問題一覧
1
Anterior drawer test
place hand of affected shoulder to examiner’s axilla, shoulder abd 80-120 deg, forward flex 20 deg and lateral rot to 30 deg, stabilize scapula with opp hand, push spine of scapula forward with index and middle finger, examiner’s thumb exert pressure on coracoid process, using arm that’s holding pt’s hand, examiner places hand around pt’s upper arm and draws humerus forward, compare movement with normal side
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In anterior drawer test, click may indicate:
labral tear, slippage of humeral head
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Modification of load and shift test
anterior drawer test
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In anterior drawer test, patient should be in what position
supine
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For anterior instability
anterior drawer test
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Empty can test is also known as
supraspinatus, jobe
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Position of patient during empty can test
sitting
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Empty can test
arm abd to 90 deg with no rotation, examiner provides resistance to abd, shoulder is medially rotated, angled foward 30 deg, thumb pointed to floor, resist while looking for weakness or pain
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Thumb pointed to floor
empty can
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Thumb’s up
full can
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Best for maximum contraction of supraspinatus
full can
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Empty can test positive
supraspinatus tear, neuropathy of suprascapular nerve
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Grandfather of meniscus test of knee
mcmurray test
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Low reliability and sensitivity
mcmurray test
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Mucmurray test
supine with complete knee flexion, medially rotate tibia and extend knee, repeat, test entire post meniscus from post horn to mid segment, may be modified by tibia med rot, knee ext, move to full ROM, repeat
16
Due to pressure of that part if meniscus is not great, this portion is not easily tested
ant half of meniscus
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What am i testing?: tibia med rot, knee ext, move to full ROM
lateral meniscus
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What am i testing?: tibia lateral rot and repeat
medial meniscus
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Wrist flexion test
phalen’s test
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Phalen’s test
examiner flex pt’s wrists maximally and hold for 1 min by pushing pt’s wrist together
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Positive for Phalen’s test
carpal tunnel syndrome, tingling in thumb, index, middle and lateral half of ring finger
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More effective because bone moves tendon during test
speed’s test
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Speed’s test
resist shoulder flexion while forearm’s supinated — pronated — elbow complete extension, may also be forward flexed 90 deg, resist eccentric movement into ext — supinated — pronated
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Speed’s test: increased tenderness in bicipital groove esp with supination
bicipital paranenonitis or tendinosis
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Pain
SLAP type i lesion
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Weakness on resisted supination
2nd to 3rd degree rupture strain of distal biceps
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Checks ability of transverse humeral ligament to hold biceps in bicipital groove
yergason’s test
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Yergason’s test
elbow flexed to 90 deg, stabilized against thorax and forearm pronated, resist supination ahd lateral rot
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If palpating biceps tendon in bicipital groove during supination and lateral rot, POP OUT TENDON:
torn transverse humeral ligament
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Tenderness in bicipital groove alone without dislocation
bicipital paratenonitis or tendinosis
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Hawkin-kennedy test patient position
standing
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Hawkin-kennedy test
forward flex arm to 90 deg, forcible med rot shoulder , may also be performed in diff degrees of forward flexion or horizontal add
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This movement pushes supraspinatus tendon against anterior coracoacromial lig and coracoid process
forward flex arm to 90 deg, forcibly med rot shoulder
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Positive Hawkin-kennedy: pain
supraspinatus paratenonitis, secondary impingement
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Related to coracoid impingement sign and Yocum test
hawkin-kennedy test
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Same with hawkin-kennedy test but involves horizontal add across body 10-20 deg before med rot
coracoid impingement sign
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More likely to approximate lesser tub and coracoid process
coracoid impingement sign
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Modified hawkin-kennedy test
yocum test
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Pt’s hand placed on opp shoulder and examiner elevates elbow
yocum test
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Neer impingement test
arm passively and forcefully elevated and arm med rotated by examiner
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This causes greater tuberosity to jam against anteroinferior border of acromion
arm passively and forcefully elevated and arm med rotated by examiner
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Positive Neer impingement test: pt’s face show pain
overuse supraspinatus, overuse biceps
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Check AC jt
arm passively and forcefully elevated and arm lat rotated by examiner