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PD III
Ortho special tests
44
Other
Graduate
03/16/2010

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Term
hyperextension with lateral rotation; examiner applies axial compression onto the patient's head, then you repeat it on the opposite side. Positive pain to the side of rotation indicative of FORAMINAL STENOSIS and NERVE ROOT IRRITATION/ COMPRESSION
Definition
Spurling's test
Term
provider places their hands under the back of the head and cups the chin while applying a distraction force. (pichocho wants us to just put hands on side of head behind ears). If pain decreases, then it is considered a positive test. DO NOT perform test if cervical instability is suspected.
Definition
cervical distraction
Term
examiner asks patient to take a deep breath and blow against closed glottis, which will increase intrathecal pressure. positive test implicates HERNIATED DISC, TUMOR, OR OSTEOPHYTE in the cervical canal.
Definition
valsalva test
Term
this sign occurs when there is an electric shock-like sensation and is triggered by flexing the neck forward. the areas affected are usually the arms and/or legs, although the sensations can radiate to the trunk.
Definition
L'Hermittes sign
Term
pt is sitting or supine. the examiner supports the head as it is slowly extended, rotated, and laterally flexed. Positive if pt is dizzy, slurred speech,or loss of consciousness.
Definition
vertebral artery test (the old lady getting hair washed)
Term
if this test is positive, the patient can have anterior cervical spine pathology, vertebral subluxations, osteophytes protrusion, soft tissue swelling, tumors.
Definition
swallowing test
Term
the scapula is protracted/flexed as if doing a push-up. the serratus anterior muscle is involved, and it is innervated by the long thoracic nerve (C5,6,7). WINGING is a positive sign for weakness of the serratus anterior.
Definition
winging scapula/ serratus anterior
Term
pt actively places hands behind the back with the thumbs as far up on the scapula as possible. testing the internal rotation function. muscles involved are the subscapularis, latissimus dorsi, and teres major.
Definition
apley scratch test
Term
pt's elbow is extended, forearm supinated and shoulder flexed to 60 degrees. the examiner resists forward flexion. positive test if pt HAS PAIN IN THE BICIPITAL GROOVE.
Definition
Speed's test
Term
with the elbow flexed, the patient is asked to forcefully supinate against resistance from the examiner's hand. PAIN REFERRED TO THE ANTERIOR ASPECT OF THE SHOULDER IN THE REGION OF THE BICIPITAL GROOVE constitues a positive result.
Definition
Yergason's test
Term
this tests for a biceps tendon rupture. pt's seated with both hands behind the head with interlocked fingers. pt contracts and relaxes biceps while provider feels the tendons. positive test= TENDON CAN'T BE PALPATED, NO BICEPS CONTRACTION NOTED.
Definition
Ludington's test
Term
pt begins with the elbow flexed to 90 degrees and the humerus resting at the side. examiner palpates the long head of the biceps and moves 3 inches distally. examiner then rolls the biceps tendon against the humerus. PAIN indicates a positive test for long head biceps tendon subluxation.
Definition
Lippman's test
Term
the 90 degrees flexed arm on the the affected side is forcibly adducted across the chest. this is a special test for the AC joint.
Definition
crossover/adduction test
Term
pt's shoulder is flexed 90 degrees adducted, internally rotated, and the elbow is extended. Pt resists downward force. test maximally loads and compresses the ACJ and superior labrum. procedure is repeated in supination. positive test is ACJ PAIN OR LABRAL TEAR WITH PAIN OR CLICKING DEEP IN THE GHJ.
Definition
O'Brien's test
Term
pt is seated or standing with the arm relaxed to the side. the examiner palpates the shoulder by placing the fingers on the anterior and posterior aspects of the humeral head. the examiner applies downward distraction force on the arm with hand placed above the elbow. (the one that Stacey can do)
Definition
sulcus sign
Term
used to detect and grade laxity of the anterior capsular mechanism. ideally patient is supine. examiner stands facing the affected shoulder that should be held at 80-120 deg of abduction and shoulder flexion and external rotation. positive test is MOVEMENT BETWEEN FIXED SCAPULA AND THE MOVABLE JOINT.
Definition
anterior and posterior drawer signs
Term
testing anterior labrum/ capsule
Definition
anterior apprehension sign/ test or Crank test
Term
patient is standing. examiner stands behind the patient and assessed the radial pulse. examiner passively extends and abducts the arm to 30 degrees. Patient hyperextends the head and neck. positive test is DIMINISHED OR ABSENT RADIAL PULSE. positive test implications POTENTIAL THORACIC OUTLET SYNDROME.
Definition
Military Brace
Term
tests for thoracic outlet syndrome. from a sitting position, pt is asked to hold both elbows at shoulder height and pushing shoulders back. open and close hands for several minutes. positive test= FEEL HEAVINESS AND FATIGUE IN SHOULDERS.
Definition
Roos test
Term
the examiner first palpates pt's radial pulse and applies a downward traction on the pt's arm being tested. examiner then instructs pt to rotate the head to the opposite side and then extend the neck and look at the ceiling. positive test= DISAPPEARANCE OF RADIAL PULSE INDICATES THORACIC OUTLET SYNDROME
Definition
Halstead maneuver
Term
holding the elbow slightly bent, apply pressure to the inside of the elbow. this places the lateral ligaments under stress. pain and instability indicate damage to the lateral collateral ligament (LCL)
Definition
varus stress test
Term
holding the elbow slightly bent, apply pressure to the OUTSIDE of the elbow. this places the medial ligaments under stress. pain and instability indicate damage to the MCL (medial collateral ligament)
Definition
valgus stress test
Term
repeated tapping over the ulnar nerve where it passes behind and underneath the medial epicondyle may reproduce symptoms of pain and tingling indicates ulnar nerve compression or entrapment
Definition
tinel's sign
Term
pain on the outside of the elbow when the hand is extended at the wrist against resistance. examiner applies pressure with the other hand to the dorsum of patient's fist-forcing it into flexion. positive when PAIN WHEN PRESSING JUST BELOW THE LATERAL EPICONDYLE ON THE OUTSIDE OF THE ELBOW, WHERE THE WRIST EXTENSORS ORIGINATE.
Definition
Tennis elbow (Mill's test)/ lateral epicondylitis
Term
the pt proates and flexes the wrist and forearm at the same time. the examiner resists in the opposite direction. a positive result is when pain is ISOLATED OVER THE ATTACHMENT OF THE WRIST FLEXOR MUSCLES ON THE INSIDE OF THE ELBOW.
Definition
Golfer's elbow (medial epicondylitis)
Term
instruct the pt to abduct the thumb so that it rests in the palm of the hand. pt then instructed to wrap the fingers over the thumb in order to make a fist. examiner then stabilizes the wrist with one hand and applies a varus force to the wrist. sharp pain on the LATERAL aspect of the wrist indicates a positive test for stenosing tenosynovitis to the abductor pollicus longus and/ or the extensor pollicus brevis tendon sheath(s)
Definition
finkelstein test (DeQuervain's disease)
Term
examiner maintains stabilization of digits in extension except for digit being tested. stabilize the MCP joint of digit being tested. Examiner asks the pt to flex the PIP. positive test is IF HAS LOSS OF FLEXION OF THE PIP, meaning that there is rupture of the FDS tendon or tendon damage.
Definition
flexor digitorum superficialis tendon test
Term
examiner maintains stabilization of digits in extension except for the digit being tested. stabilize the MCP and PIP of digit being tested. ask the pt to flex the DIP. positive test is if has loss of flexion of DIP, meaning that there is rupture or tendon damage of the flexion digitorum profundis.
Definition
flexor digitorum profundis test
Term
evaluates the tightness of the hand's intrinsic muscles. hold the metacarpophalangeal joint in a few degrees of extension and move the proximal interphalangeal joint into flexion. if PIP can be flexed, the intrinsic muscles are NOT tight and are not limiting flexion. positive test= UNABLE TO FLEX PIP JOINTS.
Definition
Bunnel-Littler test
Term
examiner taps lightly over the pt's transverse carpal ligament, looking for signs of paresthesia distally (median nerve affected). positive test= carpal tunnel syndrome
Definition
tinel's sign at wrist
Term
position the patient with the dorsal aspect of both hands in full contact with both wrists maximally flexed. instruct the patient to hold the position for 1 minute. tingling or numbness radiating into the fingers (especially the palmar surface) indicates a positive test for median and/or radial nerve impairment
Definition
phalen's test
Term
"prayer hands" testing for carpel tunnel syndrome
Definition
reverse phalen's test
Term
pt is instructed to hold a piece of paper between the 1st and 2nd digits by forcefully opposing those digits. the examiner then attempts to pull the paper out. an inability to hold the contraction and/or a weak contraction indicates a positive test for ulnar nerve impairment.
Definition
froment's sign
Term
AKA "gamekeeper's thumb" or "skier's thumb". valgus force on the MCP joint of the thumb. this stresses the ulnar collateral ligament and causes stretching or rupture of the ligament. MCP joint becomes painful and swollen, and the thumb feels weak when you pinch or grasp. you may see bruise-like discolorations on the skin around the joint.
Definition
valgus stress test for ulnar collateral ligament
Term
examiner instructs pt to make a fist, then assesses contour of MCP joints. if third metacarpal is level with second and fourth metacarpals, lunate dislocation is suspected.
Definition
murphy's sign (lunate dislocation)
Term
the examiner stabilizes pt's distal radius and ulna with one hand and grasps the pt's scaphoid bone with the thumb and index finger of the other. the examiner then attempts to translate the pt's scaphoid anteriorly and posteriorly. dislocation and/or subluxation indicates a positive test for scaphoid instability.
Definition
watson clunk test (scaphoid instability)
Term
this tests for collateral circulation when performing an ABG. you are mainly checking the patency and circulation of the ULNAR artery because you will be getting the ABG from the radial artery.
Definition
digital allen test
Term
a screening test for pathology of the hip joint or sacrum. place the pt in the supine position, flex the leg and put the foot of the tested leg on the opposite knee. slowly press down on the superior aspect of the tested knee joint lowering the leg into further abduction. the test is positive if there is pain at the hip or sacral joint, or if the leg cannot lower to the point of being parallel to the opposite leg.
Definition
FABER or patrick test
Term
when the patient is standing on the affected side, the OPPOSITE hip drops. indicates weakness of the affected gluteus medius muscle, the hip abductors, or painful osteoarthritis of the hip.
Definition
trendelenberg test
Term
testing for IT band tightness. pt lies on uninvolved side, examiner abducts and extends hip to allow IT band to move posteriorly over the greater trochanter, examiner lowers leg. positive if HIP REMAINS ABDUCTED.
Definition
ober test
Term
place one hand flat on the examining table under the pt's lumbar lordosis. have the patient fully flex the hip on the side opposite the one being assessed. this will cause rotation of the pelvis and flattening of the lumbar lordosis. see if the leg being assessed is slightly elevated off the examining table.
Definition
thomas test
Term
test for rectus femoris contracture. pt is prone. bend the ipsilateral knee. positive test is IPSILATERAL FLEXION OF THE PATIENT'S HIP.
Definition
Ely's test
Term
attempt to sublux unstable hip. infant lies supine, hips flexed to 90 degrees. stabilize the pelvis. place index and middle finger over greater trochanter. place the thumb at the inner thigh inguinal crease. gently adduct the hip while applying downward/ posterior force. positive if HIP CLUNK felt on exam.
Definition
Barlow's test
Term
designed to detect unilateral congenital dislocations of the hip. child is supine with both knees flexed if one knee is positioned higher than the other the test is positive.
Definition
Galleazzi's test
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