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Orthopedic Tests-MT

Orthopedic Testing, +ve signs, description, purpose

Test NamePurposeMethodPositive Sign
Valsalva's - Thoracolumbar Checking for the presence of space occupying lesions Hold breath and bear down as if to have a bowel movement. Reproduction or exacerbation of spinal pain or radiation into the limb.
Chvostek's Test - TMJ Integrity of facial nerve and blood calcium levels (demonstrate first) - tap the parotid gland, which overlies masseter muscle (state to client) - twitching of the facial nerve
3 Finger/2 Knuckle Insert - TMJ A quick way to determine nomral mandibular opening (demonstrate first) - place two or three flexed proximal interphalangeal joints into open mouth hypomobility mandible deviates in a C to the side of TMJ thats hypomobile, S movement when opening - suffering from muscle imbalance, inability to open initially indicates lack of rotation of TMJ
Wright's Test - Cervical Suspected thoracic outlet sydrome due to entrapment of subclavian vessels and brachial plexus beneath tendon of pectoralis minor and coracoid process (demonstrate first) - Upper limb placed and maintained in shoulder hyperabduction, palpate radial pulse (state first) - diminishment of pulse, pain, numbing and pins and needles
Eden's Test (Costoclavicular) - Cervical When compromise of the thoracic outlet might be attributed to entrapment of the subclavian and brachial plexus as they pass between clavicle and first rib (demonstrate first) - palpate radial pulse and continues to do so while depressing and retracting shoulder (state first) - diminishment of pulse, pain, numbing and pins and needles
Adson's Maneuver - Cervical Rule out compression of neurovascular bundle, secondary to a cervical rib or abnormalities of scalene musculature (demonstrate first) - head extended and rotated toward side being tested. Palpate pulse while extending and externally rotating the shoulder. Client holds breath. (state first) - disappearance of pulse, pain, numbing and pins and needles
Hautant's Test - Cervical Vertebrobasilar artery insufficiency (demonstrate first) - seated with arms outstretched and forearms sypinated. Close eyes and bring head into full backward bending and rotation. (state first) - if one hand sinks and pronates to side of compromise
Maigne's Test - Cervical vertebrobasilar artery insufficiency (demonstrate first) - supine, head into full backward bending and rotation, hold for 30 seconds (state first) - faintness, dizziness, nystogmus and personality changes
Backward Bending Test - Cervical Vertebrobasilar artery insufficiency (demonstrate first) - lies supine with pillow beneath upper and middle thoracic spine, head supported in neutral. Head is brought into full backward bending, without sidebending or rotations. 8 - 12 seconds (state first) - faintness, dizziness, nystagmus and personality changes
Vertebral Artery Quadrant Test - Cervical Vertebrobasilar artery insufficiency (demonstrate first) - lies supine, pillow beneath upper and middle thoracic spine, head supported in neutral. Head brought into side bending with rotation to same side. Observe 8 - 12 seconds. No Signs Go To Backward Bending Test. (state first) - faintness, dizziness, nystagmus, and personality changes
Valsalva's Maneuver - Thoracolumbar Checking for presence of space occupying lesions i.e herniated disc, tumor (demonstrate first) - Hold breath and bear down as if to have a bowel movement (state first) - reproduction of exacerbation of spinal pain or radiation into the limb.
Lermittie's Test - Thoracolumbar Involvement or irritability of lumbar spinal nerve roots by assessing reproduction of symptoms when nerve roots are tensed (demonstrate first) - lies supine, passively performs straight leg raise of uninvolved leg. Causes pressure on lumbar spine. (state first) - pain reproduced in back or involved limb.
Milgram's Test - Thoracolumbar Checking for presence of space-occupying lesion (demonstrate first) - supine, life both lower limbs simultaneously 2-4" off of the table and hold for 30 seconds (state first) - if unable to hold limbs for 30 seconds or reproduction of pain in spine or radiation into limb.
Hoover's Test - Thoracolumbar Whether the subject may be malingering or holding effort (demonstrate first) - supine, place one hand under each heel and ask to raise one limb (state first) - no increase of pressure in hand from opposite limb.
Ely's/Femoral Nerve Stretch - Thoracolumbar Wether there is any irritation of the femoral nerve. (demonstrate first) - prone, flex subjects knee while supporting thigh just proximal to knee. Stabilize pelvis while extending hip to provide further stretch of femoral nerve. (state first) - pain reproduced or exacerbated in back or throughout femoral nerve distribution
Slump Test - Thoracolumbar Involvement or irritability of lumbar spinal nerve roots by assessing reproduction of symptoms when nerve roots are tensed (demonstrate first) - seated with hands clasped behind the back, slump forward, with 1 arm apply pressure to shoulders and overpressure to forward bent neck. With overpressure extend knee and dorsiflex ankle then release. (state first) - symptoms progressively increase once head and neck are released there should be a noticeable decrease in pain.
Soto-Hall Test - Thoracolumbar involvement or irritability of spinal (lumbar) nerve roots by assessing reproduction of symptoms when nerve roots are tensed. (demonstrate first) - lies supine, passively raise involved lower limb, keep it straight just before pain, head and neck passively flexed. (state first) - symptoms reproduced
Brudzinki's Test - Thoracolumbar Involvement or irritability of lumbar spinal nerve roots by assessing reproduction of symptoms when nerve roots are tensed. (demonstrate first) - lies supine with both hands behind neck. Assist in flexing head, neck and upper back. (state first) - pain in low back, pelvic girdle or lower limb
Braggard's Test - Thoracolumbar Involvement or irritability of lumbar spinal nerve roots by assessing reproduction of symptoms when nerve roots are tensed. (demonstrate first) - lies supine, examiner raises involved lower limb to the point just short of where symptoms begin. Dorsiflex ankle. (state first) - symptoms reproduced in lower back
Quadrant (Kemp) Test - Thoracolumbar Evaluation of intervertebral foramina narrowing (demonstrate first) - stand behind subject, standing, move into backward bending, place hand on shoulder to guide movement. Simultaneously move into rotation and sidebending toward painful side. Complete ROM or Pain (state first) - limited ROM by provocation of symptoms.
Compression Test - Thoracolumbar Assess the presence of a space-occupying lesion in the lumbar spine that may be compressing the spinal nerve root (demonstrate first) - seated, moderate and even downward force (no forward, backward or sidebending) (state first) - increased compression tends to exacerbate symptoms of distraction tends to alleviate a space-occupying lesion.
Distraction Test - Thoracolumbar Assess the presence of a space-occupying lesion in the lumbar spine that may be compressing the nerve root. (demonstrate first) - Sits with upper limbs crossed, reach around thorax and grasp forearms. Straigten or lean back to distract. (state) - Distraction tends to alleviate a space-occupying lesion.
Skin Rolling - Thoracolumbar To assess soft tissue mobility and locate trigger points, area of congestion, and temperature discrepancies (demonstrate first) - Life an area of skin between thumb and forefinger of each hand. Skin is "rolled" forward along the length and in direction desired (state) - Areas that are tethered, congested, hot, cold or tender
Straight Leg Raise (Lasegue's) Test - Thoracolumbar Involvement or irritability of lumbar spinal nerve roots by assessing reproduction of symptoms when nerve roots are tensed. (demonstrate first) - Lies supine, nontest limb in extension on table, passively raise other limb keeping hip slightly adducted and internally rotated and knee fully extended. Angle of hip and table measured. (state) - reproduction of symptoms in back along sciatic nerve.
Anterior Gapping Test (Transverse Anterior Stress Test) - Sacroiliac Implicates SI articulation as a source of symptoms. Specifically SI ligaments (demonstrate first) - Lies supine, pillow under knees, cross upper limbs to contact right ASIS with right hand and Left ASIS with Left hand. Force directly lateral and posterior to separate them. (state) - If motion reproduces localized unilateral SI pain
Posterior Gapping Test (Transverse Posterior Stress Test) - Sacroiliac Implicates the posterior SI ligaments as a source of symptoms. Compliments anterior (demonstrate first) - supine, contact lateral aspect of ASIS bilaterally. Force is directly medially and anterior (state) - reproduced SI joint/localized pain
Posterior - Anterior Spring Test (Sacral Apex Pressure Test) - Sacroiliac Implicates SI joint as a source of pain (demonstrate first) - prone, hypothenar eminence of caudal hand contacts PSIS on side to be tested. Cranial hand contacts the apex of sacrum and produce short post/ant. stress to spring sacroiliac joint (state) - reproduced pain in localized SI joint.
Sacroiliac Rocking Test (Sacrotuberous Ligament Stress Test) - Sacroiliac Indentify irritation of sacrotuberous ligament (demonstrate first) - supine, passively and maximally flex test hip and knee. Maintained flexed position and adduct hip in direction of opposite shoulder (state) - pain in area of SI joint
Gillet's Test (Sacral Fixation Test) - Sacroiliac Evaluates SI joint for restricted mobility (demonstrate first) - stands, stand behind and locate and compare the position of one PSIS relative to S2 tubercle. Subject raises knee, again compare. Ischial Tuberosity and S2 tubercle should also be compared. (state) - PSIS and or tuberosity is restricted in cephalad direction
Gaenslin's Test (Passive Hip Extension) - Sacroiliac Implicates SI joint as a source of symptoms (demonstrate first) - supine, holding knees to chest. Move lower trunk to edge of table so hip bone clears table. Lower limb lowers over side of table (state) - pain reproduced in SI joint, if leg can fall, negative sign, if leg can't fall, positive test, and psoas is tight.
Yeoman's Test - Sacroiliac Assess pathology of the anterior SI ligaments (demonstrate first) - prone, passively flex knee to 90 degrees and then extend hip (state) - Pain in SI joint area. Tissues may also cause pain in this area.
Caudal Shear Test - Sacroiliac Implicate SI Joint as a source of symptoms (demonstrate first) - prone, contact base of sacrum with cephalad hand and stabilizes hip joint at ischial tuberosity. Forearms parallel to table, a shear force is applied to move the sacrum on the hip bone in the caudal direction. (state) - positive if reproduced symptoms and local to SI joint
Cephalad Shear Test - Sacroiliac Implicate the SI joint as a source of symptoms. (demonstrate first) - caudal hand contacts apex of sacrum and cephalad hand stabilizes hip bone along iliac crest. A shear force is given to move sacrum on the hip bone in the head direction. (state) - positive if symptoms reproduce and local SI joint pain.
Patrick's Test (Faber Test) - Sacroiliac Alert of possibility of hip pathology or involvement of SI Joint (demonstrate first) - supine, positions limb to be tested in flexion, abduction, and external rotation so foot rests on opposite knee. Slowly and passively press knee to table and press on counter limb. (state) - positive pain in back or hip or remains in plane and does not lower to table.
Created by: snewell on 2004-11-09



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