Podcast
Questions and Answers
The Neer Impingement Sign is performed with the patient in what position?
The Neer Impingement Sign is performed with the patient in what position?
- Supine
- Sitting or Standing (correct)
- Decubitus
- Prone
The Hawkins Impingement Sign is also known as what?
The Hawkins Impingement Sign is also known as what?
- Hawkins-Kennedy Test (correct)
- Speed’s Test
- Neer Test
- Empty Can Test
The Passive Cross-Body Adduction Test assesses what?
The Passive Cross-Body Adduction Test assesses what?
- Acromioclavicular Joint Pathology (correct)
- Glenohumeral Joint Stability
- Rotator Cuff Tendonitis
- Bicipital Tendon Instability
A positive Speed’s Test indicates what condition?
A positive Speed’s Test indicates what condition?
The Empty Can Test is also known as what?
The Empty Can Test is also known as what?
Pain on top of the shoulder during O’Brien’s Test indicates pathology in which structure?
Pain on top of the shoulder during O’Brien’s Test indicates pathology in which structure?
What action is the patient asked to perform during the Subscapularis (Gerber's) Lift Off Test?
What action is the patient asked to perform during the Subscapularis (Gerber's) Lift Off Test?
What does the presence of a visible sulcus sign indicate?
What does the presence of a visible sulcus sign indicate?
During the Apprehension Test, what action by the examiner would indicate potential anterior shoulder instability?
During the Apprehension Test, what action by the examiner would indicate potential anterior shoulder instability?
In the Relocation Test, what action is performed by the examiner after placing the patient's arm in the apprehension test position?
In the Relocation Test, what action is performed by the examiner after placing the patient's arm in the apprehension test position?
The Ulnar Nerve Tinel Sign is performed by tapping where?
The Ulnar Nerve Tinel Sign is performed by tapping where?
Resisted Wrist Extension assesses for:
Resisted Wrist Extension assesses for:
What condition is suggested by pain at the medial epicondyle during Resisted Wrist Flexion?
What condition is suggested by pain at the medial epicondyle during Resisted Wrist Flexion?
During the Flexor Digitorum Profundus test, what action isolates the flexor digitorum profundus?
During the Flexor Digitorum Profundus test, what action isolates the flexor digitorum profundus?
An inability to flex at the PIP joint indicates injury to which structure?
An inability to flex at the PIP joint indicates injury to which structure?
What is the position of the patient's wrist during the Carpal Tunnel Compression Test (Durkan test)?
What is the position of the patient's wrist during the Carpal Tunnel Compression Test (Durkan test)?
What is the expected finding in a positive Phalen's Test?
What is the expected finding in a positive Phalen's Test?
During the Thumb Ulnar Collateral Ligament Instability Test, what is the examiner assessing?
During the Thumb Ulnar Collateral Ligament Instability Test, what is the examiner assessing?
What action is performed by the examiner during Finkelstein's Test?
What action is performed by the examiner during Finkelstein's Test?
The Straight Leg Raise primarily assesses for what?
The Straight Leg Raise primarily assesses for what?
What position is the patient placed in to perform Ober's Test?
What position is the patient placed in to perform Ober's Test?
The Piriformis Test is designed to compress which nerve?
The Piriformis Test is designed to compress which nerve?
The Patrick's Test assesses what two structures?
The Patrick's Test assesses what two structures?
What action does the examiner perform during the Patellar Apprehension Test to assess for patellar instability?
What action does the examiner perform during the Patellar Apprehension Test to assess for patellar instability?
What test finding indicates cartilage damage to the patellofemoral joint?
What test finding indicates cartilage damage to the patellofemoral joint?
During the Lachman's Test, the tibia is pulled in what direction?
During the Lachman's Test, the tibia is pulled in what direction?
While performing the Anterior Drawer or Posterior Drawer test, what indicated a positive exam?
While performing the Anterior Drawer or Posterior Drawer test, what indicated a positive exam?
What is being assessed in the Valgus and Varus Stress Test?
What is being assessed in the Valgus and Varus Stress Test?
Apley's Compression Test, how do you apply a compression force?
Apley's Compression Test, how do you apply a compression force?
What is the patient instructed to do during Thessaly test?
What is the patient instructed to do during Thessaly test?
The Thompson's Test assesses which ankle structure?
The Thompson's Test assesses which ankle structure?
During the Anterior Drawer Test of the ankle, the ankle is placed in plantar flexion at what degree?
During the Anterior Drawer Test of the ankle, the ankle is placed in plantar flexion at what degree?
The Sub Talar Tilt Test involves which specific ankle motion?
The Sub Talar Tilt Test involves which specific ankle motion?
What does the Thompson's Test primarily identify?
What does the Thompson's Test primarily identify?
During the Metatarsal Compression Test, what pathology is being evaluated?
During the Metatarsal Compression Test, what pathology is being evaluated?
A positive finding in the Metatarsal Compression Test includes:
A positive finding in the Metatarsal Compression Test includes:
The O’Brien’s test involves forward flexion of the arm to 90 degrees, followed by horizontal adduction. Maximally internally rotating the shoulder with the forearm fully pronated with thumb facing down will cause pain and reduced/eliminated pain with supination if which of the following is occurring?
The O’Brien’s test involves forward flexion of the arm to 90 degrees, followed by horizontal adduction. Maximally internally rotating the shoulder with the forearm fully pronated with thumb facing down will cause pain and reduced/eliminated pain with supination if which of the following is occurring?
A patient presents with suspected acromioclavicular joint arthritis. Which orthopedic test would be most appropriate to help confirm this diagnosis?
A patient presents with suspected acromioclavicular joint arthritis. Which orthopedic test would be most appropriate to help confirm this diagnosis?
The presence of laxity during the anterior drawer test of the ankle indicates injury to which particular ankle structure?
The presence of laxity during the anterior drawer test of the ankle indicates injury to which particular ankle structure?
What is a limitation of special orthopedic tests?
What is a limitation of special orthopedic tests?
Which of the following is true regarding joint laxity?
Which of the following is true regarding joint laxity?
A basketball player lands awkwardly after a jump, and you suspect an anterior cruciate ligament (ACL) injury. Which of the following tests would be MOST sensitive in the acute setting?
A basketball player lands awkwardly after a jump, and you suspect an anterior cruciate ligament (ACL) injury. Which of the following tests would be MOST sensitive in the acute setting?
While assessing a patient in clinic, you apply varus stress to their ankle via what bone?
While assessing a patient in clinic, you apply varus stress to their ankle via what bone?
The Neer Impingement Test is designed to identify:
The Neer Impingement Test is designed to identify:
During the Hawkins Impingement Test, the examiner passively performs what action?
During the Hawkins Impingement Test, the examiner passively performs what action?
The Passive Cross-Body Adduction Test primarily assesses pathology in which joint?
The Passive Cross-Body Adduction Test primarily assesses pathology in which joint?
A positive Speed’s Test is MOST indicative of:
A positive Speed’s Test is MOST indicative of:
The Empty Can Test is specifically designed to assess the integrity and function of which muscle?
The Empty Can Test is specifically designed to assess the integrity and function of which muscle?
Pain deep within the shoulder joint during O’Brien’s Test suggests:
Pain deep within the shoulder joint during O’Brien’s Test suggests:
During the Subscapularis (Gerber's) Lift Off Test, the patient is unable to lift their hand off their back. What does this indicate?
During the Subscapularis (Gerber's) Lift Off Test, the patient is unable to lift their hand off their back. What does this indicate?
A visual depression between the acromion and humeral head may indicate:
A visual depression between the acromion and humeral head may indicate:
During the Apprehension Test, what patient response would indicate potential anterior shoulder instability?
During the Apprehension Test, what patient response would indicate potential anterior shoulder instability?
When performing the Ulnar Nerve Tinel Sign, the elbow should ideally be positioned at what degree of flexion?
When performing the Ulnar Nerve Tinel Sign, the elbow should ideally be positioned at what degree of flexion?
Resisted Wrist Extension is used to evaluate:
Resisted Wrist Extension is used to evaluate:
Pain at WHICH location during Resisted Wrist Flexion suggests medial epicondylitis?
Pain at WHICH location during Resisted Wrist Flexion suggests medial epicondylitis?
During the Flexor Digitorum Profundus test, what action by the examiner isolates the flexor digitorum profundus?
During the Flexor Digitorum Profundus test, what action by the examiner isolates the flexor digitorum profundus?
During the Flexor Digitorum Superficialis Test, the examiner holds all fingers other than the finger being tested, then asks the patient to flex at which joint?
During the Flexor Digitorum Superficialis Test, the examiner holds all fingers other than the finger being tested, then asks the patient to flex at which joint?
The Carpal Tunnel Compression Test (Durkan test) involves applying direct pressure to what area of the wrist?
The Carpal Tunnel Compression Test (Durkan test) involves applying direct pressure to what area of the wrist?
When performing Phalen's Test, how long should the position be maintain before a positive test is considered?
When performing Phalen's Test, how long should the position be maintain before a positive test is considered?
During the Thumb Ulnar Collateral Ligament Instability Test, what specific motion is the examiner applying?
During the Thumb Ulnar Collateral Ligament Instability Test, what specific motion is the examiner applying?
During Finkelstein's Test, the examiner performs which specific wrist movement?
During Finkelstein's Test, the examiner performs which specific wrist movement?
The Straight Leg Raise is performed by placing the patient in what position?
The Straight Leg Raise is performed by placing the patient in what position?
During Ober's Test, the IT band is tight if which of the following is observed?
During Ober's Test, the IT band is tight if which of the following is observed?
The Piriformis Test is most likely positive if there is radiation along which nerve during the motion?
The Piriformis Test is most likely positive if there is radiation along which nerve during the motion?
The FABER test is an acronym for what?
The FABER test is an acronym for what?
During the Patellar Apprehension Test, the examiner applies a lateral patellar glide to assess for what condition?
During the Patellar Apprehension Test, the examiner applies a lateral patellar glide to assess for what condition?
What test finding indicates cartilage damage to the patellofemoral joint during the Patellar Grind Test?
What test finding indicates cartilage damage to the patellofemoral joint during the Patellar Grind Test?
During which of the following is the knee flexed between 20 and 30 degrees?
During which of the following is the knee flexed between 20 and 30 degrees?
Which of the following is an indication of a positive Anterior or Posterior Drawer test?
Which of the following is an indication of a positive Anterior or Posterior Drawer test?
In Valgus and Varus Stress Tests, what indicates a first degree sprain?
In Valgus and Varus Stress Tests, what indicates a first degree sprain?
What steps occur during Apley's test after the patient is set up?
What steps occur during Apley's test after the patient is set up?
Thessaly test is done when the patient is standing on one leg performing internal and external rotation of their knee, and the examiner is supporting them. The patient is to flex their knee, but how much?
Thessaly test is done when the patient is standing on one leg performing internal and external rotation of their knee, and the examiner is supporting them. The patient is to flex their knee, but how much?
Which of these is the most accurate description of Anterior Drawer Test for the ankle?
Which of these is the most accurate description of Anterior Drawer Test for the ankle?
What is the primary motion assessed during the Sub Talar Tilt Test?
What is the primary motion assessed during the Sub Talar Tilt Test?
The Thompson’s Test is utilized to assess:
The Thompson’s Test is utilized to assess:
What pathological condition is the Metatarsal Compression Test designed to identify?
What pathological condition is the Metatarsal Compression Test designed to identify?
During the Metatarsal Compression Test, a positive finding is:
During the Metatarsal Compression Test, a positive finding is:
In O’Brien’s Test, if a patient is experiencing labral pathology, where do you expect to feel pain?
In O’Brien’s Test, if a patient is experiencing labral pathology, where do you expect to feel pain?
Which orthopedic test is designed specifically to identify acromioclavicular joint arthritis?
Which orthopedic test is designed specifically to identify acromioclavicular joint arthritis?
In an anterior drawer test of the ankle, what would damage to the ATF ligament result in?
In an anterior drawer test of the ankle, what would damage to the ATF ligament result in?
If someone has more laxity in their joints than others, it would indicate:
If someone has more laxity in their joints than others, it would indicate:
In the straight leg raise (SLR) test, what action could increase the discomfort?
In the straight leg raise (SLR) test, what action could increase the discomfort?
An extremely rare condition, the "Acromioclavicular Vacuum Phenomenon," can lead to false negatives in what test because it reduces localized pain?
An extremely rare condition, the "Acromioclavicular Vacuum Phenomenon," can lead to false negatives in what test because it reduces localized pain?
During Thompson's test, if the patient displays the presence of slight plantarflexion of the foot, while resting against the table, what does this indicate?
During Thompson's test, if the patient displays the presence of slight plantarflexion of the foot, while resting against the table, what does this indicate?
A doctor is testing a patient for subacromial impingement to diagnose a possible rotator cuff injury. If the patient felt deep pain in the shoulder region at 70 degrees through 120 degrees of abduction of the arm, what does this indicate?
A doctor is testing a patient for subacromial impingement to diagnose a possible rotator cuff injury. If the patient felt deep pain in the shoulder region at 70 degrees through 120 degrees of abduction of the arm, what does this indicate?
What is the sensitivity and specificity of Thessaly's Test?
What is the sensitivity and specificity of Thessaly's Test?
Which of the following BEST reflects the utility of special orthopedic tests?
Which of the following BEST reflects the utility of special orthopedic tests?
What does laxity refer to in the context of orthopedic special testing?
What does laxity refer to in the context of orthopedic special testing?
During the Neer Impingement test, what specific motion is performed by the examiner to provoke shoulder pain?
During the Neer Impingement test, what specific motion is performed by the examiner to provoke shoulder pain?
A positive Passive Cross-Body Adduction Test suggests pathology in which joint?
A positive Passive Cross-Body Adduction Test suggests pathology in which joint?
Which action should the patient perform during Speed's Test?
Which action should the patient perform during Speed's Test?
During the Supraspinatus (Jobe/Empty Can) Test, what position are the patient's arms placed in?
During the Supraspinatus (Jobe/Empty Can) Test, what position are the patient's arms placed in?
In the O’Brien’s Test, internal rotation is performed with the forearm in what position?
In the O’Brien’s Test, internal rotation is performed with the forearm in what position?
During the Sulcus Sign assessment, the examiner is looking for a depression between which two anatomical structures?
During the Sulcus Sign assessment, the examiner is looking for a depression between which two anatomical structures?
In the Relocation Test, what specific anatomical structure is the posteriorly directed force applied to?
In the Relocation Test, what specific anatomical structure is the posteriorly directed force applied to?
Provocation of local pain and paresthesias in the medial forearm and two ulnar fingers is indicative of which condition?
Provocation of local pain and paresthesias in the medial forearm and two ulnar fingers is indicative of which condition?
During Resisted Wrist Flexion, the patient's hand should be in what position?
During Resisted Wrist Flexion, the patient's hand should be in what position?
During the Flexor Digitorum Superficialis test, what action by the examiner isolates the flexor digitorum superficialis?
During the Flexor Digitorum Superficialis test, what action by the examiner isolates the flexor digitorum superficialis?
Which anatomical structure is primarily assessed during the Thumb Ulnar Collateral Ligament Instability Test?
Which anatomical structure is primarily assessed during the Thumb Ulnar Collateral Ligament Instability Test?
What specific action is performed by the examiner during Finkelstein's Test to assess for De Quervain's tenosynovitis?
What specific action is performed by the examiner during Finkelstein's Test to assess for De Quervain's tenosynovitis?
During Ober's Test, which muscle and band is being tested?
During Ober's Test, which muscle and band is being tested?
What lower extremity physical exam test suggest a piriformis syndrome.
What lower extremity physical exam test suggest a piriformis syndrome.
During the Thessaly test, at what degree of flexion are the patient's knees when performing internal and external rotation.
During the Thessaly test, at what degree of flexion are the patient's knees when performing internal and external rotation.
A patient presents with suspected Morton's neuroma. Which orthopedic test would be most appropriate to help confirm this diagnosis?
A patient presents with suspected Morton's neuroma. Which orthopedic test would be most appropriate to help confirm this diagnosis?
Lachman's Test: Despite its widespread use and general reliability, it can pose challenges due to substantial variations in a patient's lower-body anatomy. What is the primary anatomical reason?
Lachman's Test: Despite its widespread use and general reliability, it can pose challenges due to substantial variations in a patient's lower-body anatomy. What is the primary anatomical reason?
All but one of the following is true regarding Thessaly's Test, which one is the false claim?
All but one of the following is true regarding Thessaly's Test, which one is the false claim?
Flashcards
Neer Impingement Sign
Neer Impingement Sign
A test for shoulder impingement syndrome. Arm is internally rotated and fully flexed while stabilizing the scapula. A positive equals pain with passive flexion.
Hawkins Impingement Sign
Hawkins Impingement Sign
A test for shoulder impingement; arm flexed at 90 degrees with forearm parallel to floor, then internally rotate while keeping elbow in same position. Pain with passive internal rotation equals positive.
Cross-Body Adduction Test
Cross-Body Adduction Test
Passively bring patients arm to maximal cross body adduction. Pain localized at acromioclavicular joint (AC) is positive.
Speed's Test
Speed's Test
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Empty Can Test (Supraspinatus or Jobe)
Empty Can Test (Supraspinatus or Jobe)
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Obrien's Test
Obrien's Test
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Gerber's Lift Off Test (Subscapularis)
Gerber's Lift Off Test (Subscapularis)
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Sulcus Sign
Sulcus Sign
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Apprehension Test
Apprehension Test
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Relocation Test
Relocation Test
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Ulnar Nerve Tinel Sign
Ulnar Nerve Tinel Sign
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Resisted Wrist Extension
Resisted Wrist Extension
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Resisted Wrist Flexion
Resisted Wrist Flexion
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Flexor Digitorum Profundus/Flexor Pollicis Longus Tests
Flexor Digitorum Profundus/Flexor Pollicis Longus Tests
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Flexor Digitorum Superficialis Test
Flexor Digitorum Superficialis Test
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Carpal Tunnel Compression Test (Durkan test)
Carpal Tunnel Compression Test (Durkan test)
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Median Nerve Tinel’s sign
Median Nerve Tinel’s sign
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Phalen's Test
Phalen's Test
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Thumb Ulnar Collateral Ligament Instability Test
Thumb Ulnar Collateral Ligament Instability Test
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Finkelstein's Test
Finkelstein's Test
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Straight leg raise
Straight leg raise
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Ober's Test
Ober's Test
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Piriformis Test
Piriformis Test
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Patrick's Test
Patrick's Test
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Patellar Apprehension Test
Patellar Apprehension Test
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Patellar Grind Test
Patellar Grind Test
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Lachman's Test
Lachman's Test
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Anterior & Posterior Drawer Tests
Anterior & Posterior Drawer Tests
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Valgus And Varus Stress Tests
Valgus And Varus Stress Tests
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Apley's Compression Test
Apley's Compression Test
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Thessaly Test
Thessaly Test
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Anterior Drawer Test
Anterior Drawer Test
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Sub Talar Tilt Test
Sub Talar Tilt Test
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Metatarsal Compression Test
Metatarsal Compression Test
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Thompson's Test
Thompson's Test
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Study Notes
- Unit 13 focuses on orthopedic specialty examinations.
- The objectives are to understand when to perform specialty tests and demonstrate competency in performing a patient examination using specialty orthopedic tests.
- Topics include upper and lower extremities.
Special Testing
- Each joint has specific tests to help determine a particular disease or injury.
- No test is 100% specific or sensitive; use them as tools in the overall diagnosis.
- Tests suggest problems unique to a joint's structure or ligament; a positive anterior drawer test may indicate a torn ACL.
- A negative test does not automatically mean that the joint tested is normal or uninjured.
- Some special tests are specific to testing ligament and capsular laxity under stress.
- Laxity refers to the amount of give or "play" within the joints' surrounding tissue.
- Some patients have more or less joint laxity.
- It is recommended to test both sides and establish a baseline for normal laxity.
Upper Extremities: Impingement Syndrome
- Impingement Syndrome video: https://www.youtube.com/watch?v=TcsJOLSYcHg
Neer Impingement Sign
- This test is for shoulder impingement or rotator cuff tear
- Stabilize the patient's scapula while grasping the arm, internally rotating, and fully flexing it.
- Pain indicates a positive Neer impingement sign for impingement syndrome.
- Neer Impingement Sign video: https://www.youtube.com/watch?v=nNyax0iocZo
Hawkins Impingement Sign
- This test is also know as the Hawkins-Kennedy Test
- Forward flex the shoulder and elbow to 90 degrees with the forearm parallel to the floor.
- Support the elbow and passively internally rotate the shoulder by pressing down on the forearm.
- Pain indicates possible impingement, reinforces Neer impingement sign.
- Hawkins Impingement Sign video: https://www.youtube.com/watch?v=X9YiuvQJVJc
Passive Cross-Body Adduction Test
- This test is appropriate for Acromioclavicular joint pathology including: sprain, separation, and arthritis.
- With the patient seated or standing, the examiner passively brings the patient's arm into maximal cross-body adduction.
- Pain that localizes to the AC joint indicates injury or arthritis.
- Passive Cross-Body Adduction Test video: vt816x6o
Speed's Test
- Used for biceps lesions, tendinitis, or possible superior labrum anterior to posterior (SLAP) lesions
- This test involves the patient flexing the shoulders to 90 degrees with elbows extended and forearms supinated, then resisting a downward force by the examiner at the wrists.
- Pain in the anterior shoulder indicates a positive test, possibly biceps tendinitis.
- Speed's Test Video: https://www.youtube.com/watch?v=gbG_O9Gv8aQ&t=109s
Supraspinatus (Jobe/Empty Can) Test
- This test is for supraspinatous weakness, inflammation, or possible rotator cuff tear.
- Standing or seated, the patient extends arms and flexes shoulders to 90 degrees halfway between the sagittal & coronal plane.
- The arms are then internally rotated (thumbs down "empty can" position).
- The patient is asked to resist examiners downward force bilaterally
- https://www.youtube.com/watch?v=De050UTxwoo
O'Brien's Test
- Assesses AC joint or labral pathology based on where the pain manifests.
- Arm is forward flexed at 90 degrees and horizontally adducted 20-30 degrees toward the midline.
- Patient internally rotates the shoulder with forearm pronated and thumb down, resisting downward force on the arm below the elbow.
- Repeat with forearm in supination.
- Pain with pronation reduced/eliminated with supination is a positive test.
- Pain on top of the shoulder signifies AC joint pathology, while deep/internal pain signifies labral pathology.
- O'Brien's Test video: https://www.youtube.com/watch?v=qkDvVBi0gg8
Subscapularis (Gerber's) Lift Off Test
- Use in cases of suspected subscapularis strength or tendon rupture.
- The patient internally rotates the arm behind the back with the dorsum of the hand resting on the back.
- They then try to lift the hand off the back against resistance.
- Inability to exert force indicates a tear.
- Subscapularis Liftoff Test video: https://youtu.be/AgkTH52_PBI
Sulcus Sign
- Indicates inferior shoulder instability
- While the patient is standing, the examiner pulls the patient's arm downward while looking for a hollow sulcus between the lateral edge of the acromion and the humeral head.
- Compare to the opposite shoulder.
- The presence of a visible sulcus suggests inferior shoulder laxity and possible multidirectional instability
- Sulcus Sign video: https://youtu.be/vV7u2JtdYWI
Apprehension Test
- Checks for anterior shoulder instability.
- Position the patient supine with the shoulder near the table's edge.
- Passively abduct the shoulder to 90 degrees and flex the elbow to 90 degrees with the hand facing up.
- Externally rotate the forearm to 90 degrees by pushing it toward the table, look for signs or reports of apprehension.
- https://youtu.be/jZ2_9dAXKA5M
Relocation Test
- Assesses anterior glenohumeral instability.
- After the Apprehension test, apply a posteriorly directed force on the anterior aspect of the patient's upper humerus.
- Relief symptoms is a positive relocation test of symptomatic anterior shoulder instability
Ulnar Nerve Tinel Sign
- The patient's elbow should be bent to 45 degrees
- Palpation and light percussion posterior to the medial epicondyle (along the ulnar nerve) may produce local pain and parasthesias typically in the medial forearm and two ulnar fingers
- A positive result indicates an ulnar nerve entrapment
Resisted Wrist Extension
- Checks for extensor supinator tendon rupture, lateral epicondyle fracture, lateral epicondylitis (tennis elbow), or radial nerve lesions
- With the patient's hand pronated and forearm supported, have the patient make a fist and hold the wrist in extension while the examiner pushes the wrist down into flexion.
- Pain suggests lateral epicondylitis, fracture, or nerve lesions.
Resisted Wrist Flexion
- Assess for potential fracture of the medial elbow, golfer's elbow, or lesions involving ulnar or median nerves.
- Position the patient with their hand supinated and forearm supported. Instruct the patient to extend their fingers and hold the wrist in flexion. With the examiner gently
Flexor Digitorum Profundus/Flexor Pollicis Longus Tests
- Assesses injury to tendons, median nerve, or its interosseous branch.
- With hand palm up and fingers extended, hold PIP joint in extension and ask the patient to flex the distal finger joint against resistance.
- For the IP of the thumb, hold base of thumb stationary and perform the same procedure
- Inability to flex at DIP or IP joint suggests a flexor digitorum profundus injury for the fingers or flexor pollicis longus injury in the thumb
Flexor Digitorum Superficialis Test
- Performed when either injury to superficialis finger tendons is suspected, or injury to the median nerve.
- With patient's palm up on the table, extend all digits then hold down all digits except the finger being tested; ask patient to flex at PIP jointFlexor digitorum profundus tendons work as a unit
- By holding non tested fingers in full extension, you prevent assistance from the pull of the extensor digitorum profundus tendon
- In ability to flex at PIP joint suggests injury
Carpal Tunnel Compression Test (Durkan test)
- Used to assess for Carpal tunnel syndrome
- The examiner supports the patients supinated wrist, flexed to 20 degrees and presses firmly with finger / thumb, in the space between the flexor carpi radialis and palmaris longus tendons
- Numbness or tingling in the distribution of the median nerve within the fingers indicates carpal tunnel syndrome
Median Nerve Tinel's Sign
- The examiner Percuss the median nerve at the wrist flexion creasing in line with the metacarpal of the middle finger
- Reproduction of parathesia into the median nerve is a positive test
Phalen’s Test for Carpal Tunnel Syndrome
- Instruct the patient to position the elbows in a relaxed position. Then allow gravity to pull position as • Numbness or tingling in then median nerve distribution within 60 seconds is a positive test for carpal tunnel syndrome
Thumb Ulnar Collateral Ligament Instability Test
-
Assesses sprains in the ulnar collateral ligament
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Hold non-injured thumb at the radial and ulnar aspects, approximately to the first knuckle
-
With the other hand, hold the knuckle, keeping joint extended
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Push stress to the side while pushing the thumb away from the index
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Compare to non-injured thumb
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Normally, there should be a slight opening with a firm end point
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Absence of a firm end point when the knuckle is flexed indicates a tear in the collateral ligament
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During force there should be a slight opening with some resistance
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Thumb Ulnar Collateral Ligament Instability Test video (https://youtu.be/ LA
###Finkelstein’s Test for DeQuervain’s tenosynovitis
- Instruct the patient to flex the thumb across the palm
- Examiner, then, passively deviates the wrist -Sharp pain over the first comparent is a positive test suggesting DeQuervains tenosynovitis https://youtub.be/RbY29EeZEnA
Topic: Spine
- A straight leg raise is a key spine assessment.
- Place the patient in the supine position.
- Raise the patient's relaxed and straightened leg, flexing the thigh at the hip.
- Assess the degree of elevation, quality/distribution of pain, and effect of foot dorsiflexion.
- Pain radiating below the knee in the ipsilateral leg is a positive test for lumbosacral radiculopathy.
- Foot dorsiflexion can further increase leg pain in lum neuropathy.
Lower Extremities: Ober's Test
- Ober's Test is for ITB Contracture
- Place patient in a lateral decubitus position, with the side to be tested facing up.
- Flex patient's knee to 90 degrees, abduct hip to about 40 degrees, and fully extend the hip.
- Adduct limb toward examination table.
- The test is positive if limb fails to adduct past the midline, suggesting tightness in the iliotibial and/or tensor facia latae.
- Ober's Test video: https://www.youtube.com/watch?v=_Amjv6FzDeLE&t=24s
Piriformis Test
- It is useful to assess tightness in the piriformis muscle compressing the scaitic nerve
- The patient is asked to lie on their side and bring their top leg over and in onto the table.
- Hold patients knee & hip, while internally rotating their hip
- Positive if pain goes down the leg Piriformis Test video: https://youtu.be/zha5jlv
Patrick's Test aka FABER (Flexion, ABduction, External Rotation)
- Used for detecting hip or SI pathology
- Position the patient supine and allow patient to rest their right ankle at left knee with the right hip flexed to 45-50%
- Stabilize the left hip by applying pressure then apply gentle pressure until resistance is felt along the right knee and lateral hip of the patient
- Pain in the hip joint is a positive test that indicates pathology
- Pain in the sacroiliac (SI) joint means there may be injury or inflammation at the point the legs meet
- Patrick's Test video: https://www.youtube.com/watch?v=89Qiht82zmg
Patellar Apprehension Test
- Determines Patellar stability
- Place the patient in a supine and relaxed position, where the ankle is grasped and abducted far from the table
- With one hand perform a lateral patellar glide and push the thumb for far side in one sweep in an arch path
- Positive - indicates a patella pain sundrome Patellar Apprehension Test video: https://www.youtube.com/watch?v=_4TnCQppTy1g
Patellar Grind Test
- Used for condromalacia, arthritus, or degenerative joint disorder of patella
- The patient is asked to lie flat onto the bed
- For passive testing, the doctor applies passive and relax patella
- The doctor may pull the patella and then flex the knee and vice-versa
- Doctor place the patient on flat floor and perform similar
Lachman's Test
- Use for ACL injury, by inspecting tibia
- Examiner is to set on side and look for knee flexion
- With the larger and smaller legs, make smaller and place between patella
- Then place legs of limb across distal and proximal femur
-Lachman's Test video: https://m.youtube.com/watch?v=JFkbKNNazxq
Anterior & Posterior Drawer Tests
- Is the first step before patella and is used for ACL and PCL injuries
- The best way to do so is test the unaffected knee.
- With the patient in a flat position and the hips and knees bended, the knee is at 90 degree angles, the foot is placed on the chair and the hand are paced on the inner calf
- An anterior movement can only apply through forward motion. And it requires force while a push requires backward force
- Assess forward movement and pull forward • Anterior:. https://www.youtube.com/watch?v=_IdnBKv38EEQ
Valgus & Varus Stress Tests
- Used commonly for MCL (Medial Colateral Ligament) and LCL(lateral Colateral Ligament) respectively-
- Test the non injured side firs
- The MCL - Is more commonly associated with direct trauma - LCL is related to various trauma Apply force with the patient and thigs supported, on the quadriceps, by gripping the distal tibia
- Use hand and force in the ankle and reciprocating
Apley’s Compression Test
Test of lateral and external of the patients leg to see pain
- If the patient doesn't have pain. Then push until it occurs during compression test
- It is positive and suggests that medial or external of the knee - medial in ternal rotation of the legs
Thessaly Test
- Assess miniscal
- Standing in one leg with, flex the knee, rotate internally - the test is for patients that can follow instructions and stand on one leg
Anterior Drawer Test
- Anterior talofibular ligament assessment
- It is a testing of ankle
- Place the patient on the seat/ bed and knee flexed with 90 degree
- Place an approximately angle with with 20 degrees of plantar or flexion by cupping hand around the posterior heel
- Push the heel posteriorly while doing so on the patients heel
- If not in a firm manner . There is an elevated risk of ankel https://www.youtube.com/watc?v=Ac.BEYYKcto
Sub Talar Tilt Test
- It assess ligaments
- Make sure to have stabilized Tiba Then grab calcaenous to and then invert - Asymmetric indicates chronic axility of ligament ( Excessive motion or the the side to the other indicate chrinictly Pain during these test is unrealiable . The test that must be conducted - If the patient is a position to push and pull. Then.
###. Metatarsal Compression Test Assess mortar Used by sitting pt on a exam
- Table with one force - One of the is a palpable , sign of
- Used by putting for up, and apply pressure into the foot and
###. Thomas Test
- The best way to test rupture.
- Place patient in a down position - Grasp the bally and gently seewe Then apply force with and hand The foot should be planted in a manner at best / with respect of results .
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