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Orthopedic Testing, +ve signs, description, purpose

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Test Name
Purpose
Method
Positive Sign
Valsalva's - Thoracolumbar   show Hold breath and bear down as if to have a bowel movement.   Reproduction or exacerbation of spinal pain or radiation into the limb.  
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show 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  
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show 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  
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show 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  
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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   show
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show 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  
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Hautant's Test - Cervical   show (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  
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show 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  
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Backward Bending Test - Cervical   Vertebrobasilar artery insufficiency   show (state first) - faintness, dizziness, nystagmus and personality changes  
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Vertebral Artery Quadrant Test - Cervical   show (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  
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show 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.  
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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.   show
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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   show
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Hoover's Test - Thoracolumbar   show (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.  
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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.   show
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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.   show
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show 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  
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show 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  
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show 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  
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Quadrant (Kemp) Test - Thoracolumbar   Evaluation of intervertebral foramina narrowing   show (state first) - limited ROM by provocation of symptoms.  
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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)   show
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Distraction Test - Thoracolumbar   show (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.  
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Skin Rolling - Thoracolumbar   To assess soft tissue mobility and locate trigger points, area of congestion, and temperature discrepancies   show (state) - Areas that are tethered, congested, hot, cold or tender  
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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.   show
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show 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  
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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   show
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Posterior - Anterior Spring Test (Sacral Apex Pressure Test) - Sacroiliac   show (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.  
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show 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  
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show 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  
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show 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.  
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Yeoman's Test - Sacroiliac   Assess pathology of the anterior SI ligaments   (demonstrate first) - prone, passively flex knee to 90 degrees and then extend hip   show
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Caudal Shear Test - Sacroiliac   show (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  
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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.   show
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show 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.  
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