Musculoskeletal I > UE Tests > Flashcards

UE Tests Flashcards

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1
Q

Describe the locking position/ quadrant position special test.

A
  • Patient supine
  • Hand cups posterior scapula with fingers over the shoulder, and forearm blocking the axillary border
  • Internal rotate the shoulder near maximally and flex the elbow
  • Extend the shoulder slightly
  • Abduct to end range
    • Assess pain/ discomfort **
  • Externally rotate from IR
    • Assess “hill” created, and pain/ discomfort **
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2
Q

What are 3 tests for shoulder impingement?

A
  • Rent test
  • Supine impingement
  • Empty can test
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3
Q

Describe the rent test.

A
  • Patient short seated
  • Extend shoulder and flex elbow
  • Palpate anterior to acromion
  • Slowly IR and ER shoulder feeling for greater tuberosity, and a “rent” or groove of 1 finger breadth that may be present if there is a tear.
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4
Q

Describe the supine impingement test.

A
  • Patient supine
  • Shoulder abducted to end range
  • Externally rotate the arm, and abduct towards patient’s ear
    • Internally rotate arm; Observe for increased pain in shoulder **
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5
Q

Describe the empty can test.

A
  • Patient flexes arms to 90 degrees while horizontally abducted in the plane of the scapula
  • Overpressure downwardly directed, while patient resists
    • Assess pain or weakness **
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6
Q

What are two tests for the subscapularis?

A
  • Lift-off test

- IR Lag sign

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7
Q

Describe the lift-off test.

A
  • Patient sitting
  • Shoulder extended and IR with the elbow flexed so that the dorsal aspect of the hand lies on the patient’s back
    • Ask patient to lift hand off back; Inability to do so indicates subscap problem **
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8
Q

Describe the IR lag sign.

A
  • Pt short sitting
  • Arm behind back as in lift-off test
  • Lift Pt hand off back
  • Ask patient to hold position
    • If Pt hand drifts into ER, the test is positive for a subscap problem **
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9
Q

What does the drop arm test test?

A
  • Supraspinatus
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10
Q

Describe the drop arm test.

A
  • Pt standing with PT in front of Pt
  • Passively abduct to 90 degrees
  • Pt slowly lowers arm
    • If patient cannot lower arm in controlled manner, the test is positive **
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11
Q

What are 3 tests for the infraspinatus/ teres minor?

A
  • External rotation lag sign
  • Hornblower’s sisgn
  • Drop sign
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12
Q

Describe ER lag sign.

A
  • Pt seated with PT to rear of Pt
  • Elbow flexed 90 degrees
  • Shoulder abducted 20 degrees in plane of scapula
  • Passively ER shoulder to endrange
  • Ask patient to hold
    • If Pt cannot hold, the test is positive **
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13
Q

Describe drop sign.

A
  • Pt seated with PT to rear
  • Elbow is 90 degrees blexion, shoulder 90 degrees abduction in scapular plane
  • Passively ER to endrange
  • Ask Pt to hold position
    • Assess ability to maintain ER **
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14
Q

Which test is specific for teres minor?

A

Hornblower’s sign.

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15
Q

Describe hornblower’s sign.

A
  • Pt seated with PT to rear
  • Elbow flexed 90 degrees
  • Shoulder abducted 90 degrees
  • Pt ER against resistance
    • Assess ability to hold ER **
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16
Q

What is a test for a rotator cuff tear or posterior impingement?

A
  • Posterior impingement sign
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17
Q

Describe posterior impingement sign.

A
  • Pt supine
  • Shoulder 90 - 110 degrees abducted
  • 10 - 15 degrees shoulder extension
  • Max ER of shoulder
    • Assess pain **
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18
Q

What is a test for internal impingement?

A
  • IR Resisted Strength Test
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19
Q

Describe IR resisted strength test.

A
  • Pt stands with PT to rear
  • 90 degrees shoulder abduction
  • 80 degrees shoulder ER
  • 90 degrees elbow flexion
  • Test resisted IR and ER
    • If ER > IR, test is positive for internal impingement **
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20
Q

What is a test for a SLAP lesion?

A
  • Biceps load II
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21
Q

Describe the Biceps Load II.

A
  • Pt supine with PT to involved side
  • 120 degrees shoulder abduction
  • 90 degrees elbow FLX
  • Forearm full SUP
  • Move shoulder to end range ER
  • Pt performs resisted elbow flexion
    • Assess pain **
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22
Q

What are tests for labral lesions/ long head of biceps pathology?

A
  • Yergason’s test
  • Crank test
  • Kim test
  • Jerk test
  • Speed’s test
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23
Q

Describe yergason’s test.

A
  • Pt seated or standing with PT to front
  • 90 degrees elbow FLX
  • Full PRN
  • Arm at side
  • Resisted supination
    • Assess pain in bicipital groove **
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24
Q

What does a crank test test?

A
  • Labral tear

- SLAP lesion

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25
Describe the crank test.
- Pt sitting or supine with PT to involved side - 160 degrees shoulder scaption - 90 degrees elbow FLX - Compression through humerus - IR and ER to attempt to pinch torn labrum * * Assess pain with or w/o clicking in shoulder **
26
What does a Kim test test?
- Posterioinferior labral lesion
27
Describe the Kim test.
- Pt seated with back support with PT on involved side - Grasp elbow and mid humerus - 90 degrees shoulder abduction - Axial compression of humerus - Posterioinferior glide to proximal humerus with diagonal elevation * * Assess sudden pain in shoulder **
28
What does the Jerk Test test?
- Posterioinferior labral lesion
29
Describe the Jerk Test.
- Pt seated with PT to rear - Support elbow and fix scapula - Axial compression of humerus - Horizontal adduction * * Assess sharp pain with or w/o clunks/ clicks **
30
What does Speed's Test test?
- SLAP lesion - Any Labral lesion - Biceps pathology
31
Describe Speed's Test.
- Pt standing with PT to front - Extend elbow - Supinate forearm - Resisted shoulder FLX from 0 - 60 degrees * * Assess pain in bicipital groove **
32
What are 4 tests for shoulder instability?
- Anterior release/ surprise - Apprehension test - Apprehension/ Relocation test - Load and shift test
33
What instability does anterior release/ surprise test?
Anterior.
34
Describe Anterior Release/ Surprise test.
- Pt supine with PT to involved side - Forearm grasped with hand over proximal humerus - Posteriorly directed force through humerus - 90 degrees abduction and max ER of shoulder - Release proximal humeral force * * Assess sudden pain, or increased pain **
35
What instability is measured by the apprehension test?
Anterior.
36
Describe the Apprehension Test.
- Pt standing or supine with PT to rear or on involved side - Max ER shoulder in 90 degrees ABD - Pull proximal humerus anteriorly * * Assess splinting or pain **
37
What does apprehension/ relocation test test?
- Anterior instability - Labral tear - SLAP lesion
38
Describe the Apprehension/ Relocation Test.
- Pt supine with PT to involved side - 90 degrees shoulder ABD - Max shoulder ER - If pain or splinting is ellicited, provide posteriorly directed force to proximal humerus * * Assess decreased pain or splinting; no change indicates impingement **
39
What does the Load and Shift test test?
- Anterior, posterior, and inferior laxity
40
Describe the Load and Shift test.
- Pt supine with PT to involved side - Stabilize scapula over shoulder - Compress with grip around proximal humerus - Apply A-P and S-I forces assess amount of translation as either I (to rim of glenoid) or II (beyond) - Perform inferior glide to assess translation
41
What are 3 tests for AC joint injury?
- AC Resisted Extension - Cross-over sign - AC joint palpation
42
Describe AC Resisted Extension Test.
- Pt seated with PT to rear - 90 degrees shoulder FLX - 90 degrees elbow FLX - Resist extension
43
Describe cross-over sign?
- Passively FLX shoulder to 90 - Maximally horizontally adduct * * Assess pain in AC **
44
What are the 4 tests for Thoracic Outlet?
- Hyperabduction test - Roos Test - Adson's Test - Costoclavicular Maneuver
45
Describe the Hyperabduction test.
- Pt sits straight * * Assess radial pulse ** - Abduct arm with flexed elbow, and ER * * Reassess pulse, and check for parathesias **
46
Describe Roos Test.
- Patient sitting - 90 degrees ABD, ER, and elbow flexion - Pt rapidy open and closes hands for a minute * * Assess reproduction of symptoms **
47
Describe Adson's Test.
- Pt sits straight * * Assess radial pulse ** - Pt breaths deep, tilt head backwards, and rotate towards the affected side * * Reassess radial pulse and check for parathesias **
48
Describe Costoclavicular Maneuver.
* * Assess radial pulse with patient sitting straight ** - Pt retracts and depresses scapula and holds for 1 min * * Reassess radial pulse, and check for parathesias**
49
Describe a short axis GH mobilization.
- Patient supine - Stabilize humerus with hand, and forearm with body - Orient arm at 90 degree angle to proximal humerus directly distal to joint - Push outwards
50
Describe a long axis GH mob.
- Fist into table blocks scapula - Grab around distal humerus, and hug forearm with body - Twist to distract/ inferiorly glide
51
Describe a dorsal humeral glide in abduction and flexion.
- In abduction, stabilize elbow/ forearm in one hand, and push directly downwards on proximal humerus - In flexion push through the long axis of the humerus for a posterior stretch
52
Describe a ventral humeral glide.
- Pt prone - Arm abducted - Downward force through proximal humerus
53
Describe physiologic lateral rotations, and dorsal-ventral humeral oscillations.
PLR: Pt prone, and small amplitude oscillations near end range; use arm to block movement past end range DVHO: Quick, small amplitude arthrokinematic movement
54
What are the 2 SC joint mobs?
- Craniodorsal clavicular glide | - Caudoventral clavicular glide
55
What are the 2 AC joint mobs?
- Ventral clavicular glide | - Dorsal clavicular glide
56
What are the scapular mobilizations?
- Dorsal tilt - Medial/ lateral - Superior/ inferior - Upward and downward rotation
57
What are 4 medical diagnoses that include rotator cuff disorders?
- Impingement syndrome - Rotator cuff/ glenoid labral tears - Posterior shoulder pain - GH hypermobility/ instability
58
What are 4 tests for wrist/hand instability?
- Gamekeeper's (skier's) Thumb Test - Varus/ Valgus Stress (at MCP, PIP, DIP) - Watson Scaphoid Test - Ulnomeniscotriquetral Dorsal Glide
59
Describe the Gamekeeper's Thumb Test.
- Stabilize hand - Bring thumb into EXT - Apply valgus stress to thumb at MCP * * Assess is more than 30 - 35 degree valgus stress is allowed ***
60
Describe the Watson Scaphoid Test.
- Forearm slightly pronated. - Grasp wrist from radial side with thumb over scaphoid - Move from slight extension and ulnar deviation into slight flexion and radial deviation - Release grip on scaphoid * * Assess if laxity allowed the scaphoid to be dislocated by determining if there is a clunking sound of the scaphoid moving back into place **
61
Describe Ulnomeniscotriquetral dorsal glide.
- Hand grip over dorsal ulnar side of forearm - Thumb over pisiform - Perform dorsal glide * * Assess pain or laxity **
62
What is the test for dequevain's disease?
- Finkelstein's test (paratendonitis of APL and EPB)
63
Describe finkelstein's test.
- Fist with thumb in middle - Patient ulnar deviates - PT provides overpressure * * Assess pain on radial portion of wrist/ forearm **
64
What is an arterial filling test for the ulnar and radial artery?
- Allen Test
65
Describe the Allen Test.
- Elbow resting on table with fingers pointed at ceiling - Occlude radial/ ulnar arteries - Pt opens and closes fist for 30 seconds - Patient open hands - Release one artery - Observe filling pattern and time
66
What are 6 tests for Carpal Tunnel Syndrome?
- Katz Hand Diagram - Phalen's Test - Reverse Phalen's Test - Flick Maneuver - Tinel's Sign - Median Nerve Compression
67
Describe Katz Hand Diagram.
- Patient fills out chart according to pain, numbness, tingling, and decreased sensation, which produces a diagnostic score
68
Describe phalen's test.
- Patient sits with elbows supported, and arms pointed up - Allow wrists to fall - Hold for 60 seconds * * Assess parathesias and pain **
69
Describe the Flick Maneuver.
- Patient performs characteristic flick maneuver | * * Assess if symptoms have resolved **
70
Describe Tinel's Sign.
- Strike patient on median nerve at wrist with reflex hammer, or fingers * * Assess reproduction of Symptoms **
71
Describe the Median Nerve Compression Test.
- Apply gentle sustained pressure over the median nerve at the wrist using the thumbs - Hold for 15 seconds to 2 minutes - Assess reproduction of symptoms
72
Describe the Median Nerve Compression Test with Wrist Flexion.
- Fully extended elbow with wrist flexed 60 degrees | - Follows normal compression test procedure from this point
73
Describe reverse phalens test.
- Put hands together in full extension (prayer position) - Hold for 1 minute - Assess reproduction of symptoms
74
Describe Froment's Sign.
- Attempt to hold piece of paper with pen style grip - Pull paper out from hand * * Assess PIP flexion **
75
What test refers to changing proximal joint position to asses change in ROM in the fingers?
Bunnell-Littler Test.
76
What MCP position limits PIP motion due to intrinsics? What relieves restriction?
- Extension limits flexion ROM | - Flexion relieves tension
77
How is the ORL tested in the Bunnell-lIttler test?
- Ass DIP flexion with PIP in flexion and extension | - If limited in extension, and increased in flexion, then test is positive.
78
What is the use of Mill's manipulation?
- Elongate and tear the scar formed in chronic lateral epicondylitis. - Also manips radial head
79
Describe Mill's manip.
- Full elbow EXT - Wrist fully flexed - Ulnar deviation and pronation - Stretch on lateral epicondyle - Quick ventral thrust
80
What are 2 tests for lateral epicondylitis?
- Cozen's Test | - Lateral Epicondylitis Test
81
Describe Cozen's Test.
- Pt sitting or standing - Elbow FLX 90 degrees - Resisted wrist extension * * Assess reproduction of pain along lateral epicondyle **
82
Describe the Lateral Epicondylitis Test.
- Extension of the 3rd digit is resisted | * * Assess pain at lateral epicondyle **
83
What are 4 tests for elbow stability?
- Moving Valgus Stress Test - Posterior Lateral Rotary Instability - Varus Stress Test - Valgus Stress Test
84
Describe the moving valgus stress test.
- Pt upright - Shoulder ABD 90 degrees - Elbow flexed 120 degrees - Apply valgus stress and bring elbow from 120 to 70 degrees FLX * * Assess pain**
85
What does the moving valgus stress test specifically test?
Chronic Medial Collateral Ligament Tear
86
Describe Posterior Lateral Rotary Instability.
- Pt supine - Flex shoulder above patient's head - Fully extend elbow - Fully supinate forearm - Apply valgus force with axial compression while flexing elbow * * Assess lateral displacement (a click) of the radius or appression as the elbow approaches 90 degrees **
87
What are the tests for nerve entrapment at the elbow?
- Elbow flexion test - Pressure Provocation - Tinel's Sign
88
Describe the Elbow Flexion Test.
- Pt sitting - Both elbows flexed and wrists extended fully, but not forcibly * * Assess reproduction of pain, or parathesias along ulnar nerve distribution **
89
What condition does the Elbow Flexion Test specifically test?
Cubital Tunnel Syndrome.
90
Describe the Pressure Provocation test for the ulnar nerve.
- Compress ulnar nerve lightly proximal to the cubital tunnel for 60 seconds with the elbow in 20 degrees flexion and the forearm supinated
91
Describe Tinel's Sign for the ulnar nerve.
- 4 - 6 tips using fingers or a reflex hammer proximal to the cubital tunnel on the ulnar nerve * * Assess reproduction of symptoms in an ulnar nerve pattern **
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