Term
|
Definition
• Median plane—bisects the body into right and left halves
• Parallel to the median plane is the sagittal plane
• The terms medial and lateral are used to describe locations in reference to the medial plane
– Ifpositionisclosertothemiddleplane,itisconsideredmedial
– Furtherawayfromthemiddle/medialisconsideredlateral
– Forexample:ulnarisoftensubstitutedformedialandradialaslateral
• The front part of the body is known as the anterior or ventral surface
– Theanterioraspectofthehandisthevolarorpalmarsurface
– Thedorsalaspectofthefootisthesidefacingupwardsandplantar aspect is the sole
• The back part of the body is posterior or dorsal |
|
|
Term
|
Definition
• Refers to the direction to which the distal segment of the joint points
• VaLgus—whenever the distal part is more lateral
• Varus—the distal part is more medial |
|
|
Term
| Genu Varum vs. Genu Valgum |
|
Definition
• Genuvarum—bowedlegs
• Genuvalgum—knockknees |
|
|
Term
|
Definition
pes cavis- high arch
pes planus- flatfoot |
|
|
Term
|
Definition
| chronic contraction of a muscle in response to genetic, mechanical, chemical, or psychologic stressors. Increased tone results in a shortened tight muscle. |
|
|
Term
|
Definition
| decreased muscle tone. It may be congenital or due to muscular dystrophy or CP. |
|
|
Term
|
Definition
Muscle Disease
• A disease of the muscle in which the muscle fibers do not function properly. This results in muscular weakness.
• Medication, alcohol, or substance-abuse may be a clue to drug-induced myopathy.
Minimal or no symptoms
Weakness, especially of pelvic girdle muscles;
Severe crippling deformities and contractures
• Endocrinopathy, such as thyroid dysfunction (hypo or hyperthyroidism) or Cushing’s syndrome, may be the cause of true muscle weakness. |
|
|
Term
| Inflammatory myopathy should be suspected if |
|
Definition
there is symmetric proximal muscle weakness and no evidence of an alternative explanation for the weakness or if there are other features of a systemic rheumatic disease such as rash, interstitial lung disease, polyarthritis, or Raynaud phenomenon.
• A history of recurrent episodes of exertion- related pigmenturia and weakness suggests a metabolic myopathy. |
|
|
Term
|
Definition
• Twitching of the muscle
• May be a sign of motor neuron disease: amyotrophic lateral sclerosis (ALS), radiculopathies, entrapment neuropathies, and metabolic disorders such as thyrotoxicosis, tetany, and anticholinesterase overdoses |
|
|
Term
|
Definition
• Acute hypocalcemia directly increases peripheral neuromuscular irritability.
• As measured EMG, tetany consists of repetitive, high-frequency discharges after a single stimulus.
• Hyperexcitability of peripheral neurons is probably the most important pathophysiologic effect of hypocalcemia, but hyperexcitability occurs at all levels of the nervous system, including motor endplates, the spinal reflexes, and the central nervous system.
• Symptoms typically begin with perioral and acral paresthesias. These symptoms can cause hyperventilation, leading to respiratory alkalosis and an elevation in arterial pH, which in turn exacerbate the paresthesias.
• The motor symptoms of tetany include stiffness and clumsiness, myalgia, and muscle spasms and cramps.
• In the hands, the result is forced adduction of the thumb, flexion of the metacarpophalangeal joints and wrists, and extension of the fingers (carpopedal spasm).
• Spasm of the respiratory muscles and of the glottis (laryngismus stridulus) can cause cyanosis.
• Autonomic manifestations include diaphoresis, bronchospasm, and biliary colic. |
|
|
Term
|
Definition
• Trousseau’s sign is the induction of carpopedal spasm by inflation of a sphygmomanometer above systolic blood pressure for three minutes.
• Carpopedal spasm, is adduction of the thumb, flexion of the metacarpophalangeal joints, extension of the interphalangeal joints, and flexion of the wrist.
• It may also be induced by voluntary hyperventilation for one to two minutes after release of the cuff. |
|
|
Term
|
Definition
• Chvostek’s sign is contraction of the ipsilateral facial muscles elicited by tapping the facial nerve just anterior to the ear.
• The response ranges from twitching of the lip to spasm of all facial muscles and depends on the severity of the hypocalcemia |
|
|
Term
| Evaluation of Muscle Strength |
|
Definition
• 0 = No contraction detected
• 1 = Slight contraction detected
• 2 = Movement only when gravity is eliminated
• 3 = Movement against gravity but not with resistance
• 4 = Movement against gravity with some resistance
• 5 = Movement against gravity with full resistance
• If muscle weakness is found, compare proximal and distal strengths |
|
|
Term
| Abduction (Valgus) Stress Test |
|
Definition
Collateral Ligaments
• Medial instability of the knee
• Apply a valgus lateral stress to the knee while the patient’s knee is stabilized and the ankle is in a slight lateral rotation and pulled laterally
• The test is first performed with the knee fully extended, then repeated with the knee at 20–30 degrees of flexion
• Excessive movement of the tibia away from the femur indicates a positive test
• Positive findings with the knee fully extended indicate a major disruption of the knee ligaments
• A positive test with the knee flexed is indicative of damage to the MCL |
|
|
Term
| Adduction (Varus) Stress Test |
|
Definition
Collateral Ligaments
• Lateral instability of the knee
• Apply a varus (medial) stress to the patient’s knee while the ankle is stabilized
• The test is done with the knee
in full extension, then again at 20–30 degrees flexed
• A positive test with the knee extended suggests a major disruption of the knee ligaments
• A positive test with the knee flexed is indicative of damage to the lateral collateral ligament |
|
|
Term
|
Definition
• Checks for compression of the subclavian artery by an extra cervical rib or by a tight scalene anterior and scalene medius muscle in thoracic outlet syndrome
• The patient stands and the examiner stands behind the
patient feeling patient’s radial pulse
• When the patient turns head toward the arm being tested and back, an absent or diminished pulse indicates compression of the subclavian artery |
|
|
Term
| Ankle Anterior Drawer Test |
|
Definition
• Designed to identify anterior ankle instability at the anterior talofibular ligament
• Patient sits with leg dangling over table
• Stabilize the distal tibia and fibula with one hand while the other hand holds the foot in 20 degrees of plantar flexion
• The test is positive, if, while drawing the
talus forward in the ankle mortise, there
is laxity or straight anterior translation that is greater than the other side
• Could mean a grade 2–3 ankle sprain caused by anterior talofibular ligament rupture and possibly calcaneo-fibular ligament rupture if the talar tilt is also positive |
|
|
Term
|
Definition
• Helps distinguish between meniscal and ligamentous problems
• This test should be followed by positive Apley’s Compression Test
• With patient prone, flex the leg 90 degrees
• Kneel on the back of the thigh or hold it down with your hand to stabilize it and pull up on the leg by grasping the ankle
• While maintaining traction, rotate the tibia internally and externally
• If the patient complains of pain, the ligaments are damaged
• Note: if only the meniscus is damaged this should not cause the patient pain |
|
|
Term
| Apley’s Compression or Grinding Test |
|
Definition
• Used to diagnose a torn meniscus in the knee
• With the patient prone, flex the leg 90 degrees
• Kneel on the back of the thigh to stabilize it and lean hard on the heel to compress the medial and lateral menisci between the tibia and the femur
• Rotate the tibia externally and internally while maintaining compression
• The patient will have pain at the site of injury |
|
|
Term
| Apprehension Test for Shoulder Dislocation: Anterior |
|
Definition
• Glenohumeraljointinstability, pathology to the labrum, rotator cuff muscles, or joint capsule
• Withthepatientsupine, examiner slowly abducts and externally rotates the patient’s arm
• The test is positive if the patient becomes apprehensive and resists further motion |
|
|
Term
| Apprehension Test for Shoulder Dislocation: Posterior |
|
Definition
• With the patient supine, the examiner slowly flexes the patient’s arm to 90 degrees and the patient’s elbow to 90 degrees
• The examiner then internally rotates the patient’s arm
• A posterior force is then applied to the patient’s elbow
• The test is positive if the patient becomes apprehensive and resists further motion |
|
|
Term
|
Definition
• Ballottementisamedicalsign which indicates increased fluid in the suprapatellar pouch over the patella at the knee joint.
• To test ballottement, apply downward pressure toward the foot with one hand, while pushing the patella backwards against the femur with one finger of the opposite hand. |
|
|
Term
| Brachial Plexus Tension Test |
|
Definition
• Done to detect nerve root compression
• The patient is supine and slowly abducts and externally rotates the shoulder just to the point of pain
• With the examiner supporting the shoulder and forearm, the forearm is then supinated and the wrist flexed
• Positive if the patient’s symptoms are reproduced or increased |
|
|
Term
|
Definition
Knee Effusion
• Testing for this is done by pressing the fluid out of the suprapatellar pouch down behind the patella
• Start about 15 cm above the superior margin of the patella and slide your index finger and thumb firmly downward along the femur
• This is done to milk fluid into the space between the patella and the femur
• AKA Stroke (wipe) Test |
|
|
Term
|
Definition
| for fluid in the knee joint. One hand compresses the suprapatellar pouch, B) while the thumb and finger of the other hand detects the fluid impulse on either side of the patella. C) In the patellar tap test, the finger pushes the patella onto the front of the femoral condyle through the fluid resistance. |
|
|
Term
|
Definition
• To test for sciatic nerve compression
• First do a straight leg raise test
• The leg is raised to the point at which the patient reports pain
• The knee is slightly flexed to reduce the symptoms
• Digital pressure is then applied to the popliteal fossa
• The test is positive if there is a tingling or burning sensation in the hip and buttocks
• AKA Popliteal Pressure Sign, Cramm Maneuver |
|
|
Term
|
Definition
• Tinel’s sign—sharply tap or apply pressure on the median nerve
– Paresthesia in the median nerve distribution indicates a positive test
• Phalen’s sign—patient holds both wrists in full flexion
for two minutes
– Reproducible paresthesia indicates a positive test |
|
|
Term
|
Definition
also known as Patellar Femoral Grind Test
• Tests for patellar-femoral pain syndrome and evaluates the articular surface of the patella
• Patient is supine with a towel
roll under the knee (keeping it
flexed to about 5 degrees. If the knee is fully extended, the test
may pinch the superior joint capsule)
• Cup the superior pole of the patella and stabilize it by moving it distally
• Have the patient contract the quadriceps and all the patella to glide underneath your hand (don’t change the pressure
of your hand)
• This test is positive if the patient reports excessive pain or you feel a gritty sensation |
|
|
Term
|
Definition
Shoulder
• Done to evaluate the glenohumeral joint
• A clunk-like sensation indicates a free labral fragment, and a “click” on manipulation suggests a labral tear
• The patient lies supine and rotates the arm in the extended position
• Place one hand at the elbow, applying pressure against the humerus while the other hand is placed over the glenohumeral joint with the thumb on the anterior surface |
|
|
Term
|
Definition
Tennis Elbow
• Lateral epicondylitis
• Patient in comfortable position
• Stabilize elbow while palpating lateral epicondyle with thumb
• Make fist
• Pronate forearm and radial deviate and extend wrist while the examiner applies resistance |
|
|
Term
|
Definition
Anterior/Posterior Ligaments
• Detect anterior and posterior instability of the knee at the ACL and PCL
• Patient lies supine with the knee flexed 90 degrees
• Sit across the forefoot of the flexed lower limb
• With the patient’s foot in neutral position, pull forward and push backwards in the proximal part of the calf. Both lower limbs are tested
• The test is positive if there is excessive anterior movement of the tibia with respect to the femur, indicating an ACL lesion
• Excessive posterior movement would indicate a PCL lesion |
|
|
Term
|
Definition
• Test for rotator cuff tear, particularly the supraspinatus muscle
• Ask the patient to abduct the arm to 90 degrees
• Apply pressure to the patient’s arm and ask the patient to keep arm in abduction
• If the patient is unable to do this and the arm “drops” = positive |
|
|
Term
|
Definition
• Tests for irritation of the ulnar nerve, which can be located within the ulnar groove, located between the olecranon process and the medial epicondyle
• Patient is asked to hold elbow fully flexed for five minutes
• The test is positive if numbness
or tingling becomes apparent within this time span
• The earlier the symptoms, the more extensive the irritation
• AKA Ulnar Nerve Stretch Test |
|
|
Term
|
Definition
• Used to detect pathology of the hip or SI joint
• Patient lies supine and the foot on the same side of the hurt hip is placed on the contralateral knee (now the hip is flexed, abducted, and externally rotated)
• Stabilize the opposite hip and push down on the flexed knee
• If pain, may be pathology
• AKA Patrick test |
|
|
Term
|
Definition
• De Quervain’s tenosynovitis (affects thumb abductors and extensors)
• Ask patient to flex the thumb and close the fingers over it
• Next, move the hand into ulnar deviation
• Pain will occur in this position if positive |
|
|
Term
|
Definition
• Designed to identify the presence of inflammation (tendonitis) in the area of the medial epicondyle
• The patient flexes the elbow and wrist, supinates the forearm, and then extends the elbow and wrist
• Positive if patient complains of pain over the medial epicondyle
• Pain laterally is called tennis elbow |
|
|
Term
|
Definition
• Done for subacromial impingement or rotator cuff tendonitis
• The arm is forward, elevated to 90 degrees, and then forcibly internally rotated
• Pain over the coracoacromial arch would indicate a positive test |
|
|
Term
|
Definition
• Done to detect inflammation of tissues within the subacromial space
• Position the patient sitting
• Internally rotate the arm with the thumb facing downward, then abduct and forward flex the arm
• If impingement is present, the patient will experience pain as the arm is abducted |
|
|
Term
|
Definition
• Designed to demonstrate a torn ACL
• Similar to the anterior drawer test except the knee is flexed to 15–30 degrees and in external rotation (which relaxes the iliotibial band)
• The drawer maneuver is attempted while the thigh is stabilized on the table
• Excessive forward movement would indicate a torn ACL |
|
|
Term
| Ligamentous Instability Tests: Valgus Stress Test/Test of Ulnar Collateral Ligament |
|
Definition
• Flex the elbow to 20–30 degrees and stabilizing with one hand at the humeral epicondyle and the other above the wrist
• Apply valgus stress to the elbow
• Pain and laxity as compared
to the opposite side is a positive test |
|
|
Term
| Ligamentous Instability Tests: Varus Stress Test/Test of Radial Collateral Ligament |
|
Definition
• Flex the elbow to 20–30 degrees
• Stabilizing with one hand at the humeral epicondyle and the other above the wrist
• Apply a varus stress to the elbow
• Pain and laxity as compared to the opposite side is a positive test |
|
|
Term
|
Definition
• Analternativeterm that refers to the tarsometatarsal joints of the foot
• A Lisfranc fracture is a disruption of the ligamentous attachments between the tarsometatarsal joint |
|
|
Term
| Measurement of Leg Length |
|
Definition
| • Taking the distance between the ASIS and the tip of the medial malleolus |
|
|
Term
|
Definition
• By compressing the MTP joint between the thumb and forefoot
• Pain is positive test |
|
|
Term
|
Definition
• Test to demonstrate a torn meniscus (usually posterior) in the knee
• Flex the knee
• With the knee flexed, externally and internally rotate the tibia on the femur
• With the leg externally rotated, place a valgus stress on the knee (push the knee in medially and grab the ankle and pull laterally)
• With the knee externally rotated and in valgus stress, slowly extend the knee
• If you hear or feel a “click,” the test is considered positive for a torn medial meniscus |
|
|
Term
|
Definition
• A neuroma usually located between the 3rd and 4th metatarsal heads
• Painful to palpation |
|
|
Term
|
Definition
• A test to identify impingement of the supraspinatous tendon in the coracoacromial arch
• The arm is fully pronated and placed in forced flexion
• Pain reproduced over the coracoacromial arch indicates a positive test |
|
|
Term
| Osgood-Schlatter Syndrome |
|
Definition
| • Tenderness and swelling at the site of the infrapatellar tendon insertion into the tibial tubercle |
|
|
Term
| Patella Apprehension Test |
|
Definition
• Designed to identify dislocation of the patella, usually secondary to a weak vastus medialis obliquus and/or an increase in the Q angle
• The patient lies supine and relaxed with the knee resting in full extension
• Carefully and slowly displace the patella laterally
• The test is positive if the patient expresses a sensation of instability, expresses apprehension (“it feels like it’s going to dislocate again”) or if the patient actually contracts the quadriceps to prevent further lateral displacement |
|
|
Term
|
Definition
• Designedtoidentifyinjury to the dorsal SI ligaments
• Havethepatientlie supine and manually compress the ASIS posteriorly and medially
• Positive test is pain in the SI region |
|
|
Term
|
Definition
• This test checks for possible stress fracture in the ankle joint, tibia, or fibula
• To perform this test the patient is seated on table with the leg in a dependent position and the ankle at 90 degrees
• The heel is then firmly percussed with an open hand
• Pain referred back to a specific spot
on one of the bones of the ankle or the
shaft of the tibia or fibula would indicate a possible fracture
• This test can also be performed in other areas to check for fracture
• AKA Thump Test/Bump Test |
|
|
Term
|
Definition
• Theangleformed between a line from the ASIS to the center of the patella and a line from the center of the patella to the center of the tibial tubercle when the patient is standing
with the feet in
neutral position |
|
|
Term
|
Definition
• Done for diagnosis of radicular pain in cervical extradural compressive mono radiculopathy such as herniated disk, epidural pain compression, or nerve root compression—most commonly at C5 or C6
• Patient is sitting or lying position
• The patient’s shoulder is abducted actively or passively so that the hand or forearm of the patient rests on the patient’s head
• The test is positive if there is a decrease in symptoms |
|
|
Term
|
Definition
• Todetectnerveroot compression or dural adhesions to the nerve or joint capsule
• Theexaminerflexesthe patient’s head to one side while applying downward pressure on the opposite shoulder
• Test is positive if pain is increased |
|
|
Term
| Side-Lying Iliac Compression Test |
|
Definition
• To detect the presence of SI joint dysfunction
• Patient lies on his or her side
• Stand above the patient and with elbows fully extended, interlock your palms and place them over the most cephalad margin of the iliac crest
• Examiner then exerts a downward and cephalad directed force on the crest
• Test is positive if painful symptoms in the SI, gluteal, or crural regions are reproduced |
|
|
Term
|
Definition
• Theanatomicalsnuffboxis the small depression slightly dorsal to the radial styloid process formed when the thumb is
fully extended
• Intheolddays,itwasaplace to put snuff and sniff it
• Pain in the snuff box suggests a navicular fracture; aka scaphoid bone |
|
|
Term
|
Definition
• To examine the proximal tendon of the long head of the biceps looking for tendinitis
• Patient’s elbow is flexed 20–30 degrees with the forearm in supination and the arm in about 60 degrees flexion
• Examiner resists forward flexion of
the arm while palpating the patient’s
biceps tendon over the anterior aspect of the shoulder
• The test is positive if pain in the area of the bicipital groove |
|
|
Term
| Spondylolisthesis/Spondylolysis |
|
Definition
• Spondylolisthesis describes the presence of a spondylolysis where there has also been anterior slippage of the vertebra with the lysis (usually L5) on the vertebra below (usually the sacrum)
• Spondylolysis is a medical term used to describe the presence of a “defect” or stress fracture in the posterior arch of the vertebra
– It occurs at the LS (L5/S1) in about 85% of cases. The remainder occur L4/5 or above |
|
|
Term
|
Definition
• Thistestisusefulto detect sciatica
• Patientlyingsupine
• Flextheextendedleg to the trunk at the hip
• Thepatientisaskedto plantar and dorsiflex the foot
• Stretchessciaticnerve
• Pain is positive test |
|
|
Term
|
Definition
• To identify a tear in the supraspinatus tendon
• The patient abducts the arm to 90 degrees with the elbows extended and the arms internally rotated
• The arm are placed 30 degrees anteriorly (in the coronal plane) and the patient resists as the examiner forces arms downward
• Empty beer can sign |
|
|
Term
|
Definition
• To identify lesions of the calcaneo-fibular ligament
• Patient sits on a table with the leg in dependent position and knee flexed to 90 degrees
• Brace the heel with one hand and with the other invert the foot (tilting the talus medially)
• The test is positive if there is joint laxity (amount of inversion on the involved side is excessive)
• Positive test indicates a calcaneo-fibular ligament rupture and possibly an anterior talo-fibular ligament rupture (when anterior ankle drawer test is also positive) |
|
|
Term
| Thompson-Doherty Squeeze Test |
|
Definition
• Thistestsforintegrity of the Achilles tendon
• Withpatientlying prone, squeeze the calf and note the motion of the foot
• Footshouldplantarflex
• Arupturedtendon produces no motion |
|
|
Term
|
Definition
• Found in people with weak or paralyzed abductor muscles of the hip, namely gluteus medius and gluteus minimus
• The patient is asked to stand unassisted on each leg, in turn, while the examiner's fingers are placed on the anterior superior iliac spines. The foot on the contralateral side is elevated from the floor by bending at the knee
• 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 |
|
|
Term
|
Definition
• Done to determine the stability of the long head of the biceps tendon in the bicipital groove
• Have patient flex arm while holding the elbow in one hand and patient’s wrist in the other
• Externally rotate the patient’s
arm while patient resists—and at the same time pull downward at the elbow
• If biceps tendon is unstable, it will pop out of the bicipital groove and cause pain |
|
|
