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48 Cards in this Set
- Front
- Back
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Jackson’s Compression Test
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o Patient is seated
o Doctor stands behind the patient o Doctor laterally flexes the pt’s head towards one side o Doctor places their hands on top of the pt’s head and axially compresses along the plane of the cervical articular pillars o Classical response = Increase in radicular pain on side of lateral flexion o Classical Importance = IVF encroachment o Test is done bilaterally |
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Maximal Foraminal Encroachment Test
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o Patient is seated
o Doctor instructs the pt to first laterally flex their head o Doctor instructs the pt to bring their chin towards the side of lateral flexion o Doctor instructs the pt to extend their head o Classical response = Increase in radicular pain on the side of lateral bend o Classical Importance = IVF encroachment o Test is done bilaterally |
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Bakody’s Test
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o Patient is seated
o Doctor grasps wrist and rasies pt’s arm slowly over pt’s head o Doctor places hand on pt’s head o Doctor asks pt to repeat the above and to perform it actively o Classical response = Relief of pain in the arm o Classical Importance = Reduction of nerve root tractioning o Test is done bilaterally |
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Shoulder Depressor Test
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o Patient is seated
o Doctor stands behind the pt o Doctor laterally flexes pt’s head towards one side o Doctor forcibly depresses contra lateral shoulder o Classical response = Increase in radicular pain o Classical Importance = Adhesions of the dural sleeve are exaggerated o Test is done bilaterallly |
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Adson’s Test
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o Patient is seated
o Doctor stands behind the pt o Doctor takes pt’s radial pulse while abducting the arm and slightly extending it o Doctor notes the amplitude of the pulse o Doctor instructs the pt to rotate their head towards the arm being tested o Doctor instructs the pt to take a deep inhalation and hold it for at least 10 seconds o Doctor instructs the pt to extend their head o Classical response = Dampening of radial pulse amplitude o Classical Importance = Anterior Scalene TOS o Test is done bilaterally |
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Eden’s (Soldier’s) Test
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o Patient is standing
o Doctor is along side the pt and will palpate the pt’s radial artery noting amplitude o Doctor instructs the pt to bring their shoulder backwards and then force them downwards all the while palpating the radial pulse for amplitude o Classical response = Dampening of the radial pulse amplitude o Classical Importance = Costoclavicular TOS o Test is done bilaterally |
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Wright’s Hyperabduction Test
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o Patient is seated
o Doctor palpates the radial pulse noting the amplitude o Doctor extends the arm and then abducts the arm to 120 degree while noting the amplitude o Classical response = Dampening of the radial pulse amplitude o Classical Importance = Pectoralis minor compression TOS o Test is done either bilaterally or simultaneously (prefer simultaneously) |
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Valsalva Maneuver
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o Patient is seated
o Dr instructs the pt to place thumb in mouth o Dr instructs the pt to take a deep breath and hold it o Dr instructs the pt to puff out cheeks o Dr instructs the pt to try to blow thumb out of their mouth o Classical response = Increase in radicular pain o Classical Importance = Discal lesion due to increase in intrathecal pressure o Test is done midline |
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Cervical Distraction Test
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o Patient is seated
o Doctor places hand either under the occiput/chin or places thumbs on occiput and cups around the ears but not over the ears. o Doctor axially distracts upwards o Classical response = Relief of radicular pain o Classical Importance = Removal of discal pressure o Test is done midline |
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Adams’ Position
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o Pt is standing or seated
o Dr stands behind the pt and observes for evidence of scoliosis (rib humping, high shoulders, winging scapula) o Dr instructs pt to bend forward at the waist o Dr re-examines his observed findings looking for any changes o Classical response = change in observed findings o Classical Importance = Functional scoliosis o Test is done midline |
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Murphy’s Punch Test
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o Pt is either seated or standing
o Dr stands behind the pt on opposite side being tested o Dr delivers a short choppy blow to the pt’s flank at the level of the 12th rib (posterior) o Classical response = Increase in lancinating pain from the flank in to the groin o Classical Importance = Kidney inflammation o Test is done bilaterally |
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Laseque’s straight leg raise
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o Patient is supine
o Doctor places one hand under the patient’s ankle and the other hand on the patient’s knee. (affected leg) o Doctor raises the affected to 90 degree or to the point of symptoms. o Classical response: Doctor notes the type of pain and the degrees of angulation o Classical Importance= Increase in sciatic radiculopathy from 0-30 degrees means sacroiliac lesion, 30-60 means lumbosacral lesion, above 60 degrees means lumbar lesion. o Test is done unilaterally |
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Braggard’s test
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o Patient is supine
o Doctor can only do this test if there was a classically significant Straight Leg Raise. o Doctor performs the S.L.R. to the point of the patient’s classical signs. o Doctor then lowers the patient’s leg 5 degrees below the point of classical signs and then dorsiflexes the ankle. o Classical response: Increase in sciatic radiculopathy o Classical Importance= Stretching of the sciatic nerve is aggregative o Test is done unilaterally |
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Fajersztajn’s test
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o Patient is supine
o Doctor raises the unaffected leg to the point at which pain is created on the contralateral side. o Doctor lowers the unaffected 5 degrees below the level of pain on the contralateral side and then dorsiflexes the ankle. o Classical response: Increase in sciatic symptomology down the affected leg. o Classical Importance= Irritation of sciatic nerve due to an inflamed disc by tractioning the nerve due to pelvic rotation o Test is done unilaterally |
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Double leg raise
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o Patient is supine
o Doctor performs a single straight leg raise on each side noting the degree at which symptoms are reproduced o Doctor elevates both legs simultaneously to the point of symptoms and once again notes the degree of angle. o Doctor compares the difference between degrees with one leg vs both legs being elevated. o Classical response: Pain at lower lever when both legs are raised then single leg raise o Classical Importance= Easier tractioning on the sciatic nerve due to combined movement of the pelvis. o Test is done bilaterally and simultaneously |
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Goldthwaite’s test
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o Patient is supine
o Doctor places one hand (two fingers) under the patient at the lumbosacral junction o Doctor places their other hand under the heel of one ankle and raises the leg off of the table. o Classical response: Doctor observes whether symptoms become apparent before or after the lumbosacral articulation moves. o Classical Importance= Pain occurring before Lumbosacral motion means Sacroiliac involvement. Pain occurring while Lumbosacral articulation is moving means Lumbosacral involvement. Pain occurring after the lumbosacral joint moved and is no longer moving means lumbar involvement. o Test is done bilaterally |
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Lewin’s Gaenslen’s
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o Patient is side lying with the unaffected side down.
o Doctor instructs the patient to grasp the knee of the unaffected side and pull it towards their chest. o Doctor extends the affected hip while stabilizing the unaffected leg at the knee. o Classical response: Pain in the Sacroiliac joint on the side being pulled off the table o Classical Importance= Sacroiliac joint lesion o Test is done bilaterally |
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Iliac Compression test
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o Patient side lying
o Doctor places both hands on the innominates and presses downward o Classical response: Pain in the sacroiliac joint o Classical Importance= Sacroiliac joint lesion o This is a simultaneous test ( table actually pushes up as doctor pushes down) |
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Nachlas test
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o Patient is prone
o Doctor passively flexes the patient’s knee bringing the heel to the ipsilateral buttock. All the while the doctor is pressing downward on the ipsilateral sacroiliac joint. o Classical response: Increase in local lumbar, lumbosacral or sacroiliac joint. o Classical Importance= Strain or sprain of the above structures o Test is done bilaterally |
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Ely’s Heel To Buttock test
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o Patient is prone
o Doctor flexes the patient’s knee and brings the heel onto the contralateral buttock. o Doctor notes if the above can be done, if so then the doctor lifts the flexed knee off the table in order to extend the hip. o Classical response: Increased nerve root pain o Classical Importance= Torsional stress in the hip, or lumbar nerve root lesion, or psoas irritation o Test is done bilaterally |
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Hibb’s test
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o Patient is prone
o Doctor flexes one of the patient’s knees to 90 degrees. o Doctor externally rotates the same leg while stabilizing the contralateral pelvis o Classical response: Increase pain in the sacroiliac joint o Classical Importance= Sacroiliac joint lesion o Test is done bilaterally |
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Yeoman’s test
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o Patient is prone
o Doctor stands on the opposite side of the sacroiliac joint being tested o Doctor flexes the knee on the side being tested bringing the heel onto the ipsilateral buttock o Doctor grasps the bent knee and extends the hip while pressing downward on the tested sacroiliac joint o Classical response: Pain felt deep in the anterior sacroiliac joint o Classical importance= Deep anterior sacroiliac strain/sprain o Test is done bilaterally |
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Kemp’s test
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o Patient is seated with their arms folded
o Doctor stands behind the patient o Doctor obliquely bends the patient backwards first to one side and then the other. o Classical response: Increase in radicular pain upon bending o Classical Importance= Increase in pain when bending away from the pain means medial disc lesion. Increase in pain when bending towards the pain means a lateral disc lesion o Test is done bilaterally |
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Belt test
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o Patient is standing
o Doctor stands behind the patient o Doctor instructs the patient to bend forward from the waist and try and touch their toes. o Doctor then grasps the patient’s A.S.I.S.’s and places his hip into the patient’s sacrum and asks the patient to once again bend forward from the waist and try and touch their toes. o Classical response: Doctor observes the patient’s response, ease of motion and compares the responses from the supported and non supported position. o Classical Importance=Pain on both supported and non supported means lumbar involvement. No pain when supported means S.I. lesion o Test is done midline |
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BUNNELL-LITTLER TEST
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o Pt is seated
o Dr takes the pt’s wrist in pronation and extends the MCP joint and flexes the PIP joint o Dr takes the pt’s wrist in pronation and flexes the MCP joint and flexes the PIP joint o Classical response = a difference in tension in the PIP joint from the 2 tested positions o Classical Importance = if the PIP joint is tight only when the MCP joint is extended, think about the finger intrinsic being tight. If the PIP joint is tight with both the extended and flexed MCP joint, you need to think of capsular involvement. o This test is done bilaterally |
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RETINACULAR TEST
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o Pt is seated
o Dr takes pt’s wrist in a pronated fashion and PIP joint in a neutral position and then flexes the DIP joint. o Dr takes pt’s wrist in a pronated fashion and PIP joint in a flexed position and then flexes the DIP joint. o Classical response = a difference in tension in the DIP joint from the 2 tested positions o Classical Importance = if the DIP joint is tight only when the PIP joint is neutral, think about finger intrinsic being tight. If the DIP joint is tight in both neutral and flexed PIP joint, think of capsular involvement. o Test is done bilaterally. |
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PHALEN’S TEST
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o Pt is seated
o Dr instructs pt to place hands back to back while elevated above the sternum o Dr instructs pt to hold this position for about 1 min. o Classical response = tingling into digits 1-3 volar surface o Classical Importance = median nerve entrapment (carpal tunnel syndrome) o Test is done simultaneously |
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TINEL’S TEST (WRIST)
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o Pt is seated with their hand supinated
o Dr supports the hand with one hand and palpates the carpal tunnel o Dr strikes the carpal tunnel with percussion hammer o Classical response = tingling distal to the tapping o Classical Importance = Median nerve lesion (carpal tunnel) o This is a bilateral test |
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MILL’S TEST
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o Pt is seated
o Dr palpates pt’s lateral epicondyle o Dr instructs the pt to do the following in one fluid motion: flex the elbow, flex the wrist, pronate the wrist, point index finger then extend the elbow o Classical response = pain in the lateral Epicondyle o Classical Importance = Lateral epicondylitis o This is a bilateral test |
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COZENS TEST
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o Pt is seated with elbow flexed at 90*
o Dr instructs pt to pronate and extend their wrist o Dr palpates lateral Epicondyle o Pt is instructed to maintain their wrist in extension as Dr applies resistance o Classical response = pain in lateral epicondyle o Classical Importance = Lateral Epicondyle o This test is done bilateral test |
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YERGASON’S TEST
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o Pt is seated
o Dr instructs pt to flex elbow 90* and keep wrist pronated o Dr palpates the bicipital groove with one hand and then assumes the handshake position with the other o Dr instructs pt to now flex elbow completely and supinate their wrist/forearm while Dr applies resistance and all the while palpating the bicipital groove. o Dr then applies a little external rotation at the end of the pt’s motion once again palpating the bicipital groove. o Classical response = pain in bicipital groove or palpable click in the same area o Classical Importance = Tenosynovitis of the biceps tendon or Subluxation of the biceps tendon o This test is done bilateral test |
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APPREHENSION TEST
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o Pt is seated
o Dr is in front of the pt on side being tested o Dr flexes elbow to 90*, abducts and externally rotates the shoulder while noting pt’s facial expression o Classical response = reactive guarding during the maneuver o Classical Importance = shoulder instability from prior dislocation o Test is done bilaterally |
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DUGAS TEST
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o Pt is seated
o Dr instructs pt to flex shoulder to 90* then reach across and touch the opposite shoulder o Dr instructs the pt to bring elbow towards their chest while still holding onto the opposite shoulder o Classical response = Inability to perform the maneuver o Classical Importance = Shoulder dislocation o Test is done bilaterally |
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DAWBARN’S TEST
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o Pt is seated
o Dr stands behind the pt and palpates the pt’s subacromial bursa noting pt’s response to the pressure. If the Dr can’t palpate the bursa well, slightly flex and extend the shoulder while elbow is flexed to 90* o Dr flexes elbow to 90* then abducts to 90* o Classical response = pain in the subacromial area that decreases with abduction of the shoulder o Classical Importance = Subacromial bursitis o Test is done bilaterally |
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CODMAN’S DROP ARM TEST
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o Pt is standing
o Dr passively abducts pt shoulder to ~150* o Dr instructs pt to take control of their arm and slowly bring it back down towards their side o Dr observes the ease and fluidity of motion o Dr then repeats the above procedure but adds resistance to the pt bringing arm down to side. Again noting ease and fluidity of motion o Classical response = inability to lower arm smoothly o Classical Importance = supraspinous pathology if 120 – 90* and then again from 20 – 0* ; Deltoid pathology from 90 – 20* o This test is done bilaterally |
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Foot Drawer Test
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o Patient is supine with their ankles off the edge of the examination table
o Doctor grasps the heel of the ankle being tested with one hand and the tibia just above the ankle with the other. o Doctor applies and anterior to posterior and then a posterior to anterior sheer force. o Classical response: Anterior or posterior translation of the ankle o Classical Importance= Anterior talofibular or posterior talofibular ligament laxity. o Test is done bilaterally |
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MEDIAL STABILITY
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o Patient is supine
o Doctor grasps the tibia with one hand and the foot with the other o Doctor rotates the foot into eversion o Classical response: Excessive eversion o Classical Importance= Deltoid ligament sprain o Test is done bilaterally |
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LATERAL STABILITY
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o Patient is supine
o Doctor grasps the tibia with one hand and the foot with the other. o Doctor rotates the foot into inversion o Classical response: Excessive inversion o Classical Importance= Anterior talofibular ligament sprain o Test is done bilaterally |
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GRINDING PATELLA
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o Patient is supine with the knees fully extended
o Doctor forces the patella into the patella groove with strong pressure and then grinds it medially and then laterally o Doctor should repeat this test with the knee flexed at 30 degrees o Classical response: Increase in retro patella pain o Classical Importance= Chondromalacia patella o Test is done bilaterally |
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McMURRAY’S CLICK
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o Patient is supine
o Doctor places one hand under the patient’s heel and then flexes the knee to about 90 degrees along with some abduction o Doctor applies a lateral to medial force (valgus stress) to the knee while extending and adducting it. o Classical response: A palpable or audible click as the knee is brought into extension o Classical Importance= Medial meniscus damage o Test is done bilaterally |
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Patella Apprehension Test
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o Patient is supine with their legs fully extended
o Doctor grasps the patella and manually displaces it laterally while observing the patient’s face. o Classical response: Visible facial sign of apprehension o Classical Importance= Patella dislocation o Test is done bilaterally |
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AP - PA Drawer Test
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o Patient is supine
o Doctor bends the patient’s knees to 90 degrees and keeps the patient’s feet flat on the table. o Doctor grasps the proximal tibia with both hands and pulls posterior to anterior then push anterior to posterior. Doctor supports the feet of the patient with their body so that they don’t move when the proximal knee is either pulled or pushed. o Classical response: AP or Posterior tibia translation o Classical Importance= ACL or PCL damage o Test is done bilaterally |
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APLEY’S COMPRESSION
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o Patient is prone
o Doctor flexes the patient’s knee to 90 degrees. o Doctor places their knee onto the patients thigh in order to stabilize it o Doctor grasps the patients calf near the ankle and compresses the tibia into the femur o Doctor repeats this with the addition of lateral and medial rotation o Classical response: Pain in the knee upon compression o Classical Importance= Meniscal injury(Medial rotation evaluates the lateral meniscus while Lateral rotation evaluates the medial meniscus) o Test is done bilaterally |
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APLEY’S DISTRACTION
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o Patient is prone
o Doctor flexes the patient’s knee to 90 degrees o Doctor places their knee onto the patient’s thigh in order to stabilize it o Doctor grasps the patient’s calf near the ankle and distracts the tibia off of the femur o Doctor repeats this with the addition of lateral and medial rotation o Classical response: Pain in the knee upon distraction o Classical Importance= Ligamentous injury (Medial rotation evaluates the lateral collateral ligament while Lateral rotation evaluates the medial collateral ligament) o Test is done bilaterally |
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PATRICK’S TEST (FABERE)
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o Patient is supine
o Doctor Flexes the patients knee , abducts, externally rotates and then extends the patient’s hip (sign of 4) o Doctor stresses the side further by pressing downward on the flexed knee. o Classical response: Pain within the hip joint o Classical Importance= Hip joint lesion o Test is done bilaterally |
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ANVIL
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o Patient is supine
o Doctor slightly raises one leg and strikes a blow to the heel with the ulnar side of a closed fist. o Classical response: Increase in pain within the hip joint o Classical Importance= Hip joint lesion o Test is done bilaterally |
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OBER’S
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o Patient is side lying on the side not being tested
o Doctor instructs the patient to flex their lower leg at the knee for stability. o Doctor raises the upper leg and then releases it and lets it drop onto the other leg o Classical response: Failure of the limb to fall back to the table or if it falls posteriorly o Classical importance= TFL contracture o Test is done bilaterally |
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TRENDELENBURG
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o Patient is standing
o Doctor instructs the patient to raise one knee towards their chest while balancing on the supporting limb. o Classical response: Gluteal fold will drop below the level of the contralateral side o Classical Importance= Gluteus Medius weakness on the side of which the patient stands. o Test is done bilaterally |
