Upper Extremity

Question 1

Perform apprehension test for the shoulder joint

Answer 1

-pt seated
-shoulder abducted and flexed to 90
-force into external rotation
-monitor with 1 hand at GH joint
-provide anterior pressure on proximal humerus
Positive test= pt apprehension of repeat dislocation
Indicates= glenohumeroral instability

Question 2

Perform sulcus sign for should joint

Answer 2

• grasp pt elbow and apply inferior traction while monitoring at GH joint
• positive test= indentation appears beneath acromion (see gap)
• indicates= GH instability

Question 3

Perform yergason test for shoulder joint

Answer 3

• pt arm at side with elbow flexed at 90
• use 1 hand to palpate bicipital groove (find by pronating/supinating pt arm and feel for tendon)
• other hand grasp pt wrist
• start pronated internally rotated and have pt supinate and externally rotate against resistance
• positive test= pain or tendon subluxation out of groove
• indicates= unstable bicipital tendon/subluxation bicipital tendonitis

Question 4

Perform speeds test for shoulder joint

Answer 4

• pt arm foward flexed to 50 at shoulder with hand supinated
• flex albow to 15
• resist at forearm while pt flexes shoulder and monitor at bicepital groove
• positive test= pain in bicipital groove
• indicates= bicipital tendonitis of longhead of biceps

Question 5

Perform the neer impringement test for shoulder joint

Answer 5

• stabilize pt shoulder and PASSIVELY flex shoulder to fully flexed position
• make joint space narrow
• positive test= pain
• indicates= subacromial bursa or rotator cuff impingement

Question 6

Perform hawkins test for shoulder joint

Answer 6

• flex arm and elbow to 90
• passively rotate humerus into internal rotation while adducting
• positive test= pain
• indicates= rotator cuff impringement

Question 7

Perform empty can test for shoulder joint

Answer 7

• elevate pt arms to 90 and internall rotate
• press down on forearms while pt resist
• positive test= pain or inability to resist
• indicates= rotator cuff pathology (specifically supraspinatus)

Question 8

Perform drop arm test for the shoulder joint

Answer 8

• doc abduct pt arm to 90 then have them slowly drop their arm
• positive test= arm will drop fast or gentle tap on wrist will cause arm to drop
• indicates= full thickness tear of supraspinatus

Question 9

Perform golfers elbow test for elbow joint

Answer 9

• anterior forearm/flexor comparment
• patients elbow flexed to 90 and forarm is supinated with wrist neutral and palm up
• place 1 hand under proximal forearm to stabilize and other ahdn over pt wrist to resist moement
• instruct pt to flex the wrist
• positive test= pain/tenderness around ME
• indicates= medial epicondylitis

Question 10

Perform tennis elbow test for elbow joint

Answer 10

• posterior forearm/extensor compartment
• pts elbow flexed to 90 forarm is pronated with wrist neutral and palm down
• 1 hand under proximal forearm to stabilize and other hand over pt hand to resist movement
• instruct pt to extend wrist
• positive test= pain/tenderness around LE (radiate down lateral forearm)
• indicates= lateral epicondylitis

Question 11

Perform valgus stress test for elbow joint

Answer 11

• arm slightly abducted and externally rotated with forearm supinated and flexed to 30
• slight medial directed force (pressing lateral to medial) at elbow
• positive test= pain/tenderness with palpation and valgus stress, increased laxity (degree laxity correlates with degree of injury to UCL)
• indicates= injury to UCL or MCL

Question 12

Perform varus stress test for the elbow joint

Answer 12

• arm slightly abducted internally rotated supinated with elbow flexed 15
• apply varus slight lateral force (press medial–>lateral) on elbow
• positive test= pain or increased laxity in RCL
• indicates= injury to RCL or LCL

Question 13

Perform tinels sign at wrist

Answer 13

• can be elicited by tapping over the transverse carpal ligament (between thenar/hypothenar eminences) with tip of finger or reflex hammer with pt wrist held in extension
• positive test= parasthesias/numbness/tingling/pain radiating to thumb, index and middle finger (median nerve distribution)
• indicates= entrapment of median n or carpal tunnel syndrome

Question 14

Perform phalen sign

Answer 14

• place dorsal aspects of pt hands together and force into wrist flexion
• hold for 60 sec
• positive test= any reproduction of sx/parasthesias in distribution of median n
• indicates= entrapment of median n or carpal tunnel syndrome

Question 15

Perform finkelstein test

Answer 15

• examiner asks pt to make fist encompassing their thumb and ulnar deviate the wrist
• positive test= increased pain in first dorsal compartment/lateral wrist
• indicates= Dequervains tenosynovitis