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54 Cards in this Set
- Front
- Back
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lumbosacral spring test
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Pt prone; with heel of hand over lumbosacral junction, attempt springing motion
Minimal amount of spring Sacral base is held posterior (e.g. RSE, L/R ST, bilateral sacral extension) |
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spinx (backward bend)
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Pt prone; palpate sacral sulcus or ILA bilat; Pt props up on elbows; note symmetry
Landmarks become more asymmetrical More asymmetrical landmarks= side of shallow sulcus sacral base is held posterior |
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ober's
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Pt lateral recumbent, involved leg up; passively abduct leg with knee bent, slightly extend hip. Slowly release leg Thigh stays in abducted position Contracture of tensor fascia lata or ITB
Tests for contracture of the tensor fascia lata or iliotibial band. Patient lies lateral recumbent on side opposite leg to be tested. Physician lifts leg into abduction with knee bent, slightly extending the hip. Slowly release leg. Thigh should drop towards table, not stay in abducted position. |
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thomas
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Pt supine, hips & knees flexed; arms hug legs toward chest; actively drops one leg at a time; evaluate lumbar lordosis & ability to lie leg flat on table Increased lordosis and/or space between knee and table Psoas muscle contraction or contracture
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patrick
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FABERE
Pt supine; Flex, ABduct, External Rotate, then Extend hip (stabilize opposite ASIS) Pain. Decreased quality/quantity motion Hip dysfunction—pain; SI joint, hip joint dysfunction & hip muscle contraction—decreased motion esp osteoarthritis |
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apley compression
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Pt prone; Flex knee to 90o: Compress down thru heel; int & ext rotate tibia Knee pain Meniscus tear
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apley distraction
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Pt prone; Flex knee to 90o: Distract pulling up on foot; int & ext rotate tibia Knee pain Ligamentous injury (commonly MCL or LCL)
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lachman's
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Pt supine; Grasp proximal tibia and distal femur; flex knee 10-30 degrees; pull tibia forward Tibia moves excessively out from under the femur ACL instability; more accurrate than drawer sign
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mcmurray's
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Pt supine; fully flex one leg, monitor medial knee joint line; rotate tibia to put valgus stress on knee; slowly extend knee. Repeat with varus stress (internal rotation) Palpable or audible click especially with knee pain Posterior medial meniscus tear—valgus
Posterior lateral meniscus tear—varus |
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ant/post drawer sign (knee and ankle)
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Pt supine; flex knee 90o with foot on table; completely stabilize foot; wrap hands around proximal tibia; pull anterior (anterior drawer); push posterior (posterior drawer) Tibia slides or moves excessively under femur Anterior drawer=ACL tear
Posterior drawer=PCL tear |
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hip drop test
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Pt standing; monitor iliac crest heights; pt bend one knee; keep foot on floor Ipsilateral hip elevates; unable to sidebend lumbar spine toward straight leg Loss of lumbar sidebending
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pelvic side shift
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Pt standing; stabilize right shoulder while pushing pelvis toward right; repeat on left side Side of freer translation Psoas syndrome on right will translate to left but not to right
psoas syndrome on right will cause a positive test to the left |
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lasegue's (SLR)
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straight leg raising test
Pt supine; stabilize ASIS; with knee straight, raise leg; dorsiflex foot Back/sciatic (radicular) pain Lumbar radiculopathy; contralateral pain increases chance of herniated lumbar disc Seated: Patient sits up straight, holding edge of table for support. Physician brings one leg into extension, then repeats on other side. Pain radiating down leg indicates possible radiculopathy. Inability of patient to stay seated straight up, or to fully extend knee, indicates contraction of hamstring muscles. Supine: Patient supine. Physicians cephalad hand holds ASIS on side of leg being raised. Knee must remain straight. If ASIS moves superiorly indicating pelvic rotation, hamstrings are tight and will limit ability to test. If leg raising creates back/sciatic pain, drop leg slightly and dorsiflex ankle. If creates pain again, more indicative of a radiculopathy. If leg raising creates back/sciatic pain on the contralateral side, further evidence of space-occupying lesion (e.g. herniated disc) in lumbar area. |
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trendelenberg
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Pt standing; observe at level of iliac crests; Pt stands on one leg, by bending and lifting opposite foot off floor Iliac crest height drops on non-stance side Weak gluteus medius on weight-bearing side
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psoas tension
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Pt prone; flex pt knee to 90o; hold pt thigh; extend hip; repeat on other side Restriction of extension motion Iliopsoas tight on side of restricted motion. hold until ASIS raised off table
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apley's scratch
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Pt touches superior & inferior aspects of opposite scapula Decreased range of shoulder motion Rotator cuff dysfunction
Evaluates range of shoulder motion. Patients reach behind their head to touch superior medial angle of opposite scapula (abduction/external rotation). Can also have patient reach across chest to touch opposite shoulder (adduction/internal rotation). Then have patient reach behind back up towards inferior angle of opposite scapula (more intense adduction/internal rotation). |
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empty can
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Pt attempt to elevate arms against resistance; shoulder flexed to 90o, internal rotated, 30 degress towards the front of the body, elbow extended, forearm pronated (thumbs down) (arms internally rotated thumbs down)
Weakness Rotator cuff tear; suprascapular nerve entrapment or neuropathy evaluates for supraspinatus tendonitis physicians gently pushing down on arms; pain is positive test |
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drop arm
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Passively abduct pt affected arm at least 90o; pt try to lower arm slowly Arm drops without control Rotator cuff tear; supraspinatus weakness
drop arm partial tear may remain up but drop when you tap the arm |
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neer's
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Passively, fully flex pt arm & pronate forearm Subacromial pain Subacromial impingement of rotator cuff tendons
stabilize scapula during the manuever to prevent scapulothoracic pain |
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hawkin's
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Passive flexion of shoulder 90o; elbow bent; internally rotate shoulder Subacromial pain Supraspinatus tendon impingement or rotator cuff tendonitis
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speed's test
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With mild flexion at elbow, flex pt shoulder 60o and supinate forearm; Pt attempts further flexion of shoulder; palpate bicipital groove Pain; Lateral or medial movement of biceps tendon in groove Biceps tendon instability or tendonitis
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yergason's test
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Pt elbow flex to 90o forearm pronated; pt attempt supination and flexion of elbow against resistance Pain in biceps tendon (long head) Biceps tendonitis or instability
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apprehension
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Abduct pt arm to 90o; externally rotate & apply anterior pressure to humerus Pain or apprehension about impending subluxation Anterior glenohumeral instability (chronic dislocating shoulder)
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adson's test
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Passively abduct & extend Pt. arm (affected side); palpate pulse; pt turns head toward & inhales deeply Diminished pulse Compression/occlusion subclavian artery between anterior & middle scalene muscles
longing evaluates for pancoast tumor, ant scalene mm a cervical rib |
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wright's test
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Hyperabduct pt arm above head; palpate radial pulse Radial pulse severely diminished Compression of neurovascular bundle between pectoralis minor muscle and corocoid process (“Hyperabduction Syndrome”)
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costoclavicular test
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military posture
Passively depress and extend pt shoulder; monitor radial pulse Radial pulse severely diminished Compression of neurovascular bundle between clavicle & 1st rib (“Costoclavicular Syndrome”) |
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phalen's test
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Pt flexes wrists; presses back of hands together; forearms horizontal; hold for one minute Pain & paresthesia of affected hand Carpal tunnel syndrome
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reverse phalen's
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prayer
Pt extends wrists; presses palms together; forearms horizontal; hold one minute Pain & paresthesia of affected hand Carpal tunnel syndrome |
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tinel's
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wrist
Tap over the volar carpal ligament—distal to wrist crease Paresthesias in first 3 fingers Carpal tunnel syndrome |
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finkelstein
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Pt make fist with thumb tucks inside; ulnar deviate wrist Pain in wrist/forearm deQuervain’s disease (stenosing tenosynovitis of abductor pollicis longus & extensor pollicis brevis tendons)
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allen tet
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Occlude both radial & ulnar artery at wrist; pt open & close fist until palm becomes pale; release one artery; repeat with other artery Hand remains pale Occlusion or poor function of released artery
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spurling
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Pt seated; extend neck; rotate head toward affected side; press down on top of head Radicular pain or paresthesia in dermatomal pattern Cervical nerve root impingement (foraminal narrowing) or inflammation
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pelvis and hip tests
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Lumbosacral Spring Test
Sphinx Test (backward bending test) Ober’s Test Thomas Test Patrick Test (FABERE test) |
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lower extremity tests
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Apley’s Compression & Distractions Tests
Lachman’s Test McMurray’s Test Anterior & Posterior Drawer Tests |
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low back tests
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Hip Drop Test
Pelvic Side Shift Test Lasegue’s Test (straight leg raising test-SLR) Trendelenberg Test Psoas Tension |
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shoulder tests
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Apley Scratch Test
Empty Can Test Drop Arm Test Neer’s Test Hawkin’s Test Speed’s Test Yergason’s Test Apprehension Test |
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thoracic outlet and carpal tunnel syndrome
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Adson’s Test
Wright’s Test Costoclavicular (Military Posture) Test Phalen’s Test Reverse Phalen’s (prayer) Test Tinel’s Test (wrist) Finkelstein Test Allen Test |
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tests for cervical nerve impingement
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Spurling Test
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accessory movments
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Movements used to potentiate, accentuate, or compensate for an impairment in a physiologic motion (e.g., the movements needed to move a paralyzed limb).
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accomidation
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A self-reversing and nonpersistent adaptation
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gravitational line
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Viewing the patient from the side, an imaginary line in a coronal plane which, in the theoretical ideal posture, starts slightly anterior to the lateral malleolus, passes across the lateral condyle of the knee, the greater trochanter, through the lateral head of the humerus at the tip of the shoulder to the external auditory meatus; if this were a plane through the body, it would intersect the middle of the third lumbar vertebra and the anterior one third of the sacrum. It is used to evaluate the A-P (anterior-posterior) curves of the spine. See also midmalleolar line.
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lumbosacral angle
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represents the angle of the lumbosacral junction as measured by the inclination of the superior surface of the first sacral vertebra to the horizontal (this is actually a sacral angle); usually measured from standing lateral x-ray films; also known as Ferguson’s angle.
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lumbosacral lordotic angle
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an objective quantification of lumbar lordosis typically determined by measuring the angle between the superior surface of the second lumbar vertebra and the superior surface of the first sacral segment; best measured from a standing lateral x-ray film.
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linkage
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dysfunctional segmental behavior where a single vertebra and an adjacent rib respond to the same regional motion tests with identical asymmetric behaviors (rather than opposing behaviors). This suggests visceral reflex inputs.
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lovett law
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: States that there is an association between the superior and inferior vertebrae, which are paired two by two. The cervical and superior thoracic biomechanics act in a synchronous manner with the lumbar and inferior thoracic biomechanics. For example, if C1 is in a right posterior positional lesion, L5 also moves into a right posterior position. In this case, L5 is the " Lovett partner" of C1. The treatment of L5 helps to stabilize C1 and the skull by changing the lines of gravity. (French usage).
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pelvic declination
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pelvic unleveling
Pelvic rotation about an anteriorposterior (A-P) axis. |
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pelvic index
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PI
Represents a ratio of the measurements determined from postural radiograph: One (y) beginning from a vertical line originating at the sacral promontory to the intersection with the horizontal line from the anterior-superior position of the pubic bone. The second measurement (x) is along this same horizontal line. Normal values are age-related and increase in subjects with sagittal plane postural decompensation. Pelvic index (PI) equals x/y. |
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postural decompensation
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Distribution of body mass away from ideal when postural homeostatic mechanisms are overwhelmed. It occurs in all cardinal planes, but is classified by the major plane(s) affected. See planes of the body
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posture
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Position of the body. The distribution of body mass in relation to gravity.
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prime mover
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A muscle primarily responsible for causing a specific joint action.
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regional extension
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historically, the straightening in the sagittal plane of a spinal region; also called Fryette’s regional extension
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sacral base declination
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unleveling
With the patient in a standing or seated position, any deviation of the sacral base from the horizontal in a coronal plane. Generally, the rotation of the sacrum about an anterior-posterior axis. |
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sherrington law
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1. Every posterior spinal nerve root supplies a specific region of the skin, although fibers from adjacent spinal segments may invade such a region. 2. When a muscle receives a nerve impulse to contract, its antagonist receives, simultaneously, an impulse to relax. (These are only two of Sherrington’s contributions to neurophysiology; these are the ones most relevant to osteopathic principles.)
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tropism, facet
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Unequal size and/or facing of the zygapophyseal joints of a vertebra. See also facet asymmetry.
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