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UE Special Tests

All special tests of UE

TestWhat does it test for? How is it performed?
Speed's Test Tests for bicipital tendonosis/tendonopathy Patient sitting or standing with upper limb in full extension and forearm supinated. Resist shoulder flexion. May also place shoulder in 90 degrees flexion and push upper limb into extension, causing an eccentric contraction of the biceps.
Neer's Impingement Test Tests for impingement of soft tissue structures of shoulder complex (long head of biceps and supraspinatus tendon) Patient sitting, and shoulder is passively internally rotated, then fully abducted. Positive test is reproduction of symptoms
Empty Can Test Tests for a tear and/or impingement of supraspinatus tendon or possible suprascapular nerve neuropathy Patient sitting, with shoulder at 90 degrees and no rotation. Resist shoulder abduction. Then place shoulder in "empty can" position (internal rotation and 30 degrees forward) and resist abduction. Pain with "empty can" position.
Drop arm test Tests for tear and/or full rupture of rotator cuff Patient sitting with shoulder passively abducted to 120 degrees. Patient instructed slowly to bring arm down to side. Guard patient's arm from falling in case it gives way. Positive sign if patient is unable to lower arm back to side.
Posterior Internal Impingement Test Tests for impingement between rotator cuff and greater tuberosity or posterior glenoid and labrum Patient supine. Move shoulder into 90 degrees abduction, maximal external rotation, and 15-20 degrees horizontal adduction. Positive sign is reproduction of pain in posterior shoulder
Clunk test Tests for glenoid labrum tear Patient supine, with shoulder in full abduction. Push humeral head anterior while rotating humerus externally. Audible "clunk" is heard with a positive test
Anterior Apprehension Test Tests for past history of anterior shoulder dislocation Patient supine, with shoulder in 90 degrees abduction. Slowly takes shoulder into external rotation. Positive test will be if patient does not allow motion into range
Posterior Apprehension Test Tests for past history of posterior shoulder dislocation Patient supine with shoulder abducted 90 degrees with scapula stabilized. Place a posterior force through shoulder via a force on patients elbow with placing shoulder in medial rotation and horizontal adduction. Patient does not allow motion.
Acromioclavicular (AC) Shear Test Tests for dysfunction of AC joint (such as arthritis or separation) Patient sitting with arm resting at side. Examiner clasps hands and places heel of one hand on spine of scapula and heel of other hand on clavicle. Squeeze hands together, causing compression of AC joint. Positive test reproduces pain
Adson's Test Tests for pathology of structures that pass through thoracic inlet Patient sitting. Find radial pulse of extremity being tested. Rotate head toward extremity being tested, and then extend and externally rotate the shoulder while extending the head. Reproduction of neurological symptoms or disappearance of pulse.
Military Brace Test Tests for pathology of structures that pass through thoracic inlet; Also known as the costoclavicular syndrome test Patient sitting. Find radial pulse of the extremity being tested. Move shoulder down and back. Reproduction of neurological symptoms or loss of radial pulse if positive
Wright Test Tests for pathology of structures that pass through thoracic inlet; Also known as the Hyperabduction test Patient sitting. Find radial pulse of extremity being tested. Move shoulder in maximal abduction and external rotation. Taking deep breathe and rotating head opposite side being tested may accentuate symptoms.
Roos Elevated Arm Test Tests for pathology of structures that pass through thoracic inlet with arm elevated Patient standing, with shoulders fully externally rotated, 90 degrees abducted, and slightly horizontally abducted. Elbows flexed to 90 degrees and patient opens/closes hand for 3 minutes slowly. Reproduction of neuro symptoms is a positive test
Elbow Ligament Instability Test Tests for laxity or restriction in elbow lateral and medial ligaments Patient sitting or supine. Entire upper limb is supported and stabilized and elbow placed in 20-0 degrees of flexion. Valgus force placed through elbow tests ulnar collateral ligament. Varus force placed though elbow tests radial collateral ligament
Tennis Elbow Test Tests for lateral epicondylitis of elbow Patient sitting with elbow at 90 degrees flexion and supported/stabilized. Resist wrist extension, wrist radial deviation, and forearm pronation with fingers fully flexed (fist) simultaneously. Reproduces pain in lateral elbow.
Golfers Elbow Test Tests for medial epicondylitis of elbow Patient sitting with elbow in 90 degrees flexion and forearm supported/stabilized. Passively supinate forearm, extend elbow, and extend wrist. Reproduction of symptoms in medial elbow.
Tinel's Sign Tests for dysfunction of ulnar nerve at olecranon Tap region where the ulnar nerve passes through cubital tunnel. Reproduces a tingling sensation in ulnar distribution
Pronator Teres Syndrome Test Tests for median nerve entrapment with pronator teres Patient sitting with elbow in 90 degrees flexion and supported/stabilized. Resist forearm pronation and elbow extension simultaneously. Reproduces a tingling r paresthesia with median nerve distribution
Finkelstein's Test Tests for de Quervain's tenosynovitis (paratendonitis of the abductor pollicus longus and/or extensor pollicis brevis) Patient makes fist with thumb within confines of fingers. Passively move wrist into ulnar deviation. Reproduces pain in wrist.
Bunnel-Littler Test Tests for tightness in structures surrounding MCP joints MCP joint is stabilized in slight extension while PIP joint is flexed. Then MCP joint is flexed and PIP joint is flexed. If flexion is limited in both cases, capsule is tight. If more PIP flexion with MCP flexion, then intrinsic muscles are tight
Tight Retinacular Test Tests for tightness around proximal IP joint PIP is stabilized in neutral while DIP is flexed. Then PIP is flexed and DIP is flexed. If flexion is limited in both cases, capsule is tight. If more DIP flexion with PIP flexion, then retinacular ligaments are tight
Finger Ligament Instability Test Tests for laxity or restriction in wrist lateral and medial ligaments Fingers are supported and stabilized. Valgus and varus forces applied to PIP joints of all digits. Repeated at DIP joints. Primary finding is laxity but pain may be evident
Froment's Sign Tests for ulnar nerve dysfunction Patient grasps paper between first and second digits of hand. Pull paper out and look for IP flexion of thumb, which is compensation due to weakness of adductor pollicis
Tinel's Sign Tests for carpal tunnel compression of median nerve Tap region where median nerve passes through carpal tunnel. Reproduces tingling and/or parasthesia into hand following median nerve distribution
Phalen's Test Tests for carpal tunnel compression of median nerve (no tapping) Patient maximally flexes both wrists holding them against each other for 1 min. Reproduces tingling and/or parasthesia into hand following median nerve distribution
Allen's Test Tests for vascular compromise into the UE Identify radial and ulnar arteries at wrist. Have patient open/close fingers quickly several times and then make a closed fist. Using your thumb, occlude ulnar (then radial) artery, have patient open hand. Observe palm, release the compression on artery
Yergason's Test Tests for integrity of the transverse ligament; May also identify bicipital tendonosis/tendonopathy Patient sitting with shoulder in neutral stabilized against trunk, elbow at 90 degrees, and forearm pronated. Resist supination of forearm and external rotation of shoulder. Tendon of biceps long head will "pop out" of groove in a positive test
Created by: jvlassov