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PHYS med Q4 pre-midterm - tests, observations, signs, etc.
tests, observations, signs, etc.; all the
66
Other
Post-Graduate
07/26/2017

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Cards

Term
Muscle test, upper trapezius
Definition
1. Origin: External occipital protuberance, spinous process of C7
2. Insertion: Lateral 1/3 of clavicle; acromion process
3. Actions:
a. Rotation of the scapula (facing glenoid cavity superior)
b. Bilaterally, extends head and neck
c. Adducts scapula
4. Test:
The sitting patient elevates shoulder and laterally flexes neck and head with rotation of head slightly away the side being tested. Examiner places one hand on shoulder and other on head and directs force in a manner to withdraw the approximation of the head and shoulder. High occiput and low shoulder will be observed on side of weakness.


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Term
Muscle test, scalenes
Definition
1. Origin: Anterior / Posterior tubercles of transverse processes of C3-C6 2. Insertion: 1st / 2nd ribs 3. Action: Elevates 1st / 2nd ribs; flexes / rotates C-spine 4. Test: Hand is held on center of eyebrow; neck held in flexion / rotation

Test: Hand is held on center of eyebrow (knife edge, not pictured here), neck held in flex/rotation

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Term
Muscle test, Neck flexors
Definition
1. Longus colli
a. Origin: Bodies of first 3 thoracic and cervical vertebrae
b. Insertion: Bodies of 2nd, 3rd, 4th cervical vertebrae
c. Action: Flexes cervical vertebrae; unilaterally assists in rotation and lateral flexion
2. Longus capitus
a. Origin: Anterior tubercles of transverse processes of 3rd through 6th cervical vertebrae
b. Insertion: Inferior surface of basilar portion of occiput
c. Action: Flexes cervical vertebrae and head; unilaterally rotates and flexes cervical vertebrae and head


Test: Hand is held on center of forehead (knife edge, not pictured here), neck held in flex (resists downward pressure from hand)

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Term
Muscle test, neck extensors
Definition
Body is prone, hand presses into back of the head as the Pt resists the downward pressure

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Term
Neurological test, C5
Definition
Motor: deltoid and biceps
Reflex: biceps tendon (place thumb over tendon, THEN percuss with hammer-thingy)
Sensation: medial region of the arm between the shoulder and the elbow

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Term
Neurological test, C6
Definition
Motor: biceps, wrist extensors
Reflex: brachoradialis tendon
Sensation: media area below the elbow-ish,
including thumb and pointer finger

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Term
Neurological testing, C7
Definition
Motor: triceps extension, wrist flexors, finger extensors
Reflex: triceps tendon
Sensation: middle finger

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Term
Neurological testing, C8
Definition
Motor: interossei muscles (PAds and DAbs), finger flexors
Reflex: none
Sensation: lateral area of the lower arm (below elbow, includes ring and pinky finger)

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Term
Neurological testing, T1
Definition
Motor: Interossei (PAds and DAbs)
Reflex: none
Sensation: lateral, elbow-ish area

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Term
Roos' test
Definition
Stance/Procedure:
• Have patient open and close the hands for 3 minutes
• Note: The arms must be elevated with elbows bent.

Purpose:
• Test for neurovascular compromise or entrapment compression.
• Entrapment may include tissue, tumor, muscle tension, misalignment of bone, etc.
• Usually, this test is positive with the following:
o Scalenes (usually the clavical-1st rib region)
o Coracoid process (Pectoralis minor insertion)
o Ulnar distribution (C8)

Positive Test (Symptoms):
• Numbness, tingling in ulnar nerve distribution (C8), medial forearm, ring, and pinky finger.
• Indicative of Thoracic Outlet Syndrome


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Term
Valsalva test
Definition
Stance/Procedure:
• Have the patient hold breath and bear down.
• “Like you are having a bowel movement…”

Purpose:
• Increases intrathecal pressure
• Places pressure against spinal cord
• Indicative of a space occupying lesion
(disc, mass, osteophyte)

Positive Test (Symptoms)
• Radiation of pain
(due to sciatica, neuralgia, etc.)
• Note: Local pain is a negative test.


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Term
Muscle test, Sternocleidomastoid
Definition
1. Origin: Sternal head, anterior surface of manubrium;
clavicular head, upper surface of medial half of clavicle
2. Insertion: Lateral surface of mastoid;
lateral half of superior nuchal line of occiput
3. Action: Acting unilaterally, draws head toward shoulder and rotates head to opposite side; acting bilaterally, flexes head
4. Test:
Patient lying supine. With elbows bent, hands overhead. Patient turns head away from muscle to be tested and lifts head
from table. Pressure is applied against temporal area in a downward,
slightly lateral (toward patient’s head turn) direction.
Term
C-Spine Compression
Definition
Stance/Procedure:
• With hands clasped, gently apply downward pressure onto the patient’s head.

Purpose:
• Determine nerve root or disc injury.
• May modify with ROM

Positive Test (Symptoms)
• Local or radiating pain involving a nerve root
• Note: The muscles are relieved.
The discs will not be relieved if positive.


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Term
C Spine Distraction
Definition
Stance/Procedure:
• Place hands like “goal posts” with the thumbs on the
sub-occipital area and the fingers over the ears.
• Gently pull up on the patient’s head.

Purpose:
• Determine strain, sprain, or joint capsulitis.

Positive Test (Symptoms)
• Strain, sprain, or capsulitis.
• Note: The discs are relieved.
The muscles will not be relieved if positive.


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Term
C Spine Distraction
Definition
Stance/Procedure:
• Place hands like “goal posts” with the thumbs on the
sub-occipital area and the fingers over the ears.
• Gently pull up on the patient’s head.

Purpose:
• Determine strain, sprain, or joint capsulitis.

Positive Test (Symptoms)
• Strain, sprain, or capsulitis.
• Note: The discs are relieved.
The muscles will not be relieved if positive.


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Term
Shoulder Depression
Definition
Shoulder Depression
Stance/Procedure:
• Laterally flex the patient’s head while depressing the shoulder.

Purpose:
• Stretch the brachial plexus or local soft tissue.

Positive Test (Symptoms)
• Local pain = Muscle or ligament injury (i.e. neck pain)
• Radiating pain = Compression or stretching of neurovascular bundle
• Indicative of Thoracic Outlet Syndrome

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Term
Adson's test
Definition
Stance/Procedure:
• First, while patient looks straight ahead:
o Support the patient’s arm and measure initial pulse.
o Initial radial pulse amplitude baseline is important.
• Second, direct the patient to look toward the side being tested.
o Determine changes in pulse.
o Then, have the patient turn the head to opposite side.

Purpose:
• Determine neurovascular bundle compression or scalenes’ spasms.
o Subclavian artery / brachial plexus

Positive Test (Symptoms)
• Decreased amplitude (strength) of pulse
• Indicative of Thoracic Outlet Syndrome


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Term
Wright's Test
Definition
Stance/Procedure:
• First, while patient looks straight ahead:
o Support the patient’s arm & hyper-abduct and extend arm.
o Measure initial radial pulse amplitude.
• Second, direct the patient to look toward the side being tested.
o Determine changes in pulse.
o Then have the patient turn the head to opposite side.

Purpose:
• Determine the following factors:
o Compression of axillary artery
o Pectoralis minor muscle spasm.

Positive Test (Symptoms)
• Decreased amplitude (strength) of pulse
• Indicative of Thoracic Outlet Syndrome


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Term
L'hermitte's Sign
Definition
Stance/Procedure:
• Have the patient sit upright with legs extended.
• Place hand on patient’s head and push it toward the chest.

Purpose:
• Flex the cervical and thoracic spine.
• Assess the type of pain experienced.
• Local pain may not indicate significance.

Positive Test (Symptoms)
• Shooting pain = Disc lesion, cord disease, meningitis


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Term
Rust's Sign
Definition
Stance/Procedure:
• Have the patient lie down.
• Observe if the patient supports neck for stability.
Purpose:
• Check for severe injury with muscle, ligament, or disc.
• Vertebral fracture or dislocation may also be present.

Positive Sign
• Patient holds neck in stable position.


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Term
Vertebral Artery test
Definition
Stance/Procedure:
• Have patient lie supine w/ head at edge of table in your hands.
• Extend and rotate the patient’s head.
• Hold in position for 20-30 seconds; eyes of patient remain open.
• Observe any movement of eye (i.e. via fixating on blood vessel)

Purpose:
• This compresses the vertebral artery on the opposite side of head rotation and checks the patency (opening) on the same side as the rotation.

Positive Test (Symptoms)
• Vertigo, dizziness, visual blurring, nausea, faintness
• Nystagmus (oscillating movements in eye)


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Term
Soto Hall Test
Definition
Stance/Procedure:
• Have the patient lie supine.
• Place one hand under the patient’s head.
• Use other hand to stabilize the sternum.
• Flex the patient’s neck forward.
Purpose:
• Determine pain or complications.

Positive Test (Symptoms)
• Local pain = strain/sprain, bone pathology or injury, cord disease
• Radiating pain = Disc lesion or meningitis


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Term
Bakody's Sign
Definition
"monkey sign"

Stance/Procedure:
• Patient will have arm raised over and resting on the head.
Purpose:
• This is an antalgic position to offer relief to the neck.

Positive Test (Symptoms)
• Indicative of disk lesion in the neck, particularly the upper levels


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Term
Grip Strength
Definition
Stance/Procedure:
• Place both of your hands out with index and middle fingers extended.
• The patient will grip tightly three consecutive times.
Purpose:
• Determine strength of the patient’s grip.


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Term
Biceps Reflex
Definition
C5 deep tendon reflex

Biceps Reflex (C5)
• Rest the patient’s arm in your arm (of non-dominant hand) such that you can place the thumb of your non-dominant hand on the reflex tendon. Have the patient flex, if necessary, to locate the tendon.
• Using the dominant hand, swing the reflex hammer with a smooth, swift arcing motion.
• Notice activation of the tendon beneath your thumb.


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Term
Brachioradialis Reflex
Definition
C6 deep tendon reflex

• Rest the patient’s arm in your arm (of non-dominant hand) such that the wrist of the patient is hanging loose.
• Using the dominant hand, swing the reflex hammer with a smooth, swift arcing motion on the belly of the muscle.
• Notice activation of the tendon as the wrist responds.

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Term
Triceps reflex
Definition
C7 Deep tendon reflex

• Rest the patient’s arm in your non-dominant hand such that the forearm of the patient is hanging loose.
• Using the dominant hand, swing the reflex hammer with a smooth, swift arcing motion on the tendon of the muscle.
• Notice activation of the tendon as the forearm responds.

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Term
Spinal Percussion
Definition
• Using a reflex hammer, tap the cervical spinous processes.
• Ask the patient if there is any pain.
• Local pain = May indicate fracture or sprain
• Radiating pain = May indicate disc lesion
• Pain while tapping paraspinal muscles may indicate strain.


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Term
Rhomboids Muscle Test
Definition
1. Rhomboids Major
a. Origin: Spinous process of 2-5 thoracic vertebrae
b. Insertion: Medial border of scapula from spine to inferior angle
2. Rhomboids Minor
a. Origin: Ligamentum nuchae, spinous process of C7
b. Insertion: Medial border of scapula at root of spine of scapula
3. Test (Both)
Sitting patient holds arm in adduction and slight extension. Patient draws scapula into position of adduction and elevation with medial rotation of inferior angle. Examiner directs force against medial elbow in direction to abduct elbow from the body. Observation should be made for abduction of the scapula from the spine, which indicates weakness of the rhomboids. The test depends on good strength of shoulder muscles for stabilization of the shoulder during the test.
4. Test (to Avoid Recruitment)
Supine patient rolls onto scapula on opposite side from the rhomboids being tested. This position immobilizes opposite rhomboids and scapula. Test is continued as in sitting position.


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Term
Levator Scapula Muscle Test
Definition
1. Origin: Transverse processes of upper 4 cervical vertebrae
2. Insertion: Vertebral border of scapula between superior angle and root of spine
3. Action: Raises scapula to inferiorly rotate glenoid cavity, or if scapula is fixed laterally, flexes and rotates cervical spine
4. Test:
Sitting patient flexes elbow and spine while reaching inferior posterior crest of ilium with elbow. The humerus is in adduction, slight extension, and slight lateral rotation. Examiner directs force against medial elbow in a direction of abduction.


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Term
Middle trapezius muscle test
Definition
1. Middle Trapezius
a. Origin: Spinous processes 1st-5th thoracic vertebrae
b. Insertion: Superior borders of spine of scapula
c. Action: Adducts scapula, draws back acromion process
d. Test:
Prone patient extends elbow with shoulders in 90° abduction and lateral rotation (thumb toward ceiling). Examiner directs force against wrist toward floor. Shoulder muscles should have good integrity to perform this test.



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Term
Lower trapezius muscle test
Definition
2. Lower Trapezius
a. Origin: Spinous processes 6th-12th thoracic vertebrae
b. Insertion: Medial one-third of spine of the scapula
c. Action: Rotation of scapula; gives stabilization to scapula to the inferior; helps maintain spine in extension; draws back acromion process
d. Test:
Prone patient places elbow in extension, arm in lateral rotation (thumb toward ceiling) and diagonally overhead to align with fibers of lower trapezius. Examiner directs force against distal arm in downward direction toward floor. The shoulder muscles must have good integrity to perform this test.

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Term
Latissimus dorsi muscle test
Definition
1. Origin: Spinous processes of lower 6 thoracic vertebrae, lumbosacral fascia, posterior one-third of external lip of iliac crest, muscular slips from lower 3 or 4 ribs and tip of scapula
2. Insertion: Intertubercular groove of humerus
3. Action: Adducts, extends, and medially rotates humerus
4. Test:
Patient prone or standing with arm adducted, elbow strait and arm in medial rotation (thumb toward body) in slight extension. Examiner directs force in direction of abduction and slight flexion of the shoulder. Care should be taken that patient does not flex elbow, obtaining substitution.

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Term
Adam's Position
Definition
Stance / Procedure:
• Standing patient forward flexes in attempt to touch toes.

Purpose:
• Compare before and after forward flexing the level of scoliosis or kyphosis.

Positive sign / issue:
• Functional issues:
o Angle will reduce, indicating:
poor posture, overdevelopment of muscles, nerve root, disc, leg length deficiency
• Structural issues:
o Angle does NOT reduce, indicating:
hemivertebra, compression fracture, or idiopathic scloiosis

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Term
Rib compression (Lateral and A-to-P)
Definition
Stance / Procedure:
• Patient stands or sits upright.
• Examiner compresses patient’s rib cage in one of two ways
o Anterior-posterior (sternum & interscapular spinous processes)
o Lateral (sides of chest)
Purpose:
• Assess for pain upon compression.

Positive sign / issue:
• Pain is indicative rib fracture or costochondritis
• Consider issues such as asthma, bronchitis, trauma, rib breakage, etc.


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Term
Lindner's Sign
Definition
Stance / Procedure:
• Patient lies supine on table.
• Examiner flexes the head forward toward the chest.
Purpose:
• Assess for pain upon stretching the dura and nerve roots of spine.

Positive sign / issue:
• Radiating pain = Disc lesion


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Term
Abdominals Muscle test
Definition
For all abdominal muscles:
Patient is sitting with spine at approximately 60° to 75° with legs extended. Examiner directs force against anterior upper thorax while stabilizing legs against table. This primarily tests the rectus abdominal. The obliques also act bilaterally. The obliques are tested in the same manner with the patient’s spine rotated. When the patient is rotated to his right, the left external and the right internal obliques are being tested.


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Term
Quadratus Lumborum Muscle Test
Definition
1. Origin: Iliolumbar ligament, posterior part of iliac crest
2. Insertion: Inferior border of last rib and transverse process of upper 4 lumbar vertebrae
3. Action: Lateral flexion of lumbar vertebral column; depresses last rib; helps action of diaphragm
4. Test:
Prone patient abducts and slightly extends leg. Patient then elevates pelvis toward shoulder by contracting quadratus lumborum. The examiner uses manual traction at ankle in an attempt to pull pelvis down. Patient is stabilized by holding on to the table.


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Term
Neurological test, L4
Definition
Motor: Tibialis anterior

Reflex: Patellar / Quardiceps

Sensory: Medial surface of foot


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Term
Neurological test, L5
Definition
Motor: Extensor hallucis longus

Reflex: None

Sensory: Dorsum of foot


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Term
Neurological test, S1
Definition
Motor: Peroneus longus & brevis
(Eversion muscles)
Reflex: Achilles’ tendon

Sensory: Lateral surface of foot


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Term
Dejerine's Triad
Definition
Strain/cough/sneeze

Positive finding would be pain, similar to results of valsalva
Term
Bechterew's Test
Definition
Stance/Procedure:
• Patient sits on edge of table with alternating legs extended.
• Afterwards, both legs are extended together.

Purpose:
• Assess for pain when stretching sciatic nerve & lumbar nerve roots.

Positive Test (Symptoms)
• Leaning back or radiating pain (or both):
o Issue with disc, sciatic nerve, or nerve root


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Term
Kemp's Test
Definition
Stance/Procedure:
• Patient sits upright on edge of table.
• Examiner compresses dorsolumbar spine obliquely backwards.
(Rotation, Lateral Bend, Extension)
Purpose:
• Assess for pain when compressing the dorsolumbar spine.

Positive Test (Symptoms)
• Radiating pain = Disc issue

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Term
Minor's Sign
Definition
Stance/Procedure:
• Seated patient uses one hand to support back upon standing and one hand to support the off-leg to keep the involved leg side in flexion.
“climb up the legs, lock the back, and rotate up on the hips”

Positive sign / issue
• Sciatica, severe signs / symptoms


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Term
Lasegue's Test
Definition
Stance/Procedure:
• Patient lies supine on the table.
• Examiner raises the patient’s leg.

Positive Test (Symptoms)
• Local pain (0-35°) = Piriformis spasm or sacroiliac joint issue
• Radiating pain (35-70°) = Stretching sciatic / spinal nerve roots (L5, S1, S2) or disc lesion
• Local pain (70-90°) = Lumbosacral joint issue
• Tension with no pain = Tight hamstrings


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Term
Braggard's Test
Definition
Stance/Procedure:
• Following Straight Leg Raiser test, examiner lowers leg to tolerable level.
• Once tolerable level is reached, examiner dorsiflexes the foot.

Note:
• This is only performed with Positive Lasegue’s Test.

Positive Test (Symptoms)
• Pain is indicative of sciatica or disc lesion


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Term
Kernig's test
Definition
Stance/Procedure:
• Following Straight Leg Raiser test, examiner places leg in 90/90 position.
(Knee and thigh are 90° to body)
• Then, examiner extends knee to stretch sciatic nerve.

Note:
• This is only performed with Positive Lasegue’s Test.

Positive Test (Symptoms)
• Radiating pain = Disc or sciatic lesion
• Resistance without pain = Tight hamstrings

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Term
Milgram's Test
Definition
Stance / Procedure:
• Patient lies supine on table.
• Patient/Examiner raises patient’s legs 6’’ off the table.
• Patient holds the position for 30 seconds.

Positive Test (Symptoms):
• Radiating pain = Space-occupying lesion (disc, mass, spur)
• Unable to perform, yet no pain = Weak hip flexors (iliopsoas)


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Term
Bilateral Leg Lowering
Definition
Stance / Procedure:
• Patient lies supine on table.
• Patient/Examiner raises patient’s legs off the table.
• Patient slowly lowers raised legs.

Positive Test (Symptoms):
• Local pain = Lumbar or lumbosacral joint issues
• Radiating pain = Disc lesion
• Unable to perform, yet no pain = Weak abs or hip flexors (iliopsoas)


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Term
Neri's Test
Definition
Bowing test

Stance / Procedure:
• Patient forward flexes to touch toes.
• Patient’s knee on involved side will flex to avoid sciatic nerve stretch.

Positive Test (Symptoms):
• Knee flex = Sciatic nerve issue


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Term
Psoas and Iliopsoas Muscle test
Definition
1. Origin: Anterior surface of transverse process and lateral border of vertebrae; corresponding intervertebral discs of T12 through L5
2. Insertion: Lesser trochanter of femur with iliacus
3. Action: Flexes and laterally rotates thigh with origin fixed; with insertion fixed laterally, flexes spin, or acting bilaterally flexes spine or increases lordosis of lumbars
4. Test:
Supine patient flexes hip with abduction and lateral rotation. Examiner directs force against the anteromedial aspect of the leg in a direction of extension and slight abduction while stabilizing the pelvis on the opposite iliac crest


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Term
Gluteus Medius and Gluteus Minimus Muscle Test
Definition
1. Gluteus medius
a. Origin: Outer surface of ilium from iliac crest and posterior gluteal line above to anterior gluteal line below; gluteal aponeurosis
b. Insertion: Lateral surface of greater trochanter
c. Action: Abducts thigh, rotates thigh medially; maintains ilium in internal crest rotation; with gluteus minimus is major lateral pelvic stabilizer; weakness causes high hip, high shoulder, ad high occiput, all on same side.
2. Gluteus minimus
a. Origin: Outer surface of ilium between anterior and inferior gluteal lines, and margin of greater sciatic notch
b. Insertion: Anterior border of greater trochanter
c. Action: Abducts thigh, rotates thigh medially; assist gluteus medius in most functions
3. Test (Both):
Side-lying patient flexes hip and knee of lower non-tested leg for stability. Patient abducts hip with slight extension, keeping knee extended. Examiner stabilizes pelvis at right angle to table. Shifting of pelvis indicates substitution of tensor fascia, gluteus maximus or trunk muscles. Pressure is directed downward against the leg in a direction of adduction and slight flexion.


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Term
Adductors and Hip Muscle Test
Definition
Test (All):
Patient side-lyng with no anterior or posterior rotation on side to be tested. Examiner holds upper, non-tested leg up while patient holds lower leg (tested leg) up. Pressure is straight down with no rotation. Pressure is applied above knee.


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Term
Tensor Fascia Lata Muscle Test
Definition
1. Origin: Anterior outer lip of iliac crest, anterior border of ilium
2. Insertion: Middle third of iliotibial tract of fascia lata
3. Action: Thigh flexion, abduction, and medial rotation; tenses fascia lata, thus gives lateral stability along with gluteus maximus pulling of iliotibial band; stabilizes knee laterally.
4. Test:
Patient supine holds leg with knee straight in a position of abduction, slight medial rotation and hip flexion. Examiner directs pressure against leg in a direction of adduction and extension.


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Term
Gluteus Maximus Muscle test
Definition
1. Origin: Posterior gluteal line of ilium, tendon of sacrospinalis, dorsal surface of sacrum and coccyx, and sacrotuberus ligament
2. Insertion: Gluteal tuberosity of femur & iliotibial tract of fascia
3. Action: Extends the hip
4. Test:
Prone patient flexes knee and lifts knee from table. Examiner directs pressure on distal one-third of femur toward table in direction of hip flexion. Patient’s knee should be flexed enough to take hamstrings out of test by shortening them. In prone position, watch for low atonic gluteus maximus.


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Term
Piriformis Muscle Test
Definition
1. Origin: Anterior surface of sacrum between and lateral to anterior sacral foramen, margin of greater sciatic foramen, and sacrotuberous ligament
2. Insertion: Superior border of greater trochanter of femur
3. Action: Rotates thigh laterally, abducts thigh when limb is flexed; important sacrum stabilizer muscle
4. Test:
Sitting: Patient has knee flexed at 90° over edge of table and laterally rotates thigh. Examiner stabilizes leg by holding lateral portion of knee. Pressure directed toward distal leg in direction to internally rotate thigh while patient resists.
Prone: Patient flexes knee and laterally rotates thigh. Examiner supports thigh to keep it from going into abduction. Pressure directed toward the medial distal end of the leg in direction to cause medial thigh rotation as patient resists.


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Term
Trendelenburg's Test
Definition
Stance/Procedure:
• Standing patient flexes each hip/leg.

Positive Test (Symptom):
• Indicates a weak gluteus medius or hip lesion/path on stance side …
…when iliac crest on swing side drops lower than stance side
• May also indicate sacroiliac lesion on stance side if local pain present


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Term
Thomas's Test
Definition
Stance/Procedure:
• Supine patient flexes knee to chest.

Positive Test (Symptom):
• Positive if opposite thigh flexes off table:
o Flexion contracture on extended leg side
Other Symptom:
• If pain on flexed side is localized to lumbar or lumbosacral area or hip…
…the issue may be a strain sprain.


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Term
Patrick's Test
Definition
FABERE/Figure 4

Note: “FABERE” = Flexion, Abduction, External Rotation, Extension
Stance/Procedure:
• In supine patient, flex, abduct, externally rotate, and extend leg…
…by putting ankle on the opposite knee.
• Contact opposite ASIS and press down on knee.

Positive Test (Symptom):
• Localization of pain may indicate hip, sacroiliac, or groin lesion


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Term
Nachla's Test
Definition
Stance/Procedure:
• Examiner brings prone patient’s ankle to ipsilateral buttock.

Positive Test (Symptom)
• Radiating pain to anterior thigh = Disk / nerve root (L2, L3, L4) lesion
o This occurs as the femoral nerve is stretched.
• Note: Local pain may indicate sacroiliac, lumbosacral, or strain sprain lesions.


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Term
Ely's Test
Definition
Stance/Procedure:
• Examiner flexes prone patient’s leg/ankle to contralateral buttock

Positive Test (Symptom)
• If patient has hip flexion contracture, then hip will flex off table.
• Note: Local pain may indicate sacroiliac or lumbosacral strain sprain.

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Term
Hibb's Test
Definition
Stance/Procedure:
• Examiner flexes prone patient’s knee to 90° and moves leg outward.
• This causes internal rotation of the hip.

Positive Test (Symptom)
• Localized pain to hip or sacroiliac strain sprain lesion
• May also indicate piriformis spasm


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Term
Yeoman's Test
Definition
Stance/Procedure:
• Examiner flexes prone patient’s knee to 90° and extends thigh.
• Downward pressure is placed on ipsilateral sacroiliac joint.

Positive Test (Symptom)
• Localized pain to hip or…
… anterior ligaments of sacroiliac joint & facets or…
… lumbosacral lesion
• Radiating pain = Nerve or disc lesion


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Term
Hoover's Test
Definition
Stance/Procedure:
• This is a test for symptom magnification or amplification (malingering).
o In other words, is the patient “faking” it?
• The supine patient raises the involved leg while the examiner places a hand under the opposite heel.
• As the patient raises the involved leg, downward pressure from opposite leg should be felt.

Positive Test (Symptom)
• Patient pretends to be unable to perform the task.
• Note: Use this test with your best discretion or judgment if you suspect faking of injury.


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Term
Leg Length Test
Definition
Stance/Procedure:
• Patient is lying supine.
• Examiner approximates the medial malleoli and determines equality or difference.

Positive Test (Symptom)
• This test may indicate a sacroiliac lesion, structural bone length abnormality, scoliosis, etc.
• Functional issue would be a pelvic imbalance.


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