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Special Procedures

Assessment of special procedures

Fluid Wave - liver disease, ascites Pt supine, raise straight R leg against resistance
Rosving's Sign - appendicitis Palpate LLQ and pain is felt in RLQ
Psoas Test - appendicitis supine, hand on R knee, pt raise against force, + tenderness
Obtuator Test - Inflammation Examiner flex pt thigh at hip, rotates int/ext at the hip. Check for pain
Murphy's sign - cholecystitis/appendicitis supine, Liver Palpation wtih inspiration - pain
Blumberg's Sign supine, compress abd wall slowly, quick release, +pain
Indirect fist percussion supine, L palm on R ribs, give blow to L hand with R fist, +pain b/n sides
UPPER EXTREMITY Tinel's Sign- carpel tunnel Percuss over nerve, +tingle
Phalen's Sign- carpel tunnel flex both wrists 90o, fingers point down, +ache, tingle
Allen Test - vascular compromise pt make fist, compress ulnar/radial aa, pt release fist, see pale, release ulnar, blood return, + blood return
Drop Arm Test - rotator cuff Abduct arm 90o, let go, have pt slowly lower, +pt not able to slowly lower
MUSCULOSKELETAL Snuffbox Test - Scaphoid fx palpate hollow space distal to radial styloid bone, thumb extensor and abductor tendons, +tenderness
Bulge Sign - effusion knee supine, stroke up lateral edge of knee, +fluid move to medial side
Ant Drawer Sign - ACL (ant cruciate ligament) supine, flex knee 90o, cup hands around knee, apply post to ant force to draw tibia forward. + if tibia comes out like drawer
Post Drawer Sign - PCL supine, flex knee 90o, cup hands around knee, apply ant to post force and note bckwrd mvmt, +if proximal tibia falls back, abscence of end feel
Lachman Test - ACL tear supine, flex knee, grab above knee to stabilize femur, other hand around inside of upper tibia, pull forward on tibia, + if tibia moves forward excessively
Apley's Test - meniscus prone, bend knee, push down on foot and rotate tibia medially/laterally, +pain
Lat Collateral Ligament Test - lat ligament tear supine, leg extended, then slightly bent while ankle stabilized and lateral rotation
Medial Collateral Ligament Test -med ligament tear supine, leg extended, then slightly bent while ankle stabilized and lateral rotation
Ballotte the Patella - Effusion supine, push on patella and release quickly, +fluid wave
McMurrary Test - meniscal tests supine, hyperflex knee, one hand on knee, one hand on foot and rotate in/out, +pop, click
NEURO Kernig's Sign - meningitis supine, flex hip and knee, +pain in back
Brudzinski's Sign - meningitis supine, lift head toward chest, +flexion of knees/hips
Straight Leg Raise - sciative nerve, disc impinge supine, raise extended leg >45o, +back, buttock pain
Dix Hall-Pike Test - Benign Positional Vertigo Patient is brought from sitting to a supine position, with the head turned 45 degrees to one side and extended about 20 degrees backward. Once supine, the eyes are typically observed for about 30 seconds. If no nystagmus ensues, the person is brought back to sitting. There is a delay of about 30 seconds again, and then the other side is tested.
Created by: palmerag