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62 Cards in this Set
- Front
- Back
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dejerines sign
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pt seated
pt cough,sneeze, and bear down classic response: increase radicular symptomology classical importance: increase in ithrathecal pressure aggravates a disc lesion test is done midline |
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distraction test
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pt seated,
dr distracts upward classic response: relief of radicular pain classical importance: removal of disc pressure test is done midline |
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extension compression test
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pt seated
dr behind pt, ask pt to extend their head about 30 degrees, dr places both hands on pt forehead and compress along plane of articular pillars classic response: decrease in radicular pain classical importance: disc disease, disc pushed inward test is done midline |
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flexion compression test
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pt seated
dr behind pt, ask pt to flex their head, place both hands on top of pts head and compress along plane of cervical articular pillars classical response: increase in radicular pain classical importance: disc disease, disc pushed posterior test is done midline |
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foraminal compression test
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pt seated
dr behind pt, pt head is neutral, dr places hands on top of pt head and compresses along the plane of the cervical articular pillars classical response: increase in radicular pain classical importance: disc disease test is done midline |
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jacksons compression test
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pt seated
dr behind pt, laterally flex pt head to one side, place hands on top of pts head and compresses along the place of the cervical articular pillars classic response: increase in radicular pain on side of lateral flexion classic importance: IVF encroachment test done bilaterally |
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spinous percission test (cervical)
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pt seated
dr instructs pt to flex head forward, dr stands behind or to the side, palpate the cervical spinous and mark them w/pencil, gently percuss all marked spinous, then percuss 1" laterally in the soft paraspinal tissue classic response: localized pain in the affected spinous classic importance: fracture test is considered midline and bilateral test |
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tuning fork test
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pt seated
dr palpates and marks the cervical spinous, use the 128cc tuning fork and apply to each marked spinous classic response: increase in sharp pain in area of bony prominence being tested classic importance: fracture in that segment test is midline |
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valsalva maneuver
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pt seated
dr instructs pt to place their thumb in their mouth, take a deep breath and hold, puff out cheeks, and try to blow their thumb out of their mouth classic response: increase in radicular pain classic importance: disc lesion due to increase in inthrathecal pressure test is midline |
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apprehension test
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pt seated
dr in front of pt on side being evaluated, flex pts elbow 90 degrees, abduct and externally rotate the shoulder while noting pts facial expression classic response: reactive guarding during maneuver classic importance: shoulder instability from prior dislocation test is bilateral |
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booth marvel transverse humeral ligament test
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pt seated
dr behind pt while palpating the bicipital groove, flex pts elbow to 90 degrees and abduct the shoulder to 90 degrees. then rotate the shoulder externally then internally while palpating the transverse humeral ligament classic response: palpable snap and pain in the biceps tendon classic importance: loss of integrity of the transverse humeral ligament allowing for biceps tendon subluxation test is done bilateral |
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bryants sign
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pt standing w/arms hanging to the side
dr behind the pt observing the axillary folds for symmetry and height classic response: one axillary fold will be lower than the other classic importance: history of joint laxity due to glenohumeral dislocation test is bilateral simultaneous |
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codmans drop arm test
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pt is standing
dr passively abducts pts shoulder about 150 degrees, instruct pt to take control of their arm and slowly lower it to their side. dr observes the ease and fluidity of the motion. repeat procedure this time dr adds a little resistance. classic response: inability to lower arm smoothly classic importance: supraspinatus pathology is between 120-90 and 20-0 degrees. delt pathology is from 90-20 degrees. test is bilateral |
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Dawbarn's test
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pt is seated
dr stands behind and palps the pt's subacromial bursa (note the response). with the elbow flexed, abduct the shoulder to 90 degrees. classic response: pain in the subacromial area that decreases with abduction classic importance: subacromial bursitis test is bilateral |
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Dugas test
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pt is seated
dr instructs pt to flex shoulder 90 degrees, then reach across and touch opposite shoulder, then have pt bring elbow towards their chest while still holding opposite shoulder. classic response: inability to preform maneuver classic importance: shoulder dislocation test is bilateral |
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Subacromial push button sign
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pt is seated
dr stands behind pt and palps the subacromial bursa. flex pt's elbow to 90 degrees and flex and extend the shoulder while palping the subacromial bursa. classic response: pt's feeling of translocation of subacromial tenderness within the flexion/extension arc. classic importance: subacromial bursitis test is bilateral |
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Speeds test
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pt is seated
dr instructs the pt to flex shoulder about 45 degrees with hand supinated and elbow extended. dr palps the bicipital groove. dr applies pressure to the pt wrist as the pt is instructed to flex shoulder while maintaining thier elbow extension. classic response: tenderness in the bicipital tendon area classic importance: biceps tendonitis test is bilateral |
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Supraspinatus test
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pt is seated
dr instructs the pt to abduct both shoulders to 90 degrees, then dr applies downward pressure to arms as the pt resist. dr instructs the pt to angle the shoulders 30 degrees fwd and internally rotate shoulder(thumbs downs). dr applies downward pressure to arms as pt resist. classic response: weakness when the arms are angled fwd classic importance: supraspinatous tendonitis test is simultaneous |
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Transverse Humeral Ligament Test
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pt is seated
dr extends pt's elbow completely and abducts the shoulder to 90 degrees. dr palps the transverse humeral ligament while internally and externally rotating the shoulder classic response: clicking and popping of the bicipital tendon classic importance: transverse ligament laxity test is bilateral |
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Yergason's test
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pt is seated
dr instructs pt to flex elbow 90 degrees and keep wrist pronated.dr palps bicipital groove with one hand and assumes the handshake position with the other. now have the pt flex elbow completely and supinate their wrist/forearm while dr applies resistance. at the end dr applies external rotation all while palping the bicipital groove. classic response: pain or a palpable click in bicipital groove classic importance: tenosynovitis of the biceps tendon or subluxation of the biceps tendon. test is bilateral |
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Cozen's test
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pt is seated
dr instructs pt to pronate and extend their wrist. dr palps the lateral epicondyle. instruct pt to maintain their wrist in extension and dr applies resistance. classic response: pain in the lateral epicondyle classic importance: lateral epicondylitis test is bilateral |
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Hyperflexion stress test
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pt is seated w/arm flexed and relaxed resting on their knees
dr grasp wrist w/one hand and places his other hand on the pt shoulders. dr forces elbow into full flexion, note any restriction in this motion. classic response:increase or decrease in elbow motion classic importance: tendon or ligament strain/sprain test is bilateral |
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Reverse Cozen's test
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pt is seated with elbow flexed at 90 degrees
dr instructs pt to supinate and then flex their wrist, while palping the medial epicondyle. instruct pt to maintain fist flexion as dr applies resistance. classic response: pain in the medial epicondyle classic importance: medial epicondylitits test is bilateral |
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Tinel's (elbow)
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pt is seated
dr supports the elbow and palps the cubital tunnel with the same hand. dr strikes the cubital tunnel with a percussion hammer. classic response: increase in tingling distal to the site of tapping classic importance: ulnar nerve neuritis test is bilateral |
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Valgus stress test
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pt seated w/elbow extended and shoulder in approx 45 degrees flexion
dr stabalizes the upper arm while grasping the forearm. dr pulls the distal extremity away from midline of pt's body. classic response: increased motion on the medial side of the elbow classic importance: medial collateral ligament laxity test is bilateral |
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Varus stress test
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pt is seated w/elbow extended and shoulder flexed about 45 degrees
dr stabalizes the upper arm while grasping the forearm. dr pulls the distal extremity towards midline of the pt's body. classic response: increased motion on the lateral side of the elbow classic importance: lateral collateral ligament laxity test is bilateral |
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Adam's position (thoracic)
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pt is standing
dr behind pt, observes for scoliosis (rib humping, high shoulders or hips, winged scapula). dr has pt bend at the waist and reexamines his findings and look for changes. classic response: change in observed findings classic importance: functional scoliosis test is midline |
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Chest expansion test
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pt is seated, with hands on hips or folded at shoulder level parallel to floor
dr stands behind and places a tape measure around the chest at the level of nipple/t4 dr instructs pt to forcibly exhale and takes measurement dr then instructs pt to forcibly inhale and then takes another measurement classic response: greater than 1.5-2.0 inches classic importance: if less than 1.5" think ankylosing spondylitis test is midline |
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Dejerines sign/triad (thoracic)
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pt is seated
dr instructs pt to cough,sneeze, bear down classic response: increase in radicular symptomology classic importance: increase in intrathecal pressure aggravates a discal lesion test is midline |
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Forestier's bowstring test
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pt is standing w/back exposed
dr instructs pt to laterally flex w/dorsolumbar spine dr observes for shortening of paraspinal on concave side and lengthening of paraspinal on convex side. classic response: shortening on concave and lengthening on convex side classic importance: if classic response doesnt happen think A.S. test is bilateral |
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Lewin's supine
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pt is supine
dr stabilizes pt's ankles and instructs pt to perform a sit up w/out using their arms. classic response: inability to preform maneuver classic importance: A.S. test is midline |
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Schepelmann's test
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pt is seated
dr stands behind and instructs pt to laterally flex their thoracolumbar spine to one side then the other classic response: pain on the concave or convex side classic importance: intercostal neuragia(concave), pleural disease(convex) test is bilateral |
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KAPLAN’S TEST
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PX seated
Dr instructs the patient to fully extended their elbow and hold their shoulder in 90 degrees flexion, then slightly extend their wrist and grasp dynamometer and squeeze Dr records force exerted by px, and reset dynamometer to zero, repeat above while dr applies compression around the forearm about 1-2” distal to the elbow compares the 2 results. Classical response: Increase in dynamometer strength with the elbow supported Classical Importance = Lateral Epicondylitis Bilateral test. |
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EXTENSION STRESS TEST
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Patient is seated
Doctor opposes the patient’s palm and forces it into extension Classical response: Pain on the volar surface of the wrist Classical Importance = Wrist flexor strain Test is done bilaterally |
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FINKELSTEIN’S TEST
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Patient is seated with their hand pronated.
Doctor instructs the patient to flex their 1st metacarpal phalangeal joint across their palm. Doctor instructs the patient to wrap the remaining fingers around the 1st digit. Doctor then ulnar deviates the patient’s wrist while stabilizing the forearm. Classical response: Pain in the Extensor Tunnel # 1 Classical Importance = Chronic stenosing tenosynovitis (de Quervain’s) Test is done bilaterally |
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FINSTERER’S TEST
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Patient is seated with their hand pronated and in a fist.
Doctor observes for the prominence of a 3rd metacarpal Doctor strikes the area just distal to the center of the 3rd metacarpal Classical response: Absence of a third metacarpal or the elicitation of pain Classical Importance = Keinboch’s disease Test is done bilaterally |
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FLEXION STRESS TEST
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Patient is seated with the hand pronated
Doctor grasps the forearm just proximal to the wrist and forces the hand into flexion Classical response: Pain on the dorsal surface of the wrist Classical Importance = Wrist extensor strain Test is done bilaterally |
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FROMENT’S CONE TEST
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Patient is seated
Doctor instructs the patient to form a cone by touching the fingertips to the thumb Classical response: Inability to make the cone (digits 4-5 don’t adduct) Classical Importance = Ulnar nerve lesion Test is done bilaterally |
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OSCHNER’S TEST
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Patient is seated.
Doctor instructs the patient to clasp their hands together with the digits interlocking Classical response: Inability of digits 1-3 to interlock Classical Importance = Median nerve lesion Test is done simultaneously |
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PHALEN’S TEST
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The patient is seated
Doctor instructs the patient to place the hands back to back while elevated above the sternum. Doctor instructs the patient to maintain this position for approx. 1 minute Classical response: Tingling into digits 1-3 volar surface Classical Importance = Median nerve entrapment (Carpal Tunnel Syndrome) Test is done simultaneously |
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RADIAL STRESS TEST
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Patient is seated with their hands in the anatomic position.
Doctor stabilizes the forearm with one hand and grasps the patient’s hand with the other. Doctor forces the wrist in radial deviation Classical response: Pain on the ulnar side of the wrist Classical Importance = Ulnar collateral ligament sprain Test is done bilaterally |
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TINEL’S TEST (WRIST)
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Patient is seated with their hand supinated
Doctor supports the hand with one hand and palpates the carpal tunnel Doctor strikes the carpal tunnel with a percussion hammer Classical response: Tingling distal to the tapping Classical Importance = Median nerve lesion (Carpal Tunnel Syndrome) This is a bilateral test. |
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ULNAR STRESS TEST
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Patient is seated with their hands in the anatomic position.
Doctor stabilizes the forearm with one hand and grasps the patient’s hand with the other. Doctor forces the wrist in ulnar deviation Classical response: Pain on the radial side of the wrist Classical Importance = Radial collateral ligament sprain Test is done bilaterally |
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WRIST DROP TEST
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Patient is seated
Doctor instructs the patient to place both palms together with the fingers pointing upwards and both wrists fully extended. Doctor instructs the patient to separate their hands while maintaining wrist extension Classical response: Inability to maintain wrist in extension Classical Importance = Radial nerve lesion Test is done simultaneously |
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SOTO-HALL TEST
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Patient is supine
Doctor asks patient to place their own hand onto their sternum Doctor places one of their hands on top of patient’s “sternal hand” and stabilizes the sternum onto the table. Doctor takes free hand and places it under the patient’s occiput and flexes their chin onto their chest. Classical response: Local pain in the cervical or thoracic spine to the level of T7 Classical Importance = Supra spinous ligament sprain Test is done midline |
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SPINOUS PERCUSSION TEST: (THORACIC
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Patient is seated
Doctor instructs the patient to flex their body slightly forward Doctor either stands behind patient or to their side Doctor palpates the thoracic spinous processes and marks them with a grease pencil Doctor uses a percussion hammer and gently percusses all marked spinous processes Doctor then percusses 1” laterally to the marked spinous processes in the area of the soft paraspinal tissue. Classical response: Localized spinous process pain Classical Importance = Fractured vertebral segment Test is considered a midline test and a bilateral test if using the paraspinal area as well. |
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TUNING FORK TEST: (Thoracic)
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Patient is seated with their back exposed
Doctor palpates all of the thoracic spinous processes an marks them with a grease pencil Doctor uses a 128cc tuning fork and sounds the fork and applies the base of the fork to each of the marked spinous processes. Classical response: Increase in sharp pain in the area of the bony prominence being tested Classical Importance = Fracture in that segment This is a midline test |
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VALSALVA MANEUVER:
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Patient is seated
Doctor instructs the patient to place their thumb into their mouth Doctor instructs the patient to take a deep breath hold it Doctor instructs the patient to puff out their cheeks Doctor instructs the patient to try to blow their thumb out of their mouth Classical response: Increase in radicular pain Classical Importance= Discal lesion due to increase in intrathecal pressure This is a midline test |
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BRAGGARD’S TEST:
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Patient is supine
Doctor can only do this test if there was a classically significant Straight Leg Raise. Doctor performs the S.L.R. to the point of the patient’s classical signs. Doctor then lowers the patient’s leg 5 degrees below the point of classical signs and then dorsiflexes the ankle. Classical response: Increase in sciatic radiculopathy Classical Importance= Stretching of the sciatic nerve is aggrevative Test is done unilaterally |
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DEMIANOFF’S SIGN:
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Patient is supine
Doctor performs a Straight Leg Raise by placing one hand on the patient’s ankle and the other on the patient’s knee. Doctor attempts to raise the leg to 90 degrees. Classical response: Increase in sciatic radiculopathy from 0-15 degrees Classical Importance= Erector spinae spasming Test is done unilaterally |
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ENGEL’S TEST
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Patient is seated
Doctor instructs the patient to flex their head or bring their chin towards their chest Doctor instructs the patient to extend both legs out in front of the body parallel to the floor and to take a deep breath and bear down. Classical response: Increase in radicular pain Classical Importance= Discal lesion due to increase in intrathecal pressure Test is done midline |
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FEMORAL NERVE TRACTION TEST:
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Patient lies on the unaffected side (first) with the lower leg slightly flexed at the hip and knee. Patients back is not hyperextended
Doctor grasps the affected leg and extends the hip 15 degrees. Doctor then flexes the knee Classical response: Increased pain in anterior thigh Classical Importance= Femoral nerve lesion Test is done bilaterally |
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HYPEREXTENSION TEST:
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Patient is prone
Doctor anchors the patient’s ankles to the table. Doctor instructs the patient to raise their upper torso off of the table. Doctor asks the patient to point to any level of pain Doctor repeats this test but this time doctor stabilizes the sacrum and lifts the shoulders of the patient off of the table. Doctor compares the active vs passive patient response to this test. Classical response: Increased local pain in the lower back pain Classical Importance=Muscular strain if only on active, Ligamentous sprain if on passive. Test is done midline |
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JAR DROP TEST:
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Patient is standing
Doctor asks the patient to go up on their toes and then to drop abruptly onto their heels. Classical response: Increase in referred pain Classical Importance= Visceral inflammation resulting in referred pain Test is done midline |
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KEMP’S TEST:
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Patient is seated with their arms folded
Doctor stands behind the patient Doctor obliquely bends the patient backwards first to one side and then the other. Classical response: Increase in radicular pain upon bending 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 Test is done bilaterally |
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LASEGUE’S STRAIGHT LEG RAISE (S.L.R.)
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Patient is supine
Doctor places one hand under the patient’s ankle and the other hand on the patient’s knee. (affected leg) Doctor raises the affected to 90 degree or to the point of symptoms. Classical response: Doctor notes the type of pain and the degrees of angulation Classical Importance= Increase in sciatic radiculopathy from 0-30 degrees means sacroiliac lesion, 30-60 means lumbosacral lesion, above 60 degrees means lumbar lesion. Test is done unilaterally |
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LEWIN’S SUPINE
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Patient is supine
Doctor stabilizes the patient’s ankles and instructs the patient to perform a sit up without using their arms. Classical response: Inability to perform maneuver Classical Importance = Ankylosing Spondylitis Test is done midline |
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LINDNER’S TEST
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Patient is supine.
Doctor is at the head of the table Doctor places hands behind patient’s occiput and flexes the chin onto the patient’s chest. Doctor now lifts the patient’s upper torso off the table slightly so as to just pass the shoulder blades. Classical response: Increase in radicular symptoms below the level of T7 Classical Importance = Discal disease Test is done midline |
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MURPHY’S PUNCH TEST:
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Patient is either seated of standing
Doctor stands behind the patient on the opposite side being tested. Doctor delivers a short choppy blow to the patient’s flank at the level of the 12th rib (posterior) Classical response: Increase in lancinating pain from the flank into the groin Classical Importance= Kidney inflammation Test is done bilaterally |
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SPINOUS PERCUSSION TEST (LUMBAR)
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Patient is seated
Doctor instructs the patient to flex their torso forward Doctor either stands behind patient or to their side Doctor palpates the lumbar spinous processes and marks them with a grease pencil Doctor uses a percussion hammer and gently percusses all marked spinous processes Doctor then percusses 1” laterally to the marked spinous processes in the area of the soft paraspinal tissue. Classical response: Increase in pain (localized) on a spinous process Classical Importance= Fracture of the spinous process Test is considered a midline test and a bilateral test when the paraspinal tissues are evaluated as well. |
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TUNING FORK TEST:
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Patient is seated with their back exposed
Doctor palpates all of the lumbar spinous processes and marks them with a grease pencil Doctor uses a 128cc tuning fork and sounds the fork and applies the base of the fork to each of the marked spinous processes. Classical response: Increase pain Classical Importance= Fractured spinous Test is done midline |
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WELL LEG RAISE
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PX supine
Dr lefts unaffected or well leg side to 90 degree or to the point of symptoms Classical response: Increase in pain down the affected leg. Classical Importance= Discal lesion in the Lumbar spine Test is unilaterally |
