Physical Diagnosis Iii-Musculoskeletal Special Tests

Front 1

what are cervical spine tests?

Back 1

1. Spurlings compression test
2. Distraction test

Front 2

what is the spurling compression test?

what is the distraction test?

Back 2

spurling is compression of cervical spine with head laterally rotated and tilted

distraction=head lifted to see if pressure or pain is relieved

Front 3

what are tests of the shoulder?

Back 3

*apprehension test (ant instabiility)
*Speeds' test
*Empty can tst
*Gerber lift off
*drop arm
*cross arm test

Front 4

what is the ant. instability test (apprehension test)

what is it looking for?

Back 4

abduct shoulder to 90 and externally rotate shoulder while applying ant force on humerus

the test is looking for a feeling of apprehension on the patients resistance to further motion. positive indicates ant instability, labral lesion or bicipital tendonitis

Front 5

what is the speed's test?

what does it indicate?

Back 5

speeds is the elbow flexed 30 w/ forearm in supination and arm in about 60 degress of flexion. examiner resists forward flexion of the arm while palpating the pt's biceps tendon over bicipital groove

this test is looking for bicipital tendonitis

Front 6

what is the empty can test?

what is it looking for?

Back 6

abduct the shoulder to 90 and bring forward to 45. have pt internally rotate shoulder keeping the elbow fully extended while examiner resists abduction

weakness or pain indicates a tear of supraspinatus muscle or tendon or neuropathy of suprascapular nerve

Front 7

what is the drop arm test?

what is it looking for?

Back 7

drop arm is passively abduct arm to 60 and release and ask pt to slowly lower arm in same side arc of movement

positive drop of arm or extremem pain is tear in rotator cuff

Front 8

what is the cross arm test

what is it testing for?

Back 8

cross arm test is when pat raises affected arm to 90 degrees and forcible adducts shoulder

test isolates AC joint and indicates AC joint dysfuction

Front 9

what are tests for the thoracic outlet?

what pulse if felt to assess them?

Back 9

*Roos test
*Adson maneuver

-the radial pulse is felt

Front 10

what is the roos test?

what is it looking for?

Back 10

roos test i when arm is abducted to 45 and brought slightly behind. Pt then opens ans closes the hand x 3 min

looking for pain, numbness, tingling, heaviness or profound weakness that occurs in less than 3 min. positive is for thoracic outlet

Front 11

what is adson maneuver?

Back 11

bring arm up and slightly behind. ask pt to look at hand, hyperextend neck and hold breath. a weakneing of disappearance of pulse is positive indicated entrapment of brachial plexus ansd subclavian artery by scalene muscles

Front 12

what is a test for tennis elbow?

Back 12

with elbow in full extension make a fist and pronate and extend wrist against resistance.

*pain over lateral epicondyle is positive indicator of lateral humeral epicondylitis

Front 13

what are tests of the wrist?

Back 13

*Finkelstein
*Phalen/Reverse phalen
*tinel

Front 14

what is finkelstein test?

what is it testing for?

Back 14

finkelstein test is when pt makes a fist w/ the thumb inside the fingers then ulnar deviates the wrist

*pain over abductor pollicis longus and extensor pollicis brevis tendons indicates de Quervains' tenosynovitis

Front 15

what is the Phalen test?

what is it looking for?

Back 15

phalen test is when pt puts hand in prayer position and holds x 1 min

*numbness, tingling or pain indicates median n. neuropathy

Front 16

what is the tinel sign?

Back 16

tap over volar aspect of wrist at midline of crease w/ pt of reflex hammer

*an electric shock sensation in distribution of median n indicates neuropathy

Front 17

what are tests for meningitis?

Back 17

*Brudzinski's test
*kernigs test

Front 18

what is brudzninski?

what is kernig

Back 18

brudzinki=supine pt flexes neck into chest and we watch for involuntary flexion of hips and kness

kernigs=pt flexes hip and kness then extends leg. looking for lower back, neck and/or head pain w/ knee extension

Front 19

what are tests for the lumbar spine?

Back 19

*SLR
*Bragards' sign
*Bowstring test
*Hoover test

Front 20

what is SLR and Bragards?

Back 20

SLR is examiner flexes hip with knee in full extension until pt complains of pain or tightness

*if pain from 35-70 could indicate nerve root irritation

Bragards is when foot is dorsiflexed from this SLR position

Front 21

what is the hoover test?

what is it ruling out?

Back 21

hoover test is pt is supine and examiner places hand under each calcaneus. PT is asked to lift one leg and keep the other knee straight.

*if don't feel a push down with opposite hell against hand then pt is either paralyzed or not trying
*rule out hysteria and paralysis

Front 22

what are hip and pelvis signs?

Back 22

*Ortolani's and Bar4lwos'(PEDS)
*rendelenburg
*Gaenslens
*FABER test
*

Front 23

what is the FABER test?

what does a positive resutl indicate?

Back 23

FABER is when supine pt hip is flexed, abducted and externally rotated whil heel rests on opposite knee (make a figure 4)

*positive if knee remains above opposite leg for sciatica, sacroiliitis or trochanteric bursitis

Front 24

what is the trendelenburg test?

Back 24

pt balances on one leg and instructed to go up and own on toes four or five times

*if ip tilt toward unloaded leg then suspect weak gluteus medius muscle or femoral neck frx

*if pt can't go up and down on toes suspect an S1 nerve root lesion

Front 25

what is the Gaenslen's test and what is it looking for?

Back 25

lying on unaffected side the hip and knee are flexed and held to chest while affected leg is hyperextended

*pain is pos test and my indicate sacroiliac joint lesion, hip pathology or an l4 nerve root lesion

Front 26

what are knee tests?

Back 26

*patellar glide
*compression test(malacia)
*valgus/varus stress(MCL/LCL)
*Mcmurray's(MMT, LMT)
*lachmans(ACL)
**Drawer(ACL/PCL)
*Apleys compression(MMT,LMT)
*Pivot shift(ACL)

Front 27

what is the valgus test?

what is varus test?

Back 27

valgus=knee in extension and 15 flexion apply pressure to lateral aspect of knee to check MCL

Varus is knee in 30 degrees flexion and apply medial pressure to check LCL

Front 28

what is mcmurrays

Back 28

max flex knee and internally rotate tibia. while palpatingjt margin extend knee


*repeat with external rotation of tibia

*snapping or clicking along joint margin indicates a mMMT or LMT

Front 29

what is lachmans

Back 29

pt supine with test knee 15 flexed and externally rotated. stabilizeze distal femur and try to pull apart leg from thigh

*pos sign is mushy or soft end feel and suggests ACL injruy

Front 30

what is drawer test?

Back 30

flex hip 45 and knee flexed at 90. examiner sits on pt foot and pulls proxiaml tibia forward and pushes backward

*checking for ACL and PCL

Front 31

what are ankle tests?

Back 31

*ant drawer
*talar tilt
*thompson test
*morton test
*tinel test

Front 32

what is ant drawer?

Back 32

pt lies supine w ankle relaxed. examiner stabilizes tibia and fibula while hold foot in 20 plantar flexion and draws the talus forward


*check for ATFL and/or lateral ligament insufficiencies

Front 33

what is talar tilt test?

Back 33

dorsiflex foot

*gapping or rocking of ankle suggets tears of ATFL and CFL

Front 34

what is thompsons test?

Back 34

pt prone extend foot off end of table and compress calf muscle

*absence of plantar flexion indicates achilles endon rupture

Front 35

what is mortions test

Back 35

*grasp around the metatarsal arch and apply lateral pressure to squeeze the hads of metatarsals together

*pain b/w 2-4 digit that radiates to toes is pos for Moton's neuroma

Front 36

what is tinel test/

Back 36

tap inf and post medial malleolus w/ reflex hammer

*paresthesia radiating into foot is positive for tibial nerve damage