Roy Cards

The flashcards below were created by user Anonymous on FreezingBlue Flashcards.

  1. Splenic Percussion Sign
    On inspiration there is no change in the percussive note from tympany to dullness. Indicates splenic enlargement
  2. Rovsing Sign
    Pressure in LLQ produces pain in RLQ.

  3. Psoas Sign
    Pain on flexion of the thigh against resistance

  4. Obturators Sign
    Pain when the thigh is flexed on the hip, then internally rotated.

  5. Rebound Tenderness
    Done at McBurneys Point.  Appendicitis
  6. Murphys Sign
    Pressing on the gallbladder during inspiration cause the patient to stop breathing due to pain

  7. Murphy's Punch
    Percuss over kidneys

    Kidney Dx- Stones
  8. Babinski Reflex
    Stroke up lateral aspect of foot

    Dorsiflexion of great toe with splaying of other toes

  9. Chaddock's Reflex
    Stroke Lateral Malleolus to small toe

    Babinski respone

  10. Oppenheims Reflex
    Stroke down tibial crest to ankle

    Babinski Respone

  11. Gonda's Reflex
    Flick down 4th toe

    Extension of big toe

  12. Gordon's Calf
    Squeeze calf right below knee

    Babinski response

  13. Schaefer's Reflex
    Squeeze achille's tendon

    Babinski response

  14. Rossolimo's Reflex
    Tap ball of foot

    Plantar flexion of great toe with curling of other toes

  15. Hoffmann's Reflex
    Examiner extends middle phalanx of patient and flicks distal phalanx

    Flexion and adduction of the thumb and flexion of fingers

  16. Tromner's Reflex
    Examiner sharply taps tips of middle three fingers

    Flexion of all fingers including the thumb.

  17. Gordon's Finger Sign
    Examiner presses on the pisiform of the patient

    Extension of fingers or thumb and index finger

  18. Chaddock's Wrist Sign
    Examiner strokes the ulnar side of the forearm near the wrist

    Flexion of the wrist and extension and fanning of the fingers

  19. Babinski Pronation
    Patients hands placed together, palms up. Dr hands jar patients hands from below up.

    Affected hand falls in pronation good hand remains horizontal

  20. Klippel-Weil
    Patients flexed fingers are quickly extended by the examiner.

    Flexion and adduction of patients thumb

  21. Mayer's Reflex
    Passive forceful flexion of the proximal phalanges especially 3rd and 4th fingers of supinated hand

    Absence of adduction and opposition of thumb

  22. Glabella Reflex
    Examiner taps between eyebrows with index finger

    Tonic spasm of orbicularis muscle with closing of the eye

  23. Snout Reflex
    Sharp tapping of the nose or middle of the upper lip

    Exaggerated reflex contraction of the lips

  24. Halstead Maneuvar
    Examiner finds the radial pulse of the affected arm and applies downward traction on the extremity.  The patient then hyperextends neck. If negative, it is repeated with the patient rotating the head to the opposite side.

    The absence, disappearance, or noted decrease in pulse indicates TOS.
  25. Dugas Test
    The patient places the hand of the affected shoulder on the opposite shoulder and attempts to touch chest with elbow

    Positive if patient cannot touch chest wall with elbow. Indicates shoulder dislocation.
  26. Mazion's Shoulder Rock
    While standing or sitting, the patient places the palm of the affected upper limb over the top of the opposite clavicle. From this position the patient moves the elbow from the chest to the forehead, giving it an inferior to superior rocking motion.

    Positive if this action produces or aggravates shoulder or arm pain on the ipsilateral side
  27. Kaplans Sign
    Patient Seated, the arm is held straight out with the wrist in slight dorsiflexion. Grip strength is tested with dynamometer.  This is then repeated as the examiner firmly holds the patients forearm 1-2 in below elbow.

    Sign is present if initial grip strength improves and lateral elbow pain diminishes. 

    Lateral Epicondylitis
  28. Wartenbergs (Oriental Prayer) Sign
    PAtient is directed to extend and adduct the four fingers of each hand and also to extend the thumbs.  Then the patient is asked to raise both hands in front of his face so that they are side by side in the same plane with thumbs and index fingers touching tip to tip

    If there is paralysis of the abductor pollicis brevis, the thumbs will not coincide when the index fingers touch.

    Median Nerve Palsy
  29. Wartenbergs Sign
    Patient performs a hard grasp strength text with a dynamometer.  Examiner observes the position and function of the digits in the action.

    If position of abduction is assumed by the little finger, the sign is present.

    Ulnar Nerve Palsy
  30. Finsterer's Sign
    Sign is present when grasping an object hard, clenching hand, or making a fist fail to show the normal prominence of the third metacarpal on the dorsal surface, and the percussion of the third metacarpal elicits tenderness just distal to the center of the wrist joint.

    Keinbocks Dx
  31. Shrivel Test
    Patients fingers are placed in warm water for 30 minutes. Examiner removes fingers from water and observes whether the skin over the pulp is wrinkled.

    Normal fingers show wrinkling. Denervated do not.
  32. Deyerle's Sign
    While the patient is seated, the affected leg is passively extended at the knee until pain is reproduced.  The knee is then slightly flexed while strong pressure is applied by the examiner into the popliteal fossa.

    Sign is present if this pressure increases radiculitis symptoms. Irritation of sciatic nerve above knee.
  33. Lewin Punch Test
    While patient is in the standing position, the examiner punches the side of the buttock with the lesion.

    If punch elicits referred pain in the back, test is positive.

    Spinal lesion, protruded disc
  34. Beery's Test
    Test is positive when a patient with lower trunk discomfort while standing, is significantly relieved by sitting with the knees flexed.

    Hamstring muscle tightness
  35. Claudication Test
    Patient walks on a treadmill at a rate of 120 steps per minute for 1 minute. Examiner times how long it takes for patient to complain about calf pain. 

    Record Time

    Chronic Arterial Occlusion
  36. Bikele's Sign
    With arm in abduction and extension and elbow fully flexed, the patient extends the elbow.

    Radicular pain makes it positive. 

    Brachial plexus neuritis or meningeal irritation.
  37. Guilland's Sign
    While patient is supine, examiner firmly pinches the quadriceps muscle.

    Positive if there is brisk flexion of hip and knee.

    Meningeal Irritation
  38. Swallowing Test
    Patient seated, swallows grape Kool Aid

    Pain of difficulty swallowing

    SOL, disc, tumor, osteophyte, DISH
  39. Burns Bench Test
    Patient instructed to kneel on a table or stool approx 18 inces from the floor and bend the trunk forward, far enough to allow touching of the floor with fingertips or hands while doctor stabilizes patients heels.

    The malingerer will say "I cant do it"
  40. Magnuson's Test
    Patient with low back pain is directed to point at where the pain is. Doctor marks the spot. Doctor performs additional exams, then later asks the patient to point at the site of pain again.

    Change in location of pain means malingerer or hysteria.
  41. Slocums Test
    Patient is supine, the involved knee is flexed to 80-90 degrees and hip is flexed to 45 degrees. The foot is placed in 30 degree internal rotation. The foot is held in position, and the tibia is drawn forward.

    2nd Part, patient is placed in the same position except the foot is placed in 15 degrees of external rotation while the examiner draws tibia forward.

    Anterolateral/Anteromedial rotary instabilities
  42. Ballottement Test
    Patients knee flexed or extended to the point of discomfort, the doctor applies a slight tap or pressure over the patella.  

    Fluid around patella is positive.
  43. Fouchet's Sign
    Patient supine and knee in full extension, the doctor uses the flat of a hand to compress the patella against the femur. If not pain, then rub patella transversely.

    Positive if painful.  PAtellar tracking disorder, peripatellar syndrome, patellofemoral disorder
  44. Anterior Innomiante Test
    The patient is standing and places the lower extremity that is opposite the painful side approx 2-3 feet in front of the other foot.  This position makes it appear as if the patient is taking a big step forward. The patient bends the upper trunk slightly over the front foot, to put all the weight on the front foot.  The patient flexes to the point at which the heel of the back foot raises off the floor.

    The production or aggravation of lower trunk pain on the side of the posterior leg is a positive test.  Indicating unilateral forward displacement of the ilia (Anterior Innominant) in relation to the sacrum.
  45. Bakody Sign
    Patient seated and actively abducts arm to put hand on top of their head. Relief of pain means they have a cervical disc or foraminal encroachment.
  46. Distraction Test
    Patient seated and doctor passively tractions up under chin and occiput. Relief of symptoms means they have foraminal encroachment, facet irritation, or disc herniation. May also aggravate ligamentous pain.
  47. Foraminal Compression Test
    With patient seated exert strong (first test with patient in neutral) increasing downward pressure on the head. Repeat with bilateral rotation. Local pain may indicate foraminal encroachment without nerve root pressure or apophyseal capsulitis. Radicular pain may indicate pressure on a nerve root.
  48. Lhermitte’s Sign
    Seated, doctor passively flexes the patients head. Shooting, electric pain into lower extremities means they have cervical myelopathy.
  49. Maximal Cervical Compression
    Seated patient actively laterally flexes, rotates, and slightly extends head. Examiner gentley presses down on the head. This position may also compress vertebral artery. Compression should be held for 20-30 seconds. Pain on the concave side (side of flexion) indicates nerve root or facet joint pathology. Pain on the convex side (side of extension) indicates muscle strain. Vertebral artery compression indicated positive if symptoms like dizziness, nausea, feeling of fainting are elicit.
  50. O’Donoghue Maneuver
    With patient seated, put the cervical spine through resisted range of motion, then through passive range of motion. Pain during resisted range of motion or isometric muscle contraction signifies muscle strain. Pain during passive range of motion may indicate a sprain of any of the cervical ligaments.
  51. Shoulder Depression Test
    With patient seated apply downward pressure on the shoulder while passively laterally flexing the patient’s head to the opposite side. Local pain on the side being tested indicates shortening of the muscles, muscular adhesions, muscle spasm, or ligamentous injury. Radicular pain may indicate compression of the neurovascular bundle or thoracic outlet syndrome. Pain on the opposite side indicates a decreased foraminal space, facet pathology, or disc defect.
  52. Soto-Hall Sign
    While patient is laying supine with arms overhead the doctor applies pressure to sternum and passively flexes their head toward sternum. Don’t let shoulder come off table. Cervical pain means they have a vertebral body injury.
  53. Spurling’s Test
    Seated Patient’s neck is passively laterally flexed with some extension to tolerance with increased downward pressure  on head. Reproduction of symptoms in shoulder or arm means they have foraminal encroachment, cervical disc herniation, or facet irritation.
  54. Valsalva Maneuver
    Seated patient holds breath and bears down. Pain means they have a disc or a space occupying lesion.
  55. Jackson’s Test
    Doctor passively laterally flexes a seated patients head to one side while doctor presses down on top of head. If pain radiates into their arm, the patient has nerve root pressure.
  56. Adson’s Test (Scalenus Anticus)
    With patient seated, Doctor palpates the radial pulse while passively moving the patient’s arm into abduction, extension, and external rotation. The patient rotates head to the same side, takes a deep breath and holds it. A diminished or absent radial pulse or reproduction of symptoms means they have tight scalenes or a cervical rib.
  57. Allen’s Test
    Passively adbuct and externally rotate seated patients shoulder with elbow flexed to 90 degrees. Palpate the radial pulse while the patient actively rotates their head to the contralateral side.  Diminished pulse is positive test for TOS
  58. Costoclavicular Maneuver (Eden’s)
    Doctor palpates the radial pulse of seated patient and passively depresses their shoulder as the patient actively lifts their chest in an exaggerated attention posture. An absence of a pulse means they have TOS.
  59. Reverse Bakody Maneuver
    Seated patient actively abducts & externally rotates the ipsilateral shoulder to place hand on top of head. An increase in radicular pain indicates interscalene compression of lower brachial plexus and TOS.
  60. Roo's Test (East's)
    With patient seated, actively abduct both arms to 90, flex elbows to 90 and externally rotate. Patient opens/closes fist for 3 min or until symptoms occur. Paresthesia/tingling, pain, weakness indicates TOS.
  61. Wright’s Test (Hyperabduction)
    Doctor palpates radial pulse of seated patient with their arm at their side, then passively abducted and externally rotated as pulse is monitored. A reduction in pulse means they have TOS or hyperabduction syndrome. Tests axillary artery.
  62. Apley’s (Scratch) Test
    Patient seated and actively reaches behind back and is instructed to “touch opposite shoulder blade” on both sides. Patient reaches behind head to touch opposite shoulder on both sides. Loss of ROM means rotator cuff tendonitis or adhesive capsulitis.
  63. Apprehension Test
    Seated patients shoulder and elbow passively abducted at 90 degrees, doctor presses humerus anteriorly. Pain or apprehension means they have anterior instability.
  64. Codman’s Sign (Drop Arm)
    Doctor passively abducts patient’s hand to 160 degrees, then let the patient slowly, actively lower to the side. Inability to control dropping phase or giving way of the arm means they have a rotator cuff tear.
  65. Dawbarn’s Sign
    With patient seated, doctor palpates over subacromial bursa. If it’s painful the doctor passively abducts the patient’s arm and repalpates. If pain is reproduced they have subacromial bursitis.
  66. Impingement Sign
    Patient is seated with arm at side, doctor slightly passively abducts patient's arm (hand should be pronated) & moves it fully through flexion (this will jam the greater tuberosity & anterior/inferior surface of the acromion. Pain in shoulder indicates overuse injury to the supraspinatus and possibly biceps tendon.
  67. Supraspinatus Press Test (Empty Can)
    The seated patient is tested at 90° elevation in the scapula plane and full internal rotation (empty can) or 45° external rotation (full can). Do both! Patient resists downward pressure into abduction, with elbows slightly flexed, exerted by examiner at patients elbow or wrist. Weakness or pain in affected shoulder indicated a partial or full thickness tear of the supraspinatus tendon.
  68. Yerguson’s Test
    Seated Patient flexes elbow to 90 degrees, doctor stabilizes the shoulder with one hand and with the other hand grasp the patient’s wrist. Patient attempts to supinate forearm and hold elbow in flexion against the doctor’s resistance. Local pain in the biceps tendon means they have biceps tendonitis or a ruptured transverse humeral ligament.
  69. Speed’s Test
    Seated Patient has arm flexed in front of them with palm down, doctor presses down on arm and resists patients attempt at shoulder extension and forearm supination. Pain in biceps area means they have bicipital tendonitis.
  70. Cozen’s Test
    Patient seated and holds fist in extension, doctor tries to flex it at wrist, while patient resists. Have elbow slightly flexed and pronated and grasp extensors origin with other hand to elicit pain if present.  Pain in lateral epicondyle area means they have lateral epicondylitis.
  71. Reverse Cozen’s Test
    While seated, have patient make fist, pronate forearm. Examiner palpate medial epicondyle and wrist flexion against resistance. Sharp, shooting pain suggests medial epicondylitis.
  72. Mill’s Test
    With patient seated, passively flex elbow, wrist and fingers, followed by passive full elbow extension and pronation, but maintaining wrist and finger flexion. Pain in the lateral epicondyle area means they have lateral epicondylitis.
  73. Tinel’s Sign at the Elbow
    Doctor taps patient’s lateral epicondylar groove (radial nerve) and medial epicondylar groove (ulnar nerve). Tingling in the radial/ulnar nerve distribution means they have radial/ulnar nerve syndrome.
  74. Bracelet Test
    With patient seated and elbow flexed, Doctor puts hand around posterior wrist and compresses the sides, lateral compression around distal radius and ulna (or just below, depending on which image or person you ask). Have patient attempt to make a fist while performing. Pain indicates lunate dislocation scaphoid fracture, ligament laxity, RA or DJD at wrist.
  75. Finkelstein’s Test
    Patient seated with elbow slightly flexed and pronated, makes fist with thumb inside fingers, then passively ulnar deviate the wrist. Pain over abductor pollicus longus & extensor pollicus brevis means they have stenosing tenosynovitis.
  76. Froment’s Paper Sign
    The seated patient with elbow slightly flexed and pronated, is asked to hold a piece of paper between the thumb and a flat palm as the paper is pulled away. This should be performed between any digits that are believed to be problematic. Normally an individual will be able to hold the paper there with little or no difficulty. However, the patient with an ulnar nerve palsy will flex the thumb to try to maintain a hold on the paper.
  77. Phalen’s Sign
    Seated Patient flexes and pronates wrist maximally (like a reverse prayer position) and holds for 60 seconds. Do wrist extension (Prayer position) for 60 afterwards.  Tingling in the median nerve distribution means they have carpal tunnel syndrome.
  78. Tinel’s Sign at the Wrist
    Doctor taps patient’s carpal tunnel and Guyon. Tingling in the  hand means they have ulnar/median nerve syndrome(carpal tunnel).
  79. Anterior Drawer Test
    With patient supine the doctor grasps the lower tibia with one hand and calcaneus with the other hand. The tibia is held posterior while the heel is drawn anteriorly. Talus sliding forward under ankle mortise means they have anterior talofibular instability.
  80. Thompson’s Test (Simmond’s)
    Patient is prone with knee flexed to 90 degrees, doctor squeezes just distal to widest part of patients calf, with both hands tractioning downward while squeezing. Lack of plantar flexion means they have ruptured their achilles tendon.
  81. Tinel’s Sign at the Ankle
    With patient prone and knee flexed, use reflex hammer to briskly tap the medial ankle just behind the medial malleolus. An electrical shock sensation indicates Tarsal Tunnel Syndrome.
  82. Homan’s Sign
    Patient is supine or seated, doctor elevates affected leg(at hip) and brings ankle into dorsiflexion, while squeezing calf with other hand. Pain in calf area means they have thrombophlebitis.
  83. Adam’s Positions
    Patient is standing and actively flexes forward at the waist allowing hands to drop toward ground. Check posteriorly and anteriorly of patient with patient flexing cervical spine as well.  Spinal curvature straightens out and there is no evidence of rib humping indicates a functional scoliosis. Spinal curvature does not straighten out during forward bend indicates a structural scoliosis.
  84. Chest Expansion Test
    Have patient stand with arms at side.  Use a tape measure at either 1) 4th intercostal space, 2)axila level, 3) nipple level, or 4)T10 rib level.  Have patient perform full expiration for first measurement, followed by full inspiration.  Normal range is 1.5 - 3.0 inches.  Decrease means trauma or AS.
  85. Forestier’s Bowstring Sign
    With patient standing, have them actively laterally bends to both sides, with arms at side. If unable to perform or tightening of muscles on side of flexion, it is indicative of AS.
  86. Schepelmann’s Sign
    Patient seated with arms fully abducted and raised over head, doctor instructs patient to actively laterally flex thoracic spine to the left side and then to the right side. Pain on the concave or convex side indicates intercostal neuritis while pain on the convex side indicates fibrous inflammation of the pleura (or possible intercostal myofascitis).
  87. Spinal Percussion Test
    Have seated patient flex thoracic spine. This test is positive when pain is illicited upon tapping the reflex hammer over segmental vertebral spinous processes. Percuss soft tissues as well.  Increased sensitivity indicates acute subluxation, intervertebral disc syndrome, bone pathology or fracture.
  88. Sternal Compression Test
    The patient is supine and the examiner exerts downward pressure on the sternum with ulnar aspect of hand in vertical axis to sternum with other hand supporting. A positive finding of lateral rib pain suggest possible rib fracture.
  89. Amoss’ Sign
    This test is usually performed on patients with dorsolumbar or lumbosacral complaints. The patient is made to lie on his or her side and then is told to rise from the table. When this action of arising from a recumbent position causes significant localized thoracic or lumbosacral pain, the test is considered positive. A positive test indicates either Ankylosing Spondylitis, severe sprain or Intervertebral Disc Syndrome.
  90. Bechterew’s Sitting Test
    Patient is seated with legs hanging off table, painful leg is extended, then resist downward pressure on thigh (resisting hip flex). First have them actively perform, then do again with resistance.  If negative, do bilaterally. Low back pain or sciatic referral means they have a lumbar disc or sciatica.
  91. Belt Test (Supported Adam’s Test)
    While standing the patient actively flexes forward until pain is noted. The doctor wraps arm around patient’s iliac crest and braces sacrum while patient flexes forward again. Similar pain with and without bracing means they have a lumbar spine lesion. If pain decreases they have an SI lesion.
  92. Bonnet’s Sign
    This test is used to rule out radiculopathy of the sciatic nerve. The test is similar to a Straight Leg Raise except with the leg rotated internally and adduction.
  93. Bowstring Sign
    This test is done with the patient supine. The examiner performs Straight Leg Raise until the patient experiences some discomfort. At this level the examiner flexes the knee slightly and rests the foot on his or her shoulder until any pain subsides. The examiner then applies pressure to the hamstrings. If this doesn’t produce pain, the examiner moves the thumbs over the popliteal fossa and applies pressure over the popliteal. If pain is reproduced in the leg or in the back, this sign is considered present, indicating nerve root compression or a ruptured intervertebral disc.
  94. Bragard’s Sign
    Patient lies supine while the doctor lifts their leg with knee kept straight until leg radiation is produced, then lowered to where pain is eased, then foot is dorsiflexed. Do this only if SLR is positive.  Reproduction of leg pain means they have sciatica, SOL, or spinal nerve irritation.
  95. Double-Leg Raise Test (Bilateral SLR)
    This is a two-phase test: (1) The patient is placed supine, and a straight-leg-raising (SLR) test is performed on each limb: first on one side, and then on the other. (2) The SLR test is then performed on both limbs simultaneously; ie, a bilateral SLR test. If pain occurs at a lower angle when both legs are raised together than when performing the monolateral SLR maneuver, the test is considered positive for a lumbosacral area lesion.
  96. Goldthwait’s Sign
    While patient is supine the doctor places one hand under the lumbar spine and passively raises their leg. Pain before vertebral motion indicates an altered SI joint, pain after vertebral motion indicates altered lumbosacral or lumbar joint lesion.
  97. Kemp’s Sign
    While patient is seated, the doctor holds a shoulder and passively leans patient obliquely forward away from painful side, then circumducts patient backwards, while applying pressure to painful side on low back. . Pain in low back or radiating into lower extremity means they have a lumbar strain, facet syndrome, lumbar disc, or sciatica.
  98. Straight Leg Raise
    Patient supine and 1 hand on achilles and other on knee.  Passively flex patients hip. Pain in low back or radiating into lower extremity means they have a lumbar strain, facet syndrome, lumbar disc, or sciatica.
  99. Lasegue Rebound Test
    At the conclusion of a positive sign during Lasegue's supine SLR test, the examiner allows the limb to drop to a pillow without warning. If this rebound test causes a marked increase in pain and muscle spasm, then a disc involvement is said to be suspect.
  100. Lesegue Test
    Patient lies supine while the doctor lifts their leg with knee flexed.  Once in 90/90 position, passively extend patients knee. Low back or sciatic pain means they have sciatica, lumbar sprain, SI sprain, or tight hamstrings.
  101. Lewin Standing Test
    Doctor instructs patient to slightly flex knees while standing. Doctor first brings one knee into complete extension while supporting affected side pelvis with other hand. Next the doctor brings the other knee into complete extension. Finally doctor brings both knees into complete extension. Radiating pain down the leg causing flexion of the patient's knee indicates lumbo-sacral, sacroiliac, or gluteal pathologies.
  102. Lindner’s Sign
    With patient seated, examiner passively flexes patient's head toward the chest. Pain along sciatic distribution or sharp, diffuse pain indicates sciatic radiculopathy and nerve root inflammation.
  103. Milgram’s Sign
    While supine, the patient actively raises their legs six inches and does multiple reps with momentary holds. Pain or inability to hold position means they have increased intrathecal pressure indicating a space-occupying lesion.
  104. Nachlas Test
    With patient prone, doctor takes the heel of the affected leg & passively approximates it to the ipsilateral buttock while stabilizing the pelvis to prevent hip flexion. Pain in the buttock &/or pain in the lumbar region indicates sacroiliac joint lesion or lumbar pathology.
  105. Sicard’s Sign
    (Supine) Examiner lowers raised leg (see SLR) 5 degrees from point of pain and passively dorsiflexes patient's big toe. Posterior thigh and leg pain is positive for sciatic radiculopathy, usually from disc lesion.
  106. Turyn’s Sign
    With patient supine, examiner sharply dorsiflexes the big toe of the affected extremity.  Pain in the gluteal region or radiating sciatic pain indicates sciatic radiculopathy.
  107. Well-Leg Raising Test
    Patient lies supine while the doctor passively lifts the unaffected leg with knee kept straight. If positive, perform Bragards (dorsiflexion) on unaffected leg to determine extent of lesion. Radiation of leg pain means they have sciatica or a lumbar disc.
  108. Lewin Supine Test
    The supine patient with the arms at side and the legs are together and held down by the examiner and patient is asked to sit up. If the patient cannot perform this action, the test is considered positive, indicating an ankylosing dorsolumbar spinal lesion.
  109. Femoral Nerve Traction Test
    With patient in side posture, stand behind patient and passively extend superior hip and flex superior knee. Indicative of radiculopathy of the second through fourth lumbar nerves.
  110. Brudzinski Sign
    With the patient supine, the physician uses both hands to passively flex patients neck.  Flexion of the patient’s lower extremities (hips and knees) constitutes a positive sign for meningeal irritation.
  111. Kernig’s Sign
    Performed with the patient supine and passively flex unaffected of affected hip and knee in flexion. Extension of the knees is attempted: the inability to extend the patient’s knees beyond 135 degrees without causing pain constitutes a positive test for Kernig’s sign. Meningeal irritation
  112. Libman’s
    With patient seated, doctor stands behind patient. Doctor applies pressure on patient's mastoid process with thumbs until patient reports pain/discomfort. Compare side to side. Used to test patient's pain tolerance.
  113. Erichsen’s Sign
    This test is done with the patient prone. The examiner, with both hands over the dorsum of the ilia, bilaterally thrusts toward the midline. If this produces pain over the sacroiliac area, the test is positive indicating sacroiliac joint disease as opposed to hip joint disease.
  114. Gaenslen’s Test
    Patient lies supine with affected side close to edge and flex hip and knee of unaffected side and hold to chest. With other hand push on affect side thigh to extend hip (hyperextend SI joint). Pain in low back area means they have an SI lesion.
  115. Hibb’s Test
    Patient is prone the doctor passively flexes the knee as far as he can without the patients extending at the hip. Doctor internally rotates the femur maximally. Stabilize contralateral pelvis. Low back pain means they have an SI lesion, hip lesion, or piriformis spasm.
  116. Iliac Compression Test
    The patient is placed on the side with the affected side upward. The examiner places both hands over the iliac crest and cautiously leans pressure downward off and on with momentary holds. This tends to compress the sacroiliac and pubic joints. A positive sign of joint inflammation or sprain is seen with an increase in pain; however, absence of pain does not necessarily rule out sacroiliac involvement. This test is usually contraindicated in geriatrics and pediatrics or with any sign of a hip lesion or osseous pelvic pathology.
  117. Lewin-Gaenslen’s Test
    The patient is placed in the side-lying position with affected side up and the underneath 1)lower limb flexed acutely at the hip and knee THEN PERFORM 2)have patient hold lower leg to chest. The examiner stabilizes the uppermost hip with one hand. With the other hand, the uppermost leg is grasped near the knee and the thigh is extended on the hip. Initiated or aggravated pain suggests a sacroiliac lesion.
  118. Yeoman’s Test
    The patient is prone with knee at 90 degrees while the doctor applies firm pressure over the SI joint and hyperextends the thigh. Pain in the SI joint means they have an SI lesion.
  119. Allis’ Sign
    With patient supine and hips and knees at 45 degrees. The position of knee of the affected side is lower than the unaffected side when knees and hips are flexed. This is due to the location of the femoral head's posterior to acetabulum in this position.
  120. Anvil Test
    With patient supine, elevate leg with knee straight. Percussion of calcaneus compresses hip joint. Positive test with pain, which indicates fracture or hip pathology.
  121. Ely’s Sign (Heel-to-Buttock)
    Patient is prone while doctor passively flexes heal to contralateral buttocks. Pain in the low back or elevation of their pelvis from the table means they have an SI lesion, tight rectus femorus, or TFL contracture.
  122. Laguerre’s Test
    This test is done with the patient supine while the thigh and knee are flexed to right angles. Support ankle on forearm and support contralateral hip down with hand. Then the thigh is abducted and rotated outward. This forces the head of the femur against the anterior portion of the hip joint capsule. The sign is present when this action produces pain, tending to rule out a lumbosacral lesion, but indicating a hip joint lesion, iliopsoas muscle spasm or a sacroiliac lesion.
  123. Ober’s Test
    With the patient lying on the side with the unaffected side down and the unaffected hip and knee at a 90-degree angle, the examiner stabilizes the pelvis, then abducts and extends the affected leg until it is aligned with the rest of the patient's body. The affected leg is dropped into adduction. Let it free fall passively, checking to see if it falls all the way into adduction. If the iliotibial band is normal in length and unaffected, the leg will adduct and the patient will not experience pain. If the iliotibial band is tight, the leg will remain in the abducted position and the patient may have lateral knee pain.
  124. Patrick (FABERE) Test
    The patient lies supine with one foot on opposite knee. The doctor applies downward pressure on knee while bracing opposite ASIS. Pain in the hip joint or pelvis means they have hip pathology or SI lesion.
  125. Thomas Test
    With patient supine and knees at edge of table, flex the hip and knee on the side NOT being tested, and have the patient hold their knee against their chest. A positive test result occurs if the non-flexed leg raises off the table, indicating a flexion contracture of the iliopsoas muscle. Check for lumbar lordosis.
  126. Trendelenburg’s Test
    The patient is asked to stand unassisted on each leg in turn, while the examiner' observes from behind.  The foot on the contralateral side is elevated from the floor by bending at the knee. An alternative approach is to have the patient undertake this manoeuvre facing the examiner and supported only by the index fingers of the outstretched hands; this accentuates any instability of balance shown during a positive test.  In normal function, the hip is held stable by gluteus medius acting as an abductor in the supporting leg. If the pelvis drops on the unsupported side - positive Trendelenburg sign - the hip on which the patient is standing is painful or has a weak or mechanically-disadvantaged gluteus medius.
  127. Abduction Stress Test (Valgus Stress)
    With patient supine and knee flexed 15-30 degrees, the doctor applies a valgus stress through joint line with gripping ankle. Pain or laxity medially means they have a strained MCL.
  128. Abduction Stress Test (Varus Stress)
    With patient supine and knee flexed 15-30 degrees, the doctor applies a varus stress through joint line while gripping ankle. Pain or laxity laterally means they have a strained LCL.
  129. Apley’s Compression Test
    With patient prone and knee flexed to 90 degrees, the doctor applies downward pressure and rotation to lower leg pushing down on heel. Medial knee pain means they have a medial meniscus tear and lateral pain means they have a lateral meniscus tear.
  130. Apley’s Distraction Test
    With patient prone and knee flexed to 90 degrees, the doctor distracts, by putting knee in patients popliteal fossa, and rotates lower leg. Knee pain means they have a collateral or cruciate strain.
  131. Apprehension Test for the Patella
    The patient seated on the table with the knee hanging on edge of table and the quadriceps relaxed.  The examiner carefully glides the patella laterally observing for the apprehension sign.  A positive test is the presence of contraction of the quadriceps muscles by the patient in an attempt to avoid the feeling of a recurrence of the dislocation.
  132. Anterior Drawer Test
    With patient supine and knee flexed to 90 degrees, the doctor sits on their foot and pulls their tibia forwards. Pain or laxity in joint means they have an ACL tear.
  133. Posterior Drawer Test
    With patient supine and knee flexed to 90 degrees, the doctor sits on their foot and pushes their tibia backwards. Pain or laxity in joint means they have an PCL tear.
  134. Lachman’s Test
    With patient supine and knee flexed 15-20 degrees, the doctor stabilizes the femur with one hand and pulls the tibia up with the other hand. Don’t put foot between leg and don’t support ankle.  Foot should come off exam table while performing. Laxity means they have an ACL tear.
  135. McMurray Sign
    While supine, the patient’s hip and knee are flexed to 90 degrees, the doctor internally rotates the leg by using hand on heel and extends while applying valgus pressure. Then externally rotate leg and extend while applying varus pressure. Pain or crepitus with internal rotation means there is a lateral meniscus issue, pain, or crepitus with external rotation means there is a medial meniscus issue.
  136. Noble’s Compression Test
    With patient supine the doctor puts thumb over lateral epicondyle while patient repeatedly passively flexes and extends the knee. This test looks similar to McMurrays, but with thumb pressure on Lateral Epicondyle and no valgus/varus or IR/ER. Pain means they have IT band syndrome.
  137. Patellar Grinding Test (Clarke’s Sign)
    With patient supine, doctor pushes patella inferiorly at proximal pole as patient contracts quads. If painful they have patellar-femoral syndrome.
  138. Beevor’s Sign
    Abnormal upward movement of the umbilicus on attempting to raise the head from a supine position by the patient.
  139. Dejerine’s Sign (Dejerine’s Triad)
    Coughing, sneezing, and straining during defication which reproduces and aggravates radicular symptoms. This sign is present in space occupying lesions.
  140. Minor’s Sign
    This sign is often observed in patients with low back conditions in which supporting the low back is necessary in order to rise from a seated position. This test is indicative of sciatica, sacro-iliac lesions, lumbosacral lesions, and/or disc involvement.
  141. Rust’s Sign
    A patient using one or both hands (or neck brace) to stabilize their neck upright or when reclining because they feel like their head is unstable. Indicative of odontoid fracture, atlanto-axial instability.
  142. Hoover’s Sign
    When the patient attempts to raise his leg, the examiner cups one hand under the heel of the opposite foot. When the typical patient tries to raise his affected limb, he normally applies pressure on the heel of the opposite limb for leverage and a downward pressure can be felt. If this pressure is not felt, the patient is probably not really trying.
  143. Mannkopf’s Sign
    Take pt’s resting HR. Apply firm pressure over area of pain. If pulse increases by 10 bpm or more the pain is real, they are not faking/malingering.
Card Set
Roy Cards
Boards Boards Boards
Show Answers