Term
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Definition
Palpate the patient's radial pulse while moving the upper extremity in adduction, extension, and ER. Then ask patient to rotate head to involved side while taking a deep breath.
Positive sign - diminished or absent radial pulse
Indication - thoracic outlet syndrome |
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Term
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Definition
While patient is sitting, gently compress patient's head downward
Positive - local cervical pain
Indication - facet joint, transverse process, spinous process issue
Positive - Radiating arm pain
Indication - nerve root lesion, disc herniation |
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Term
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Definition
Patient holds breath and bears down
Positive - pain
Indication - herniated disc or malignancy |
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Term
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Definition
Passive neck flexion
Positive - involuntary hip/knee flexion
Indication - meningitis |
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Term
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Definition
Passive flexion of hip/knee followed by extension
Positive - neck pain or resistance with hip/knee extension
Indication - meningitis |
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Term
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Definition
Tap parotid gland over masseter muscle
Positive - twitching of facial muscle
Indication - hypocalcaemia |
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Term
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Definition
Place finger on patient's chin while mouth is slightly agape. Then hit finger with reflex hammer.
Positive - mouth clenches shut or dramatically opens
Indication - trigeminal nerve problem |
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Term
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Definition
Reach across body and touch opposite anterior shoulder. Reach over head and touch opposite posterior shoulder. Reach behind back and touch opposite shoulder blade.
Positive - limited ROM
Indication - muscle issue |
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Term
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Definition
Place patient's arm in 90 degree abduction and slightly anteriorly with palm facing down. Ask patient to hold arm in place as you gently push down on the arm.
Positive - weakness or pain
Indication - rotator cuff problem |
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Term
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Definition
Place patient's arm in 90 degree abduction and slightly anteriorly. Ask patient to turn thumbs down as you gently push down on the arm.
Positive - pain or weakness
Indication - supraspinatus problem |
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Term
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Definition
Extend patient's elbow and supinate forearm with thumbs up, then ask patient to flex shoulder to 90 degrees. Gently press down on arm.
Positive - weakness or pain in bicipital groove
Indication - biceps tendonitis |
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Term
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Definition
With elbow flexed and forearm pronated, place resistance on arm and ask patient to supinate and externally rotate as if "opening a book"
Positive - pain in bicipital groove
Indication - biceps tendon problem |
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Term
| Impingement syndrome test |
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Definition
Have patient abduct the shoulder and flex elbow to 90 degrees. Hold the patient's wrist and gently press down on patient's elbow while asking patient to resist.
Positive - pain
Indication - impingement syndrome |
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Term
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Definition
Place patient's arm in 90 degree shoulder abduction and 30 degree elbow flexion then passively IR the shoulder.
Positive - pain
Indication - RC tear or impingement syndrome |
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Term
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Definition
Place patient's shoulder in IR with thumb down then passively force the shoulder into flexion up to 150 degrees.
Positive - pain
Indication - tendonitis or impingement syndrome |
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Term
| Apprehension test [for shoulder] |
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Definition
Place patient's elbow in 90 degree flexion then passively flex the shoulder to 90 degrees. Slowly externally rotate shoulder.
Positive - apprehension on patient's face
Indication - anterior dislocation of shoulder |
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Term
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Definition
Apply lateral pressure to the wrist while applying medial pressure to the upper arm
Positive - pain and laxity
Indication - MCL problem |
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Term
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Definition
Apply medial pressure to wrist while applying lateral pressure to the upper arm
Positive - pain and laxity
Indication - LCL problem |
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Term
| Annular ligament test [for elbow] |
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Definition
Passively pronate and supinate the arm to elicit pain. Then place your left hand around the patient's radial head to stabilize before passively pronating and supinating the arm again.
Positive - presence of pain after stabilization
Indication - annular ligament problem |
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Term
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Definition
Ask patient to hold elbow at 90 degrees then extend the wrist and hold. Apply resistance to the wrist.
Positive - lateral epicondyle pain
Indication - lateral epicondylitis |
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Term
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Definition
With elbow at 90 degrees, passively flex and radially deviate the patient's wrist and ask patient to hold in position. Ask patient to actively extend elbow while the provider places resistance against the wrist.
Positive - lateral epicondyle pain
Indication - lateral epicondylitis |
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Term
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Definition
Tap on ulnar groove.
Positive - radiating pain along elbow
Indication - ulnar nerve irritation |
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Term
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Definition
Ask patient to form an "O" with their thumb and middle finger. Then place resistance against the "O" position and ask patient to resist.
Positive - inability to resist
Indication - anterior interosseous nerve palsy |
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Term
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Definition
Tap over median nerve.
Positive - pain or paresthesias
Indication - carpal tunnel syndrome |
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Term
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Definition
Ask patient to place both wrists in flexion with the dorsum of the hands touching one another then hold in place for 2 minutes.
Positive - pain or paresthesias
Indication - carpal tunnel syndrome |
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Term
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Definition
Patient makes first around thumb then ulnar deviates.
Positive - pain at thumb
Indication - DeQuavain's disease |
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Term
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Definition
Ask patient to make a tight fist. Occlude both radial and ulnar arteries. Once hand appears white, release one side and observe for redness to reappear in the hands. Repeat test with other artery.
Positive - no flushing after release of artery
Indication - patency of artery |
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Term
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Definition
With knees flexed, pull tibia anteriorly
Positive - laxity
Indication - ACL instability |
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Term
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Definition
With knees flexed, push tibia posteriorly
Positive - laxity
Indication - PCL instability |
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Term
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Definition
With knees extended, pull tibia anteriorly and push femur posteriorly
Positive - laxity
Indication - ACL instability |
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Term
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Definition
Apply valgus stress to knees with IR
Positive - pain
Indication - ACL instability |
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Term
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Definition
With patient in prone position, flex patient's knee and place downward pressure on the ankle then IR or ER
Positive - pain w/ IR
Indication - lateral meniscus tear
Positive - pain w/ ER
Indication - medial meniscus tear |
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Term
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Definition
With patient in prone position, flex patient's knee and pull ankle upward then IR or ER
Positive - pain w/ IR
Indication - lateral capsule or ligament sprain
Positive - pain w/ ER
Indication - medial capsule or ligament sprain |
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Term
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Definition
Passively flex hip and knee then ER then push knee medially. Repeat but this time, IR then push knee laterally.
Positive - clicking or pain
Indication - meniscus tear |
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Term
| Patella crunch (Clarke's) test |
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Definition
Ask patient to contract the quads then place hand proximal to patella. Ask patient to contract the quads again while you apply slight pressure. If no pain with pressure, move more distally and apply pressure again.
Positive - pain
Indication - patellofemoral syndrome |
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Term
| Apprehension test [for knee] |
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Definition
Attempt to laterally and/or medially displace patella
Positive - apprehension on face
Indication - history of patellar dislocation |
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Term
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Definition
With patient supine and legs extended, place hand over suprapatellar pouch and other hand distal to the patella. Press upper hand down into the knee.
Positive - fluid present
Indication - edema |
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Term
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Definition
Push down on patella and release
Positive - patella floats
Indication - edema |
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Term
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Definition
Hold patient's leg in 30 degree flexion by placing hand on ankle and below knee. Ask patient to relax leg then remove hand from below knee.
Positive - incomplete knee extension
Indication - meniscus tear or posterior capsular sprain |
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Term
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Definition
Passively attempt to slide talus side to side on tibia
Positive - laxity
Indicaiton - talotibial ligament problem |
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Term
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Definition
Squeeze calf muscles and patient should involuntarily plantarflex
Positive - no plantarflexion
Indication - Achilles tendon rupture |
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Term
| Tinels sign for tarsal tunnel syndrome |
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Definition
Tap on medial ankle
Positive - paresthesias
Indication - tibial nerve problem |
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Term
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Definition
With patient supine, passively flex the hip with knee extended. If pain is felt, lower leg slightly until pain disappears then dorsiflex the foot.
Positive - pain at sciatic nerve either before or after lowering leg
Indication - sciatic nerve problem |
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Term
| Opposite straight leg raise |
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Definition
With patient supine, passively flex unaffected hip with knee extended
Positive - pain in opposite leg
Indication - disc herniation |
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Term
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Definition
With patient supine, cup your hands underneath the patient's heels. Ask patient to raise one leg.
Positive - no pressure felt on hand below the opposite heel
Indication - malingering |
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Term
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Definition
With patient supine, passively flex the patient's hip and knee to 90 degrees then ER the hip and place ankle on opposite knee (make a 4-shape). Place your hands at knee and ASIS of patient then apply pressure.
Positive - inguinal or low back pain
Indication - SI joint problem |
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Term
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Definition
With patient supine and relaxed, place your hands on ASIS of patient bilaterally and press medially. Then press down and out (laterally).
Positive - pain
Indication - pelvic fracture |
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Term
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Definition
Ask patient to perform a crunch and observe umbilicus for movement
Positive - umbilicus moves
Indication - abdominal muscle weakness on the opposite side of movement |
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Term
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Definition
Have patient stand on one leg
Positive - hip drop on non-weight bearing leg
Indication - gluteus medius weakness on the weight bearing leg |
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Term
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Definition
With patient in lateral decubitus position of unaffected side, passively flex knee to 90 degrees then abduct the hip before releasing the leg
Positive - leg remains in position and does not drop
Indication - IT band tightness |
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Term
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Definition
With patient in lateral decubitus position on unaffected side, flex knee to 60-90 degrees then passively adduct the hip by applying downward pressure on the knee
Positive - pain in hip
Indication - piriformis strain or tightness
Positive - pain in buttocks
Indication - sciatic nerve impingement |
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Term
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Definition
With patient in lateral decubitus position on unaffected side, passively extend hip and flex knee to 90 degrees
Positive - pain or paresthesias
Indication - femoral nerve problem |
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Term
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Definition
With patient supine, ask patient to flex one leg to the chest
Positive - straight leg rises off the table
Indication - hip flexor tightness |
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Term
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Definition
With patient supine, ask patient to flex both knees to the chest. Have patient release one leg.
Positive - incomplete knee extension
Indication - rectus femoris tightness |
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Term
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Definition
With patient supine and knees flexed to 90 degrees, apply pressure to patient's lateral femoral condyle then passive extend the knee
Positive - pain upon extension
Indication - IT band syndrome |
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Term
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Definition
Have patient stand only on the affected leg then actively flex the knee 30-40 degrees
Positive - pain with knee flexion
Indication - IT band syndrome |
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