result:Patient will experience severe pain at approximately 30 degrees flexion over the lateral femoral condyle.

Front 9

Valgus Stress

Back 9

Position: Supine with knee in full extension first and then tested in 20-30 degrees of flexion

Test: The examiner pushes the thigh medially while stabilizing the ankle or stabilizes the thigh on the edge of the table and abducts the lower leg.

Result:Excessive amount of movement of the tibia on the femur

Front 10

Varus Stress

Back 10

Position: Supine with knee in full extension first and then tested in 20-30 degrees of flexion

Test: The examiner pulls the thigh laterally while stabilizing the ankle or stabilizes the thigh on the edge of the table and adducts the lower leg.

Result:Excessive amount of movement of the tibia on the femur

Front 11

Lachman

Back 11

Position: Supine with leg off the table. The examiner holds the knee between 30 degreesflexion and full extension. Tibia should be slighly laterally rotated

Test: Femur is stabilized by outside hand. The tibia is translated anteriorly with the inside hand

Result: Positive is mushy or soft end feel is felt with increased translation

Front 12

Anterior Draw

Back 12

Position: Supine with knee flexed to 90 degrees and hip at 45 degrees. Foot is held on the table by the examiner's body.

Test: Hands are placed around the tibia and hamstrings must be relaxed Tibia is then drawn forward

Result: Positive if tibia moves more than 6mm

Front 13

Posterior Draw

Back 13

Position: Supine with knee flexed to 90 degrees and hip at 45 degrees. Foot is held on the table by the examiner's body.

Test: Hands are placed around the tibia and hamstrings must be relaxed Tibia is then pushed back on the femur

Result: Positive if tibia moves more than 6mm

Result

Front 14

Posterior Sag

Back 14

Position: Supine with knee flexed to 90 and hip flexed to 45 degrees

Test: Look to note if tibia drops back on femur

Result: Normally should see 1cm of tibial plateu in this position. If this " step" is lost, the test is positive.

Front 15

Lachman

Back 15

Position: Supine with leg off the table. The examiner holds the knee between 30 degreesflexion and full extension. Tibia should be slighly laterally rotated

Test: Femur is stabilized by outside hand. The tibia is translated anteriorly with the inside hand

Result: Positive is mushy or soft end feel is felt with increased translation

Front 16

Anterior Draw

Back 16

Position: Supine with knee flexed to 90 degrees and hip at 45 degrees. Foot is held on the table by the examiner's body.

Test: Hands are placed around the tibia and hamstrings must be relaxed Tibia is then drawn forward

Result: Positive if tibia moves more than 6mm

Front 17

Posterior Draw

Back 17

Position: Supine with knee flexed to 90 degrees and hip at 45 degrees. Foot is held on the table by the examiner's body.

Test: Hands are placed around the tibia and hamstrings must be relaxed Tibia is then pushed back on the femur

Result: Positive if tibia moves more than 6mm

Result

Front 18

Posterior Sag

Back 18

Position: Supine with knee flexed to 90 and hip flexed to 45 degrees

Test: Look to note if tibia drops back on femur

Result: Normally should see 1cm of tibial plateu in this position. If this " step" is lost, the test is positive.

Front 19

Ely's Test

Back 19

Position: Prone

Test: Examiner passively flexes knee

Results: Hip on testing side will spontaneously flex due to tight rectus.

Front 20

Ober's Test

Back 20

Position: Sidelying with lower leg flexed at knee and hip for stability

Test: The examiner passively abducts and extends the patients upper leg and then slowly lowers the limb to the table. Test is repeated with knee flexed and extended.

Results:If ITB is contracted, limb will remain abducted and will not reach table

Front 21

Patellar Tilt

Back 21

Position: Supine with knee extended

Test: Glide patella slightly lateral and place thumbs under lateral facet and lift edge of patella with thumbs while pressing down on medial edge of patella with index fingers

Results: monitor amount of movement. decreased if reinaculum is tight.

Front 22

Lateral Apprehension

Back 22

Position: Supine with leg supported in 30 degrees of flexion.

Test: Apply lateral force to medial side of patella

Results: Monitor for increased movement and patient apprehension.

Front 23

Squat Test

Back 23

Position: Standing

Test: Have patient perform partial squat

Results: Positive for meniscus if clicks and reproduces pain.

Front 24

Loomers (2 person test)

Back 24

Position: supine flex both hips and knees to 90 and keep knees together, held in place by one examiner

Test:Second examiner grasps feet and maximally ER both tibias

Results: Positive if injured tibia rotates excessively and there is a posterior sag of affected tibial tubercle.

Front 25

Talar Tilt

Back 25

Position: Supine or Sidelying. Gastroc may be relaxed by flexing knee

Test: The foot is held in anatomical 90 degree position. The talus is then tilted side to side

Results: Adduction stresses calcaneofibular ligament. Abduction tests deltoid ligament and tibionavicular ligament adn tibiocalcaneal and posterior tibiotalar ligaments.

Front 26

Inversion Stress Test

Back 26

Position: Supine or Sidelying. Gastroc may be relaxed by flexing knee

Test: The foot is held in PF. The talus is then tilted side to side

Results: Adduction stresses anterior talofibular ligament. Abduction tests deltoid ligament and tibionavicular ligament adn tibiocalcaneal and posterior tibiotalar ligaments.

Front 27

Anterior Draw

Back 27

Position: Supine with the foot relaxed

Test: The examiner stabilies the foot in 20 degrees PF and draws the talus anteriorly. Adding inversion increases the stress on the anterior talofibular ligament and calcaneofibular ligament.

Results:A straight anterior translation indicates a tear on both sides of the ankle. A tear on a single side will result in a rotary component to the translation.

Front 28

Prone Anterior Draw

Back 28

Position:Prone with the feet extending over the end of the examining table

Test:with one hand, the examiner pushes the heel steadily forward.

Results:Excessive anterior movement and sucking in of the skin on both sides of the Achilles tendon indicate a positive sign

Front 29

Squeeze Test

Back 29

Position: Supine

Test: Examiner grips the lower leg at the midcalf and squeezes the tibia and fibula together. Then applies the same force in increasing distal locations moving towards the ankle.

Results: Pain in lower leg indicates syndesmosis if fracture, contusion, and compartment syndrome have been ruled out.

Front 30

Percussion Test- Deep peroneal N.

Back 30

Position:seated or supine

Test:tapping on anterior tibial branch in front of ankle

Results:tingling and paresthesia indicates positive sign

Front 31

Percussion Test Posterior tibial n.

Back 31

Position: Seated or supine

Test:Tapping as nerve passes just behind medial malleolus

Results:tingling and paresthesia indicates a positive sign.

Front 32

External Rotation Test

Back 32

Position: Seated with legs hanging over exam table with the knee at 90 degrees.

Test:Examiner holds ankle at 90 degree angle and applies passive lateral rotation stress to the foot and ankle

Results:High ankle spain if pain is reproduced over the anterior or posterior tibofibular ligaments and interosseous membrane. Ifpain is medial and talus displaces from the medial malleolus, indicates deltoid ligament tear.

Front 33

Quadrant Test- hip

Back 33

Position:supine

Test: The examiner flexes and adducts the patient's hip until resistance is felt Slight resistance is maintained and hip is moved into abduction while maintaining flexion.

Results:Examiner noted any irregularity of movement, pain, or patient apprehension.

Front 34

Patrick Test

Back 34

Position: Supine

Test: Examiner places foot of test leg over the knee of the opposite leg. Examiner then slowly lowers knee of test leg to the table or atleast parallel to opposite leg.

Results:Positive test is indicated if test leg is unable to drop to level parallel with other leg.

Front 35

Trendlenburg Sign

Back 35

Position:Patient stands on one lower limb

Test: Tests stability of pelvis

Results:Pelvis of opposite side drops indicating positive test on stance leg. Indicates weak glut med or unstable hip

Front 36

Craig's Test

Back 36

Position: Pronewith knee flexed to 90 degrees

Test: Examiner palpates posterior aspect of femur. the hip then passively rotated medially and laterally unil the grreater trochanter is in most lateral position. Angle on lower leg with vertical is measured

Results: Mean angle 8-15 degrees. increased anteversion leads to squinting patella and toeing in

Front 37

Weber Barstow

Back 37

Position: Supine with hips and knees flexed

Test:Examiner palpates medial malleolus. Patient performs a bridge. Examiner then passively extends legs. Examiner then compares levels of malleolus

Results: Different levels indicate assymetry

Front 38

Sign of the Buttocks

Back 38

Position: Supine

Test: Examiner performs passive SLR If there is a limitation SLR The knee is flexed and further hip flexion is attempted

Results:If flexion does not increase, the lesion is in the bottock or the hip. If flexion does increase, sciatic nerve may be involved

Front 39

Thomas Test

Back 39

Position: Supine

Test: examiner flexes one hip and patient holds the hip against the chest.

Results: Other leg will raise of table if contraction is present. Abduction of test leg indicates ITB tightness If done off egde of table and knee extends indicates rectus femoris

Front 40

Bowstringing

Back 40

Position:Supine or sitting.

Test:Supine- Examiner performs SLR test, when symptoms are felt knee is flexed slightly to 20 degrees. pressure is then applied to sciatic nerve in popliteal area
Sitting- passively extends knee to produce symptoms then slightly flexes knee below painful level, then apply pressure to nerve

Results:Pain reproduced indicates sciatic nerve involvement.

Front 41

SLR

Back 41

Position: Supine with knee extended and hip medially rotated and adducted

Test:Examiner flexes leg until patient experiences pain or tightness in back of the leg. The examiner then backs out of painful range, DF passively and asks patient to flex head to reproduce symptoms

Results:If pain is primarily back pain, most likely disc herniation. If pain is mostly in leg, it is nerve irritation from other lateral tissues.

Front 42

Si Provocation Exam

Back 42

Position: supine

Test:Anterior gapping and posterior gapping tests. Cross arms and press at ASIS and compress SI, now gram at ilium and distract SI.

Result:

Front 43

Si Provocation Exam

Back 43

Position: supine

Test:Anterior gapping and posterior gapping tests. Cross arms and press at ASIS and compress SI, now gram at ilium and distract SI.

Result:

Front 44

Piriformis Test

Back 44

Position: Sidelying with test leg on top. Patient has test leg flexed to 60 degree hip flexion and knee flexed

Test. Examiner stabilizes the hip and applies downward pressure to the knee.

Results: If piriformis is tight, muscle is painful. If it is pinching sciatic nerve, pain results in the bottock and sciatica may be experienced by the patient.

Front 45

Slump Test

Back 45

Position: Seated over edge of table with legs supported, hips in neutral position, and hands behind back

Test: Patient slumps into thoracic and lumbar flexion. Examiner places pressure over shoulders to maintain flexed spine. Patient is then asked to fully flex head. Examiner holds patient in this postion. Examiner also holds foot in full DF as patient extends knee actively. If patient is unable to fully extend knee, patient extends head and then tries to further extend knee.

Results: If knee extends further with cervical spine extended, the test is positive for increased tension in the neuromeningeal tract.

Front 46

Prone Knee Bend

Back 46

Position: Prone

Test: Examiner passively flexes the knee as far as possible

Result: Unilateral neurological pain in lumbar area, buttock, or posterior thigh may indicate L2 or L3 nerve root lesion.

Front 47

Brudzinski-Kernig Test

Back 47

Postion: Supine with the hands cupped behind the head.

Test:Patient instructed to flex head on chest. Patient then raises extended leg until pain is felt. Patient then flexes the knee

Result: If pain disappears, the test is positive and may indicate meningeal irritation, nerve root involvement or dural irritation.

Front 48

Quadrant Test-lumbar

Back 48

Position: Standing with examiner behind them

Test: the patient extends sidebends and rotates to the same side. The examiner provides overpressure into extension. Movement continues until limit is reached or pain is produced

Results: Test is positive for the side in which patient moved if symptoms are reproduced.

Front 49

Standing Unilateral Extension

Back 49

Position: Standing on one leg with examiner behind patient

Test: Patient extends and then repeats while standing on other leg.

ResultL postive test ndicated by pain in the back and is associated with a pars interarticularis stress fracture (spondylolisthsis) located on the side that patient is standing on. If rotation is added, facet joint may also be involved.

Front 50

Correction of Lateral Shift

Back 50

Position: Patient stands with examiner standing to one side.

Test: The examiner grasps the patient's pelvis with both hands and places a shoulder against the patient;s lower thorax. The examiner then pulls the pelvis towards her body. It is held for 10-15 seconds then repeated on other side.

Result: Postive test will increase neurological symptoms on the affected side.

Front 51

Long sitting test

Back 51

Position: supine with legs straight

Test: Examiner ensures medial malleoli are level. Patient is then asked to sit up. Examiner observes whether one leg moves more proximal than the other.

Result: If there is a difference, it si a funcation leg length difference resulting from a pelvic dysfunction caused by a pelvic torsion or rotation.

Front 52

Gaenslen's test

Back 52

Position: The patient lies on the side with the upper leg hyperextended at the hip. The patient holds the lower leg flexed against the chest.

Test: Examiner stabilizes the pelvis while extending the hip of the upper leg.

Result: Pain is a positive test and may be a result of ipsilateral SI joint lesion, hip pathology or an L4 nerve root lesion.

Front 53

Pelvic Girdle: Standing Flexion Test

Back 53

Position: standing with feet shoulder width apart and hands together

Test: palpate PSIS and have the patient bend forward in a smooth fashion as far as possible without bending knees. Examiner follows the PSIS with movement

Result: Positive test on the side that appears to move more. False positives with assymetric tightness of contra lateral hamsrign and ipsilateral quad lumb. Tests for dysfunction of symphysis pubis and Iliosacral movement.

Front 54

one-legged stork

Back 54

Position: standing. Clinicain places on thumb on PSIS and other on sacral crest at same level

Test: Patient raises knee towards ceiling. Examiner follows PSIS

Results: It should move inferiorly with flexion. Positive result on side that does not move or moves superiorly for SI dysfunction

Front 55

one-legged stork

Back 55

Position: standing. Clinicain places on thumb on PSIS and other on sacral crest at same level

Test: Patient raises knee towards ceiling. Examiner follows PSIS

Results: It should move inferiorly with flexion. Positive result on side that does not move or moves superiorly for SI dysfunction

Front 56

Standing Truck Sidebend

Back 56

Position: Standing with feet acetabular distance apart.

Test: Examiner monitors lumbar spine and PSIS as patient sidebends to each side.

Result: Positive lumbar finding is straightening of the curve, or increased fullness of the side of concavity. Positive pelvic result is if pelvis does not move opposite the lumber rotation.

Front 57

Prone 4 point sacral motion

Back 57

Position: Prone in neutral and then propped into lumbar extension

Test: Examiner monitors the movement of the ILA and sacral base as the patient deeply inhales and exhales. Should see ILA move in and sacral base out with inhalation and the opposite for exhalation

Front 58

prone sacral sping test

Back 58

Test:Examiner places palm of the hand over the midline of the lumbar region with the heel of the hand over the lumbosacral junction and the middle finger over the lumbar spinous processes. Provedes a short quick push with the heel of the hand toward the table.

Result: If the lumbar spine resists the movement, test is positive for SI dysfunction.