A (+) Valsalva indicates a SOL; for NBCE MCly D/T ______.
A (+) Valsalva indicates a SOL; for NBCE MCly D/T disc.
Describe the 2 steps for Max CCT...
1. Pt seated; actively rotate head & hyperextends the neck to one side.
2. If no pain; maximally LF the neck.
*NO COMPRESSION APPLIED!!!!
What does a (+) Max CCT indicate?
Nerve root compression.
A (+) Shoulder Depressor Test indicates...
Pain = Nerve Root Adhesion.
*W/ the dr's arms criss crossing & the pt seated; depress the shoulder while LFing the C-spine away from the shoulder.
What are the 2 indications associated with Soto Hall Sign?
1. Anterior localized pain = FX.
2. Posterior localized pain = ligament.
*Pt supine; Dr places one hand on the sternum while passively flexing the pt's head towards chest.
What is an A/K/A for the Shoulder ABduction Test?
*Pt seated; pt actively places affected arm on top of their head.
*Relief of pain = IVF encroachment.
ALLEN'S TEST NBCE style...
1. Pt's hand on their thigh.
2. Occlude the A's.
3. Have them pump their fist 3 x's, then clinch & open.
*Delay of more than 10 seconds for the blood to return = occlusion of the corresponding A.
Which (+) TOS test indicates compression between the first rib & clavicle?
Costoclavicular Maneuver (Eden's Test).
*Dr palpates the radial pulse while bringing the shoulder down & arm back... then the pt flexes their chin to chest.
*Alteration in radial pulse amplitude = compression between the 1st rib & clavicle.
A (+) Adson's Test indicates compression by....
A/K/A Scalenus Anticus Test = the anterior scalene &/or cervical rib.
*Pt seated, doctor slightly ABducts/extends/externally rotates the arm while taking the radial pulse... Pt rotates the head towards the tested side & extends the head... Pt takes a deep breath in & holds.
Which structures are involved with a positive Modified Adson's Test?
The subclavian A & medial scalene.
*If Adson's is negative; have the pt rotate their head to the opposite side, extend their head & take a deep breath & hold while dr feels radial pulse.
How far do you ABduct the arms with Wright's Test?
Both arms @ once to 180 degrees.
*Note the angle in which the pulse decreases... >10 degrees = asymmetrical pec minor syndrome (compression of the Ax A).
What is Reverse Bakody's testing for?
*Pt seated; places palm on top of head = increased pain.
A (+) Halstead's indicates...
*Pt extends head back & dr exerts downward traction & slight ABduction of the arm while taking the pulse.
*Test both arms at once.
What exercise should be prescribed for shoulder complaints?
Codman's Pendulum Exercises.
*DX via MRI.
Which ortho test is for degenerative tendonitis of the rotator cuff?
Apley's Test: pain or decreased motion = degenerative tendonitis.
*Pt seated; touch sup & inf angles of both scapulas.
*Show pt how to do it then go behind them to observe.
Which 2 shoulder tests are used to DX a supraspinatus tear?
1. Codman's Drop Arm.
2. Empty the Can Test (Supraspinatus Press Test).
A look of apprehension on the patients face when testing the shoulder indicates...
Apprehension Test = chronic shoulder dislocation.
*Pt seated; dr ABducts the arm slowly then rotates the shoulder w/ stabilization.
A (+) Dugas Test indicates...
You are palpating the shoulder for which 2 ortho tests?
Yergason's & Dawbarns.
Which ortho test for the shoulder DX's bicipital tendon instability?
*Pt seated; dr places LIGHT pressure @ the biceps tendon against resistance.
*Audible click in the bicipital groove = bicipital tendon instability.
Which shoulder ortho test is (+) when the pain is decreased?
*Pt seated; deep palpation over the subacromial bursa elicits pain... dr ABducts arm & pain is decreased.
Which ortho test causes the greater tuberosity to jam against the acromial surface?
*Pt seated; arm slightly ABducted, the doctor moves the shoulder through full flexion.
*Pain = overuse of tendons.
A/K/A for Empty Can Test?
Supraspinatus Press Test.
*Pt seated; shoulders ABducted to 90, then apply resistance. Have pt flex their shoulders to 30 degrees & point thumbs downward & apply resistance again... (Test like deltoid, then pour it out).
*Weakness = Supraspinatus Tear.
(+) finding for Speeds Test?
Pain = bicipital tendonitis.
SUBACROMIAL PUSH BUTTON TEST
Dr applies quick deep pressure over the subacromial bursa.