Shared Flashcard Set

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Special Tests
Special tests for GH joint
53
Physiology
Graduate
01/11/2012

Additional Physiology Flashcards

 


 

Cards

Term
Neer Impingement test
Definition

 

IR/pronation (supra), flex shoulder, stabilize scapula

ER/supination (biceps), flex shoulder

 

+ = end range pain

Term
Hawkins-Kennedy Impingement test
Definition

90 degrees flexion, stabilize scapula, then IR

 

- = do horizantal aduction, then IR

if + don't move on

 

looking for any pain response

Term
Yocum Impingement test
Definition

place hand on opposite shoulder and lifts the arm to shoulder level

 

+ = for reproduction of pain

Term
reverse impingement sign
Definition

supine, stabilize under humerus, webbed space find acromion , apply inferior glide, bring humerus into abduction

 

+ = reduce pain

Term
empty can
Definition

supraspinatus tendinitis (can be painful or weak)

90 degrees in sacpular plane, empty can, then MMT

 

+ = weakness or pain

Term
lift off sign
Definition

subscapularis muscle or tendon pathology

place hand on samll of back, lift hand off

 

+ = pain

Term
drop arm test
Definition

rotator cuff pathology

horiz abduct, hold, then lower slowly

 

+ = pain or trouble lowering arm

Term
patte/horn blower's
Definition

teres minor tear

arm is supported in 90 degrees abduction in scapular plane, elbow flexed, patient ER against resistance (Patte = one arm not coming up)

 

+ = cant hold against resistance

Term
Speed's
Definition

biceps tendon issue

1. concentric: supinated, flex shoulder agsint resistance (sup should irritate most)

pronated, flex shoulder agasint resistance

+ = pain

2. eccentric: supinated, push into extension against resistance

Term

Yeargason's

 

Definition

transverse humeral ligament

patient is IR moving into ER while turning forearm into supination, PT resists flexion and supination, finger over biceps tendon

 

feel for tendon popping out

Term
load and hsift
Definition

ant and post instability

(usually less motion posteriorly)

pt sit up tall, feet on ground; stabilize over clavicle and scapula, palpate huemral head, load it, then slide anterior

 

*compare to other side

Term
apprehension (crank) test
Definition

 

anterior instability

supine, towel under humerus, ER and abduct

 

watch for apprehension

Term
jobe subluzation/relocation
Definition

used only after + apprehension test

anterior instability

 

bring off of where apprehension was, palm over acromion, powerior force, then take back into ER and if should reduce apprehension

Term
posterior apprehension
Definition

posterior instability

stabilize scapula, palpate posterior GH joint, 90 degrees flexion, axillary load over elbow, IR horiz adduct

 

+ = apprehension

Term
push-pull
Definition

posterior instability

one hand on wrist, other heel over humerus, arm 90 abd, scaption plane, piush down and pull up with distal hand

feel for posterior motion of humerus

 

+ = <50 translation (posterior part of capsule is usually snug)

Term
jerk
Definition

posterior instability, laxity

sitting, stabilize scapula, 90 degrees forward elevation, IR, horizantally adduct, axillary load

 

+ = "clunk" of humeral head leaving glenoid, may not get apprehension

Term
sulcus sign
Definition

inferior instability

sitting or standing, rest hand on thigh (~20 abd), palpate space between acromion and head of humerus. distal hand proximal to elbow and pull down

 

+ = distance between humeral head and acromion increases

 

grade 1 = finger

grade 2 = 2 fingers

grade 3 = 3 fingers

Term
obriens test
Definition

"slap" lesion, labral tear

1. try to elicit pain, 90 degrees flexion, IR, horiz adduct 10-15 degrees, proximal hand stabilizes trunk, MMT

pain needs to be deep in shoulder, not over ACJ

 

2. if painful, same position except ER (thumb up), MMT

 

+ = pain with IR relieved by ER

Term
anterior slide
Definition

slap lesion, labral tear

sitting, hand on hip, stabilize clavicle and acromion, apply sup-ant force at elbow

 

+ = pain (over area of tear)

Term
labral crank
Definition

tear in labrum

supine, flex 160 degrees scaption, apply axillary load at elbow and Er until end range, then IR "scouring over"

 

+ = pain with or without a "click"

click is humeral head going over labrum

Term
clunk test
Definition

labral tear

supine, make fist and put under humeral head, bring arm into 160 scaption (more abd at end range), lift with fist then ER

 

+ = feel click/clunk

Term
compression/rotation
Definition

labral tear

supine, flex elbow with 20 abd, push or compress the humerous in the glendoid then IR and ER, "scouring"

 

similar to crank at lower ROM

Term
A-C shear
Definition

labral tear

palpate clavicle and heel of hand on spine of scapular to find where acromion and clavical meet, then add compression to AC joint inward

 

+ = pain

Term
ligamentous valgus instability test
Definition

Ulnar Collateral Ligament

pt seated, supinate, ER hum, slightly extended.

Palpate UCL, slightly abd forearm, test for ligament to be taut (to prevent valgus force)

gradually build up force

 

+ = pain increases, reproduction of pain, laxity

Term
ligamentous varus instability test
Definition

Radial (lateral) collateral ligament

pt seated, 20-30 degrees elbow flexion, proximal hand at medial elbow, palpate lateral colateral ligament. Slightly adduct, then build up gradually to assess motion.

 

+ = pain increased, reproduction of pain or laxity

Term
cozen's test (method 1)
Definition

active contraction of extensors

rest forearm on table, elbow flexed, ext wrist and apply pressure into flexion and radial deviation

OR

same except ecentric and ulnarly deviate, move into radial deviation

+ = reproduction of pain

Term
mill's test (method 2)
Definition

passive stretch ECRB/L

flex wrist, ulnarly deviate, passively ext elbow

palpate lateral epicondyle where ECRB/L attach

(similar to radial nerve ULTT, but  not depressing shoulder and GHJ is in flexion)

Term
method 3
Definition

extensor digitorum

palm on table, lift 3rd finger, apply pressure proximal to PIP

 

+ = reproduction of pain at lateral epicondyle

Term
medial epicondylitis (golfer's elbow) test
Definition

passive stretch inflammation of flexors

ext wrist, rad deviate, ext elbow

palpate medial epicondyle

 

+ = reproduction of pain at med epicondyle

Term

tinel's sign (at elbow)

 

Definition

ulnar nerve entrapment coming from cubital tunnel

feel ulnar nerve in cubital tunnel, brief tap cubital tunnel arm slightly extended

Term
wartenberg's sign
Definition

ulnar neuropathy

passively spread fingers, then bring back together

+ = pinky doesnt come back in

Term
test for pronator teres syndrom
Definition

compress median nerve

elbow flexed to 90, pronated

strongly resist pronation while extending elbow = maximum compression of median n by pronator teres

+ = numbness/tingling

Term
pinch grip test
Definition

anterior interosseous branch of median nerve

thumb and index finger tip to tip

+ = pad to pad

Term
sperling's
Definition

compress spine, push down on head

to clear cervical spine

Term
quadrant test
Definition

clear cervical spine

ext, side bend, rotate toward unaffected side

+ = reproduce in affected side

Term
median nerve (ULTT)
Definition

supine, depress shoulder, abduct humerus to 110 degrees, supinate forearm, extend elbow, wrist fingers and thumb

 

alternate:

supine, depress houlder, abduct 10 deg, ER, supination, elbow, wrist, finger, thumb extension. Can flex to contralateral side

Term
radial nerve (ULTT)
Definition
supine, depress shoulder, abduct shoulder 10 deg and IR, pronate, extend elbow, flex wrist with ulnar deviation hand and thumb
Term
ulnar nerve (ULTT)
Definition
supine, supinate, extend wrist with radial deviation, depress shoulder, abduct shoulder 10-90 deg, flex elbow towards head
Term
ligamentous instability for fingers
Definition

PIP, DIP, 2-5

apply valgus and varus stress, hand in neutral, stabilize proximal, move distal

 

look for inc laxity and joint space opening up, compare B

Term
thumb ulnar collateral ligament laxity or instability test
Definition

"skiers thumb"

stabilize 1st MC, thumb in slight ext = accessory and ulnar collateral ligament

apply valgus (toward radius) force

to isolate UCL, MCP in slight flexion

look for inc laxity and joint space opening up, compare B

Term
lunotriquetral ballotement test
Definition

integrity of lunotriquetral ligament

palmar and dorsal glide of lunate, stabilize triquetum with "pincher grip"

look for pain, crepitus, or increased motion compared to other

Term
murphy's sign
Definition

dislocation of lunate (punching wall)

+ = 3rd MC is in line with others or sunken

- = 3rd MC is superior/not in line with others

Term
lunotriquetral shear test
Definition

integrity of lunotriquetral ligament

supination, one hand suppors lunate, load triquetrum to produce "shear"

look for pain, crepitus, or inc motion compared to other side

Term
TFCC load test
Definition

"hand shake", stabilize forearm, compress and move wrist dorsal, palmar, supinate, pronate. key is to keep the compression throughout ROM

+ = pain over TFCC

Term
Thumb grind test
Definition

OA or DJD at CMC

"scour at thumb", stabilize carpals, grab 1st MC and load, then rotate, side to side, to grinde CMC into trapezium

+ = reproduction of pain

Term
finkelstein test
Definition

tenosynovitis of ABPL and EPB

thumb inside fist, hold thumb in place, then passively ulnarly deviate

+ = reproduction of their pain, compare B

Term
bunnell-littler test
Definition

AKA intrinsic plus test

used to differenitate decreased ROM from muscles or pasule

capsule = slack muscle and ROM still imited

muscle = slack muscle and inc ROM

Term
tinnels test at wrist
Definition

carpal tunnel (median n)

hand relaxed in supination

tap over carpal tuennl/flexor retinaculum

+ = reproduction of pain, distal to where you are tapping

Term
phalen's test
Definition

carpal tunnel

dorsum of hands together, apply flexion force (compression of carpal tunnel) hold for 1 min

+ = reproduce symptoms distal to compression (pain, numbness, tingling)

Term
reverse phalen's test prayer
Definition

palms together, stretching tissues and bring close to body and inferior for 30 seconds

OR

pt in wrist ext, squeeze thumb c fingers, apply compression over carpal tunnel for 30 seconds

= + reproduce symptoms distal to compression

Term
carpal compression test
Definition

carpal tunnel

hand relaxed in supination, compression carpal tunnel down c thumbs

+ = numbness, tingling, reproduction of pain

Term
forments sign
Definition

ulnar neuropathy

hold paper pulp to pulp c thumb and 2nd phalanx

+ = flex at IP joint at thumb when pull paper = weakness of ADP (ulnar nerve) and FPL is trying to compensate

Term
allen test
Definition

patency of radial and ulnar arteries

supination, add compression on radial and ulnar side, make fist 4-5 times, palm blanches, let up one by one

slow refill = may have vascular problem (not MS)

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