Term
|
Definition
Instruct Pt to inform about sx's; PROM and RROM of cervical
+ = pain during any ROM
Resisted pain = strain
Passive pain = sprain |
|
|
Term
| George's Screeing Procedure |
|
Definition
BP performed bilaterally (at heart level)
Radial pulses bilaterally
Auscultates subclavian artery bilaterally
+ = unequal pulses, difference in systolic BP of 10+, bruit
Subclavian artery stenosis |
|
|
Term
| Shoulder abduction test (Bakody's sign) |
|
Definition
Pt raises arm overhead so hand rests on head and ask pt about sx's
Perform bilaterally
+ = decrease or relief of sx's
Radiculopathy |
|
|
Term
|
Definition
Pt's neck is rotated to one side & Dr compresses
Performed Bilaterally
+ = radicular pain
Radiculopathy |
|
|
Term
| Foraminal Compression Test (Spurling's) |
|
Definition
Dr. applys compression in neck neutral position
If no pain, extend neck and compress
If no pain, extend and rotate then compress (Bilaterally)
+ = radicular pain to side in which neck is flexed
Radiculopathy
(IF pain is on opposite side its indicitive of muscle spasm) |
|
|
Term
|
Definition
Dr. laterally flexes head, stabilizes it
Depress the shoulder opposite to the laterally flexed head
Performed Bilaterally
+ = Radicular pain or localized pain
Radicular pain = disc, adhesion, stenosis, TOS
Local pain = muscle spasm, tightness, or ligamentous injury |
|
|
Term
|
Definition
Dr contacts the Pt's head and lifts
+ = exacerbation or relief of pain
Exacerbation = sprain/strain
Relief = Radiculopathy or facet imbrication |
|
|
Term
| Maximal foraminal compression |
|
Definition
Pt laterally flexes, rotates (same side) and extend their head
Ask if it causes any sx's
If not, Dr. adds compression
Perform Bilaterally
+ = radicular pain, non-radicular pain
Radicular pain = Radiculopathy
Non-radicular pain (same side) = joint pathology
Non-radicular pain (opposite) = strain/sprain |
|
|
Term
| Upper Cervical Quadrant Test |
|
Definition
Pt's upper cervical spine into extension (protaction), lateral flexion, and rotated (same side)
Dr. Compression
Performed Bilaterally
+ = radicular pain
Upper Cervical Radiculopathy |
|
|
Term
|
Definition
Dr. instructs pt to take a deep breath, hold it, and bear down as though having a bowel movment
+ = sever spinal or extraspinal pain
Possible space occupying lesion |
|
|
Term
|
Definition
Pt is supine, examiner stabilizes the pt's sternum on the table w/ one hand
Other hand contacts occiput and passively flexes the neck slowly
+ = Acute local vertebral pain
Cervical &/or Upper Thoracic Vertebral Fracture |
|
|
Term
|
Definition
Patient presents w/ their head help between their hands to prevent head and neck motion
Servere cervical or cranial pathology |
|
|
Term
|
Definition
pt relaxes arm
Dr measure up from olecronon to mid-arm
Performs circumferential mensuration at mid-arm
Perform Bilaterally (using same distance to midarm)
+ = difference of an inch or more between two sides, or if dominant extermity is smaller
Hypertrophy, Edema, or Atrophy |
|
|
Term
|
Definition
pt relaxs
Dr. measure down from olecronon to mid-forearm
Performs circumferential mensuration at mid-forarm
Perform Bilaterally (use same distance to mid arm)
+ = Difference of an inch or more between sides or if dominant extremity is smaller |
|
|
Term
|
Definition
Performed Bilaterally immediately for each part to compare side to side
Pt reaches in front of neck towards opposite scapula
Pt reaches behind the neck reaching towards opposite scapula
Pt reaches behind the back up as high as possible on the spine
+ = Pain &/or discrepancy of an inch or more where comparing right to left
GH Dysfunction or Tight Muscles |
|
|
Term
| Passive Humeral Abduction w/ Scapular Palpation |
|
Definition
Dr. palpates inferior angle of scapula
The other hand is used to passively abducts the humerus until scapula starts to move
Perform Bilaterally
+ = scapula movment prior to 70/80 degress
GH Joint Restriction |
|
|
Term
| Passive Humeral Abduction w/ GH Palpation |
|
Definition
Dr. palpates humeral head with finger of one had
Other hand passively abducts the humerus
Dr feels for the humeral head to drop between 80-120 of abduction
Perform Bilateral
+ = Humeral head doesn't depres
GH joint glide restriction |
|
|
Term
|
Definition
Pt's arm is flexed, elbow is straight, and palm is up
Dr stabilizes shoulder w/ one hand
Applies a downward resistance with opposite hand prox wrist
Repeat with palm down
Perform Bilaterally
+ = Pain in the bicipital groove, especially w/ palm up
Bicipital Tendinopathy or Strain |
|
|
Term
| Yergason's Test (Supination sign) |
|
Definition
Pt's elbow is flexed 90 by side of body w/ forearm pronated
Pt instructed to simulatneously supinate and externally rotate arm against resistance
Performed Bilaterally
+ = Pain in bicipital groove or tendon pops out of groove
Instability/Tear of Transverse Humeral Ligament or Tendinosis of Biceps |
|
|
Term
| Transverse Humeral Ligament |
|
Definition
Dr palpates bicipital groove
Dr passively abducts the pt's arm to 90 degrees
Dr. passively internally and externally rotates the arm
Performed Bilaterally
+ = Palpable instability of the tendon, Pain
Instability of Biceps Tendon due to tear of Transverse Humeral Ligament |
|
|
Term
|
Definition
Dr palpates bicipital groove
Dr passively abducts pt's arm with full external rotation and then lowers slowly
+ = Palpable or audible click
Subluxation or Dislocation of Biceps Tendon |
|
|
Term
| Supraspinatus test (Empty Can Test) |
|
Definition
Pt's arm is abd to 90 in the scapular plane w/ thumb pointing to the floor
Dr stabilizes shoulder w/ one hand
Contacts forearm with other hand and applies downward pressure
Performed Bilaterally
+ = Pain with or without weakness
Tear or Supraspinatus Tendinopathy |
|
|
Term
|
Definition
Dr abducts pt's arm 90 asks pt to hold it up
If pt's can hold Dr applies a slight downward pressure
If pt can hold position, they are asked to actively lower their arm
Performed Bilaterally
+ = inability to hold arm up, arm gives away w/ pressure, or comes down jerky when lowered
Can't hold up = Complete Tear of Cuff
With other findings = Partial tear of Cuff |
|
|
Term
|
Definition
Pt's hand is placed against mid-lumbar spine (palm out); then rotat hand away from back
If pt can lift hand off, Dr applies a load pushing hand back towards the spine
Performed Bilaterally
+ = Inability to lift hand away from back or resist load
Subscapularis Strain or Tendinopathy |
|
|
Term
|
Definition
Dr graps humeral head between thumb and index finger
Compress into the joint, and translate it forward (P-A) and release
Take contact again and translate (A-P)
Perform Bilaterally
+ = excessive translation in the fossa
Grade 1: Translation of up to 50% of the diameter of the head, or up to rim of the glenoid
Grade 2: head is pushed beyond rim by greater than 50% of the diameter of the head, but reduces spontaneously
Grade 3: dislocation of head |
|
|
Term
| Inferior Instability Test (Sulcus Sign) |
|
Definition
Pt flexes body forward
Dr tractions down on pt's arm with one hand while palpating humeral head with other
Perform Bilaterally
+ = visable or palpable sulcus
Inferior or multidirectional instability
+1 = sulcus less than 1 cm
+2 = sulcus between 1 & 2 cm
+3 = sulcus greater than 2 cm |
|
|
Term
|
Definition
Pt supine
Pt's arm flex to 90, elbow flexed
Dr. contacts GH joint and pushes elbow A-P (downward)
Perform Bilaterally
+ = Apprehension, pain &/or muscle spasm
Reccurent Posterior Dislocation
Posterior Instability |
|
|
Term
|
Definition
Dr passively and slowly abducts pt's arm to 90, externally rotates and extends it while pushing P-A on the joint
(Pt's elbow is bent to 90)
Performed Bilaterally
+ = Apprehension, Pain &/or Muscle Spasm
Recurrent Anterior Dislocation |
|
|
Term
|
Definition
Dr Passively and forcibly elevates the arm fully in the scapular plane w/ medial rotation
Performed Bilaterally
+ = Pain in Anterior Shoulder
Subacromial Impingement Syndrome |
|
|
Term
| Hawkins-Kennedy's Impingement Test |
|
Definition
Dr supports pt's elbow w/ one hand
Stabilizes the scapula with other hand
Arm is flexed to 90 degrees with elbow flexed to 90 degress
Passive Internal rotation is applied
Performed Bilaterally
+ = Pain in anterior aspect of shoulder
Subacromial Impingement Syndrome |
|
|
Term
| Subacromial Push-Button Test |
|
Definition
Pt is seated
Dr applies pressure to subacromial bursa
Performed Bilaterally
+ = Palpable tenderness
Subacromial Bursitis |
|
|
Term
|
Definition
W/ pt's arm by side Dr palpates for tenderness
Dr keeps finger on tender spot and passively abducts arm
Performed Bilaterally
+ = tender spot disappears as arm is abducted
Subacromial Bursitis |
|
|
Term
|
Definition
Dr stabilizes pt's elbow in 90 fex by side of body with their thumb on lateral epicondyle
forearm is pronated and wrist extended
Dr applies resistance to elbow extension
Performed Bilaterally
+ = pain around lateral epicondyle
Lateral Epicondylitis/Epicondylopathy |
|
|
Term
|
Definition
Pt elbow is flexed, forearm supinated and wrist flexed
Dr palpates lateral epicondyle
Dr passively pronates and extends elbow while maintaining full wrist flexion
Performed Bilaterally
+ = Lateral Epicondyle Pain
Lateral Epicondylitis/ Epicondylopathy |
|
|
Term
| Golfer's Elbow (Medial Epicondylitis Test) |
|
Definition
pt's elbow is flexed, forearm supinated and wrist flexed
While palpating medical epicondyle, dr passively extends both the wrist and elvow
Performed Bilaterally
+ = Pain over medial epicondyle area
Medial epicondylitis/ Epicondylopathy |
|
|
Term
| Ligamentous Instability Test |
|
Definition
Dr flexes pt's elbow slightly (20-30 deg)
Dr applies valgus force to the elbow
Dr applies varus force to the elvow
Performed Bilaterally
+ = Gappin along either medial or lateral joint line
Medial (Ulnar) or Lateral (Radial) Collateral Sprain |
|
|
Term
|
Definition
Pt is instructed to fully flex elbows and extend wrist
Hold for 3 to 5 minutes or until symptoms are produced
+ = Pain &/or paresthesias that follow distribution of ulnar nerve
Cubital Tunnel Syndrome |
|
|
Term
|
Definition
Dr. holds pt's arm in hand while contacting the olecranon and medial epicondyle with fingers
Dr uses hammer to tap ulnar nerve just distal to groove
Performed Bilaterally
+ = Pain &/or paresthesias down the distribution of ulnar nerve (compare to other side)
Cubital tunnel syndrome or regeneration of the nerve |
|
|
Term
|
Definition
Patient makes first with thumb inside
Dr passively ulnar diviates wrist
Performed bilaterally
+ = acute pain in anatomical snuff box
Stenosing tenosynovitis of abductor pollicis longus &/or extensor pollicis brevis; De quervain's disease |
|
|
Term
|
Definition
Pt puts dorsum of their hands together and hold position for 1 minute
+ = reproduction of paresthesias in median nerve distribution
Carpal Tunnel Syndrome |
|
|
Term
| Reverse Phalen's (Prayer) |
|
Definition
Pt places pals of hands together, lower them down towards waist
Pt holds for 1 minute
+ = reporduction of parethesias in median nerve distribution
Carpal Tunnel Syndrome |
|
|
Term
|
Definition
Use hammer to tap over carpal tunnel
Perform Bilaterally
+ = reproduction of pain &/or parethesias in median nerve distribution
Carpal tunnel syndrome |
|
|
Term
|
Definition
Pt holds paper between thumb and index finder
Dr attempts to pull away the paper
Performed Bilaterally
+ = Reproduction of pain &/or paresthesias in median nerve distribution
Carpal tunnel syndrome |
|
|
Term
|
Definition
Use hammer to tap over the Tunnel of Guyon
Perform bilaterally
+ = Reproduction of pain &/or paresthesias in ulnar nerve distribution
Ulnar tunnel syndrome; Tunnel of Guyon Syndrome |
|
|
Term
| Ligamentous Instability Test for the Fingers |
|
Definition
Dr holds pt's finger proximal to joint with one hand
Other hand contacts finger just above joint
Dr applies valgus & varus stress
Performed Bilaterally
+ = laxity of joint or excess motion
Sprain of the collateral ligaments |
|
|
Term
|
Definition
Pt's squeezes two of the doctor's fingers in each hand
Bilaterally simultaneously so the Dr can compare
Then have pt pick up an object (pencil, key) with thumb and each finger
+ = unequal pressure on Dr's fingers or inability to pick up a small object w/ precision
Lesion to Nerve Root; Peripheral nerve; Muscular lesion/ Bony lesion |
|
|
Term
| Costovertebral Expansion (Chest Mensuration) |
|
Definition
Tape measure placed at 4th intercostal space
Measure on full inspiration and full expriation
+ = less than 3 cm or 1 inch change
Akylosing conditions; Rib problems; Lung pathology
(if + test repeat under axilla and at T10) |
|
|
Term
|
Definition
Dr palpates spine for rib hump and scoliosis
Pt flexes forward and Dr reinspects back
+ = scoliosis or rib hump is reduced or is maintained on flexion
Scoliosis is same = Structural scoliosis
Scoliosis is reduced = functional scoliosis |
|
|
Term
|
Definition
Pt supine and Dr applies downward pressure on sternum
+ = localized pain to ribs
Rib fracture |
|
|
Term
|
Definition
Pt actively laterally flexes trunk to each side
+ = pain on either concave or convex side
Concave side = neuritis
Convex side = strain or pleurisy |
|
|
Term
|
Definition
Pts crosses arms over chest
Dr stabalizes pt's thigh on table with their arms
Pt does a sit up (5 seconds)
Dr observes umbilicus during sit up
+ = umbilicus migrates to intact side (away from effected side)
LMNL for roots that innervate the opposite quadrant from which the umbiliucs mirgrated (T6-T12) |
|
|
Term
| Forestier's Bowstring Sign |
|
Definition
Pt side bends to one direction
Pt bends to opposite direction
+ = severe limitaiton in side bending to one or both directions
Ankylosing Spondylitis or patholgoy causing muscle spasm/contracture |
|
|
Term
|
Definition
Pt bends forward
+ = pt flexes knee on affected side b/c trunk flexion puts traction on involved nerve root creating radicular pain
Radiculopathy |
|
|
Term
|
Definition
Dr tell pt to walk approx 10 ft towards Dr on their heels
+ = toes drop
L4-L5 Radiculopathy, Common Fibular Neuropathy (Deep fibular), Tibialis ant or extensor hallicis, extensor digitorum |
|
|
Term
|
Definition
Pt walks on toes away from Dr. approx 10 feet
+ = heels drop
S1 radiuculopathy, Tibial neuropathy, Gastroc/soleus problem |
|
|
Term
|
Definition
Pt actively extends each leg seperately; then both legs simultaneously
+ = Radiuclar pain &/or inability to perform due to pain &/or the patient leans back on both hands forming a tripod sign w/ extension of either one leg or both
L4 to S3 Radiulopathy |
|
|
Term
| Sitting Root Test (Lasegue Sitting) |
|
Definition
Pt seated w/ neck flexed on chest
Dr passively extends leg
Bilaterally performed
+ = Radiuclar pain in elevated leg
L4 to S3 Radiculopathy |
|
|
Term
| Sciatic Tension Test ( Deyerle's Sign) |
|
Definition
Dr raises pt's leg to point of pain at which point the knee is flexed until pain is alleviated
Dr places fingers in posterior thigh and popliteal fossa
Dr tries to recreate stretch on nerve
Performed Bilaterally
+ = Radicular pain
L4 to S3 radiculopathy |
|
|
Term
|
Definition
Pt is asked to stand up
Dr observes how it is performed
+ = Pt supports self on unaffected side while standing and keeps affected leg flexed
Possible L4 to S3 radiculopathy |
|
|
Term
|
Definition
Dr places inclinometer on tibial tub.
Slowly elevates the leg to point of pain or until full motion is achieved
Dr notes measurement
Performed Bilaterally
+ = Radicular pain
Between 35-70 deg = L4 to S3 Radiculopathy; 0-35 deg extra dural sciatic involvement |
|
|
Term
|
Definition
Performs SLR to point of pain and backs off the hip flex 5 deg or until pt is out of pain
Dr dorsiflexes the ankle
+ = Radicular Pain
0 - 35 deg = sciatic involvement; 35 - 70 deg L4 to S3 radiculopathy |
|
|
Term
|
Definition
Dr raises the unaffected leg until pain is produced or reaches 90 deg
+ = Increase in radicular pain on affected leg
Posteromedial Disc Protrusion involving L4 to S3 roots |
|
|
Term
|
Definition
Dr does WLR
Adds dorsiflexion to the ankle if asymptomatic
+ = increase or production of radiuclar pain on affected leg
Posteromedial Disc Protrusion involving L4 to S3 nerve roots |
|
|
Term
| Bowstring Test (Cram Test) (Popliteal Pressure Sign) |
|
Definition
SLR to point of pain
Dr flexes knee w/o flexing hip further
Ask pt if symptoms are relieved
Dr exertes pressure on hamstrings working down to popliteal fossa
+ = Radicular pain
L4 to S3 Radiulopathy; Extradural Sciatic Nerve involvement |
|
|
Term
|
Definition
Pt lays on side
Dr flexes pt's neck
Extends hip 15 deg while keeping knee straight
If no pain produced, knee is flexed w/o further hip ext
Performed Bilaterally
+ = Radicular pain
L2 to L4 Radiculopathy |
|
|
Term
| Ely's Heel-to-Buttock Test |
|
Definition
Lie on stomach
Dr passively flexes the pt's heel to their opposite buttock
Dr extedns hip while holding the knee in flexion
Performed Bilaterally
+ = Radicular (anterior thigh) or non Radicular pain &/or inavility to hyperextend the hip
Tight Rectus Femoris, Iliopsoas irritation, or L2-L4 Radiculopathy |
|
|
Term
| Prone Knee Bending (Nachlas Test) |
|
Definition
Dr flexes pt's knee on same side while preventing hip rotation
If knee cannot be flexed beyond 90, passively extend hip
Performed Bilaterally
+ = Radicular pain in anterior thigh, pain in buttock or lumbosacral region
L2 to L4 radiculopathy; SI Syndrome or Lumbosacral irritaion |
|
|
Term
|
Definition
Dr stabilizes PSIS area w/ one hand
Other hand grasps pt's shoulder and passively bends spine obliquely backwards
Dr repeats to other dicrection contacting the oppostie side of the spine
+ = Radicular or achy pain
Lower Lumbar Radiculopathy; Achy pain may indicate Facet syndrome, capsulitis, Sprain/strain, Muscle spasm |
|
|
Term
|
Definition
Dr internally rotates affected leg and performs SLR
If pain, externally rotates the leg and askes if this changes the symptoms
Performed Bilaterally
+ = symptoms relieved by external rotation
Piriformis Syndrome |
|
|
Term
|
Definition
Lay on side
Pts hip is flexed to 90 and positioned near edge of table
Dr puts one hand on pelvis for stabilization
Other hand puts downward pressure on pts knee
Performed Bilaterally
+ = Local buttock pain or radicular pain
Buttock pain = Piriformis Spasm; Radicular pain = Piriformis Syndrome |
|
|
Term
|
Definition
Pt near edge of table, supine
Flex knee to chest, pt holds in hands
Opposite leg is extended off the table
Dr applies pressure to each leg to shear SI join
Performed Bilaterally
+ = Pain in SI on extended side
SI joint Inflammation; Infection; Srain |
|
|
Term
|
Definition
Pt on stomach
Dr flexes pts leg to buttock
Internally rotates hip (leg goes lateral)
Performed bilaterally
+ = Pain in SI or hip joint
SI joint inflammation, infection sprain; Hip joint capsulitis, arthritis, ect |
|
|
Term
|
Definition
Pt on stomach
Dr grasps one knee
Other hand stabilizes of pts SI joint
Dr passively extends hip and applies P to A pressure on SI
Performed Bilaterally
+ = SI joint pain
SI Joint Inflammation, Infection, Sprain |
|
|
Term
| Iliac Compression Test (Approximation Test) |
|
Definition
Lie on side
Dr contacts over iliac crest and presses towards floor
Performed Bilaterally
+ = Pain in SI
SI joint inflammation, infection, sprain |
|
|
Term
| Patrick's (Fabere's Sign of 4) |
|
Definition
Dr passively flexes pt hip and knee
External rotates and abducts hip
Ankle is placed above knee on opposite leg
Dr stabilizes opposite ASIS and gently lowers pt knee down towards table and applies slight pressure down on the knee
Performed Bilaterally
+ = pain in groin or inferior gluteal fold region
Hip Capsulitis, Arthritis, Fracture |
|
|
Term
| Peripheral Joint Clearance test |
|
Definition
Pt squats down trying to keep heels on floor
Doctor is standing close to protect from falling
If pt is unable to squat down completely w/ heels on floor, have them repeat squat allowing heels to elevate
+ = Pain in hips, knees, &/or ankle joints
Problem with the Painful Joint |
|
|
Term
|
Definition
Foot is exposed and dorsiflexed slightly
Dr hits the pt's calcaneus w/ their fist
Performed Bilaterally
+ = Pain in groin &/or upper thigh
Hip Fracture, Arthritis, Capsulitis |
|
|
Term
|
Definition
Stand on one leg
Pt performs maneuver while Dr observes for dropping of pelvis
Performed Bilaterally
+ = Pelvis drops on the non-stance side when pt stands on affected leg
G. Medius weakness on stance side or unstable hip, superior gluteal neuropathy |
|
|
Term
|
Definition
Pt supine
Holds one knee to chest
Dr palpates the straighten leg
Performed Bilaterally
+ = Pt involuntarily flexes the opposite leg
Tight Hip Flexors or Hip flexion contracture - iliopsoas |
|
|
Term
|
Definition
Lide on side
Pt's hip slightly extended and abducted
Dr applies an I-S stabilizing pressure on the pelvis
Ask pt to relax their thigh and dr lowers it down towards table
Performed Bilaterally
+ = relaxed thigh remains abducted
Contracture or tightness of TFL or ITB |
|
|
Term
|
Definition
Pt's hip is flexed to 45 and knee is flexed to 90
Dr sits on pts foot and grasps proximal tibia w/ both hands
From neutral Dr pushes from A-P
From neutral Dr pulls from P-A
Performed Bilaterally
+ = 5+ mm of tibial movement in either direction
Pulling = ACL sprain, Posterolateral & posteromedial capsule, MCL sprain, ITB, Arcuate-popliteus complex
Pushing = PCL sprain, arcuate-popliteus complex, posterior oblique lig, and possibly the ACL |
|
|
Term
|
Definition
Dr flexes the pt's knee approx 20-30 deg
Stabilizes feur on the table with one hand
Other hand grabs the proximal tibia and pulls it from P-A
Performed Bilaterally
+ = Anterior translation of the tibia on the femur
ACL sprain or possibly posterior oblique ligament sprain or arcuate popliteus complex |
|
|
Term
|
Definition
Passively flexes knee 20-30 deg
Contacts medial joint line w/ one hand
Dr's other hand palpates lateral joint line and creates a varus stress by pulling tibia
Performed Bilaterally
+ = gapping along the lateral tibiofemoral joint line
Sprain of the LCL in flexion; sprain of the LCL &/or capsule, PCL, ACL in ext |
|
|
Term
|
Definition
Dr passively flexes knee 20-30 deg
Contacts lateral joint line with one hand
Drs other hand palpates medial joint line and creates a valgus stress
Performed Bilaterally
+ = gappin on the medial tibiofemoral joint line
Gapping in flexion = MCL sprain
Gapping in extension = MCL &/ or ACL, PCL, Capsule sprain |
|
|
Term
|
Definition
Dr flexes knee to 90 deg and stabilizes pt's thigh down on table w/ their knee
Interally rotates tibia and pulls up on the pt's foot
Dr externally rotates tibia and pulls up
Performed Bilaterally
+ = Pain or relief of symptoms
Nonspecific ligament sprain if pain is produced or if relief of pain possible meniscal injury |
|
|
Term
| Posterior Sag Sign (Gravity Drawer Test) |
|
Definition
Pt is supine
Hips flexed to 45 deg and their knees flexed to 90 deg (feet on table) & heels are lined up
Dr watches tibia to sag
OR
Dr flexes hips and knees to 90 deg (holding off the table) and watches for tibia to sag
+ = Tibial plateau's sag posterior in relation to the femur
Chronic Posterior Cruciate Tear |
|
|
Term
|
Definition
Dr. fully flexes knee w/ internal rotation; Dr extends knee while palpating and listening at Lateral joint line
Dr. fully flexes knee with external rotation; Dr extends knee while palpating and Listening at medial joint line
Dr repeats both procedures on the opposite knee
+ = Clicking along the medial &/or lateral joint line
Medial &/or Lateral meniscus |
|
|
Term
|
Definition
Tell pt to relax plane
Dr raises leg off table slightly w/ knee slightly flexed and then drops knee into extension
Performed Bilaterally
+ = Inability to reach full extension or rubber like end feel
Torn Meniscus or cartilage |
|
|
Term
|
Definition
Lay on stomach
Dr flexes knee to 90 deg, tibia is internally rotated and compression is added
Dr flexes knee to 90 degreses, tibia is externally rotated and compression is added
Performed Bilaterally
+ = pain on either side of the knee
Torn meniscus on the painful side |
|
|
Term
| Patella Grinding Test (Fouchet's test) |
|
Definition
Dr exerts a downward pressure on patella while moving laterally and medially
Performed bilaterally
+ = Pain under or Over patella
Pain under = chondromalacia, arthritis, chondral fx
Pain over = Prepatellar bursitis |
|
|
Term
|
Definition
Lie on back
Pts knee is fully extendd & Dr uses web contact just superior to the superior pole of the patella and asks to slowly contract quads
Repeated at 30, 60, 90 deg (if no pain in previous positions)
Performed bilaterally
+ = Retropatellar pain
Chondromalacia patella |
|
|
Term
|
Definition
pt stands
Dr contacts patella and push and holds it in medial direction
While holding patella, pt is asked to squat down approximately 30 deg to see if the pain changes
If pain does no change Dr repeats the procedure but changes the position of the patella
Procedure is repeated until a painless position is found or all positions have been tried
Performed Bilaterally
+ = Pain is relieved in one of the positions
Patellofemoral tracking disorder |
|
|
Term
|
Definition
Pt relaxes standing in neurtal position
Dr lines up pivot point on goniometer with the center patella
ONe arm is lined with the pt's ASIS and the other arm is lined up with the Center of the tibial tuberosity
Performed bilaterally
+ = angle less than 13 or greater than 18; Males=13 Females =18
Decreased = Patellofemoral Dysfunction or Patella Alta, Retroversion, Decreased tibial torsion
Increased = Anteversion, Increased tibial torsion, Patellofemoral dysfunction, Subluxating patella, Genu valgum |
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Term
| Subtalar Joint - Closed Chain |
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Definition
Pt told to stand (shoes/socks off)
Dr contacts both sides of talus with thumb and index finger & asks Pt to rotate torso until the Dr feels equal amt of talus under each finger
Dr observes the amount of tibial rotatoin of patient performed to get to neurtral
Repeats procedure for other foot
Patient is or is not in subtalar neutral |
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Term
| Subtalar joint - Open Chain |
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Definition
Lie on stomach and relax foot
Dr contacts both sides of talus (thumb and index finger) with one hand
Contact 4th/5th MTH with other hand
Dr moves foot until STJ is neurtal and evaluates foot for type of fault
Repeats procedure with other foot
Normal foot, Forefoot valgus/varus, Rearfoot varus/valgus, Plantarflexed first ray |
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Term
| Thompson Test (Simmond's Test) |
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Definition
Pt is prone with their knee flexed and Dr squeezes calf and watches for plantarflexion of the ankle
Performed Bilaterally
+ = Loss of plantarflexion
Rupture of the Achilles tendon |
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Term
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Definition
Dr stabilizes the tibia and fibula with one hand while the other hand pulls the rearfoot forward with slight inversion
Dr stabilizes the tib and fib with one hand while other hand pushes rearfoot backwards
Perfromed Bilaterally
+ = excess motion is detected
Pulling = Sprain of anterior talofibular ligament
Pushing = sprain of posterior talofibular ligament |
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Term
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Definition
Pt is either supine or side lying with knee slightly flexed (shoe under knee)
Ankle is held at 90 deg and talus is tilted in adduction and abduction
Performed bilaterally
+ = excessive motion of talus
Adduction = calcaneofibular lig sprain
Abduction = deltoid lig sprain |
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Term
| Lateral Stability Test (Inversion Stress Test) |
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Definition
Dr passively inverts the foot
Performed Bilaterally
+ = gapping of joint
Sprain of anterior talofibular ligament or calcaneofibular liag |
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