NPTE Special Tests - copied

Patellar Tap Test

Infrapatellar effusion Pt supine, knee in extension resting on table. Apply soft tab over the entral patella Positive finding is perception of the patella floating

Lateral Pivot Shift Test

Integrity of ACL Pt supine with testing knee in extension, hip flexed and abducted 30* with slight IR. Hold knee with one hand and foot with the other hand. Place valgus force through knee and flex knee Positive finding is ligament laxity as indicated by tibia relocating during the test. As the knee is flexed, the tibia clunks backward at approximately 30*-40*. The tibia at beginning of test was subluxed, and then reduced by pull of IT band when knee was flexed

Lachman Test

Integrity of ACL Pt supine, testing knee flexed 20*-30*. Stabilize femur and passively try to glide tibia anterior Positive if excessive anterior glide of tibia when compared to uninvolved limb

Posterior Drawer Test

Integrity of PCL Pt supine and testing hip flexed to 45* and knee flexed to 90*. Passively glide tibia posteriorly following the joint plane Positive if excessive posterior translation of the tibia compared to the uninvolved side

Posterior Sag Sign

Integrity of PCL Pt supine with testing hip flexed 45* and knee flexed to 90*. Observe to see whether tibia "sags" posteriorly in this position relative to femur Positive if tibia sags

Upper Limb Tension Test 1

Joint Positioning Sequence: Shoulder depression with 110* abduction, elbow extension, forearm supination, wrist extension, finger and thumb extension Sensitization Test: Contralateral cervical lateral flexion Nerve Bias: Median nerve, anterior interosseous nerve

Upper Limb Tension Test 3

Joint Positioning Sequence: shoulder depression with 10* abduction, elbow extension, forearm pronation, wrist flexion and ulnar deviation, finger and thumb flexion, shoulder medial rotation Sensitization Test: contralateral cervical lateral flexion Nerve Bias: Radial Nerve

Upper Limb Tension Test 2

Joint Positioning Sequence: shoulder depression with 10* abduction, elbow extension, forearm supination, wrist extension, finger and thumb extension, shoulder lateral rotation Sensitization Test: contralateral cervical lateral flexion Nerve Bias: median nerve, musculocutaneous nerve, axillary nerve

Upper Limb Tension Test 4

Joint Positioning Sequence: shoulder depression with 10-90* of abduction, elbow flexion, forearm supination, wrist extension and radial deviation, finger and thumb extension, shoulder lateral rotation Sensitization Test: contralateral cervical lateral flexion Nerve Bias: ulnar nerve

Bunnel-Littler Test

MCP joint is stabilized in slight extension while PIP joint is flexed. Then MCP joint is flexed and PIP joint is flexed Differentiates between a tight capsule and tight intrinsic muscles. If flexion is limited in both cases, capsule is tight. If more PIP flexion with MCP flexion, then intrinsic muscles are tight

Tight Retinacuar Ligament Test

PIP is stabilized in neural while DIP is flexed. Then PIP is flexed and DIP is flexed Differentiates between a tight capsule and tight intrinsic muscles. If flexion is limited in both cases, capsule is tight. If more DIP flexion with PIP flexion, then intrinsic muscles are tight

Barlow's Test

Pediatric Test Pt supine with hips flexed to 90* and knees flexed. Tests hip individually by stabilizing the femur and pelvis with one hand while the other hand moves the test leg into adduction while applying forward pressure posterior to the greater trochanter. Positive indicated by a click or a clunk and may indicative of hip dislocation beign reduced

Ortolani's Test

Pediatric Test Pt supine with hips flexed to 90* and knees flexed. Therapist grasps the legs so that their thumbs are placed along the pt's medial thighs and fingers are placed on the lateral thighs toward the buttocks. Therapist abducts the pt's hips and gentle pressure is applied to the greater trochanter until resistance is felt at approximately 30* Positive test is indicated by a click or clunk and may be indicative of a dislocation beign reduced

Thoracic Outlet Syndrome: Allen Test

Performed with pt in a relaxed, sitting position. The arm to be tested should be in 90* of abduction and full ER. The elbow should be in 90* of flexion. The pt rotates head to the side opposite the arm being tested while the examiner palpates the radial pulse. Radial pulse diminishes or absent after rotation of the head

Pinch Grip Test

Pt asked to pinch the tips of the index finger and thumb together Positive test if the pt cannot pinch tip-to-tip and instead presses the pads of the fingers together Ant interosseous N

Lateral Rotation Lag Sign

Pt elbow bent, therapist passively moves their shoulder into 20* of scaption and near end-range lateral rotation and asks the pt to hold that position. Positive if pt cannot hold position Infra or Supra Issue

Froment's Sign

Pt 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. Pt unable to perform test without compensating may indicate ulnar nerve dysfunction

Hip Anterior Labral Tear Test

Pt in prone, pt's hip in full flexion, lateral rotation, and abduction to begin the test. Therapist moves the hip into extension, medial rotation, and adduction. Positive test is presence of pain or click

Ludington's Test

Pt in sitting and asked to clasp both hands behind the head with fingers interlocked. The pt is then asked to alternately contract and relax the biceps muscles. Positive test: absence of movement in the biceps tendon and may be indicative of rupture of the long head of the biceps

Lift Off Sign (medial rotation)

Pt in sitting or standing. Therapist positions one hand on the posterior aspect of the patient's scapula and the other hand stabilizing the elbow. The therapist elevates the pt arm through flexion Positive test by facial grimace or pain Subscap lesion

Grind Test

Pt in sitting or standing. Therapist stabilizes the pt's hand and grasps the pt's thumb on the metacarpal. Therapist applies compression and rotation through the metacarpal. Pain indicates degenerative joint disease in the carpometacarpal joint

Supraspinatus Test (Empty Can)

Pt is positioned with arm in 90* of abduction followed by 30* of horizontal adduction with the thumb pointing downward. The therapist resists the pt's attempt to abduct the arm. Positive test is indicated by weakness or pain

Elbow Valgus Stress Test

Pt is sitting with elbow in 20 to 30* of flexion. The therapist places one hand on the elbow and the other hand proximal to the pt's wrist. The therapist applies a valgus force to test the medial collateral ligament while palpating the medial joint line. Positive test is indicated by increased laxity in the medial collateral ligament when compared to the contralateral limb

Elbow Varus Stress Test

Pt is sitting with elbow in 20 to 30* of flexion. The therapist places one hand on the elbow and the other hand proximal to the pt's wrist. The therapist applies a varus force to test the lateral collateral ligament while palpating the lateral joint line. Positive test is indicated by increased laxity in the lateral collateral ligament when compared to the contralateral limb

Yergason's Test

Pt is sitting with shoulder in neutral stabilized against trunk, elbow at 90*, and forearm pronated Resisted supination of forearm and ER of shoulder Tendon of biceps long head will pop out of groove. May also reproduce pain in long head of biceps tendon

Phalen's Test

Pt maximally flexes both wrists holding them against each other for 1 minute. Reproduces tingling and/or paresthesia into hand following median nerve distribution.

Allen Test

Pt open/close fingers quickly several times and then make a closed fist. Compress the ulnar artery and have pt open hand. Observe palm of hand and then release the compression on artery and observe for vascular refilling. Perform the same for radial artery Positive findings will present by abnormal filling of blood within hand during test

Apley's Compression Test

Pt prone, testing knee flexed to 90*. Stabilize pt thigh to table with your knee. Passively distract the knee joint, then slowly rotate tibia internally and externally. Next apply a compressive load to knee joint and again slowly rotate tibia internally and externally Pain or decreased motion during compression indicates meniscal dysfunction If pain or increase motion during the distraction then it is most likely ligamentous dysfunction

Neer Impingement Test

Pt sitting and shoulder passively, internally rotated, then fully abducted Reproduces symptoms of pain within shoulder region

Speed's Test

Pt sitting or standing with upper limb in full extension and forearm supinated Resisted shoulder flexion and forearm supination -May also place shoulder in 90* flexion and push upper limb into extension causing an eccentric contraction of biceps Reproduces symptoms (pain) in long head of biceps tendon

Wrist Tinel's Sign

Tap region where the ulnar nerve passes through cubital tunnel Produces tingling sensation in ulnar distribution

Elbow Tinel's Sign

Tap region where the ulnar nerve passes through cubital tunnel Produces tingling sensation in ulnar distribution

Craig's Test

Tests for abnormal femoral antetorsion angle Pt prone with knee flexed to 90*. Palpate greater trochanter and slowly move hip through ER and IR. When greater trochanter feels most lateral, stop and measure the angle of the leg relative to a line perpendicular with table surface Normal angle is between 8* and 15* hip IR. -Less than 8* indicates a retroverted hip -Greater than 15* indicates an anteverted hip

Piriformis Test

Tests for piriformis syndrome Pt supine with foot of test leg passively placed lateral to opposite limb's knee. Testing hip is adducted. Observe position of testing knee relative to opposite knee Positive if testing knee is unable to pass over resting knee and/or reproduction of pain or paresthesia in buttock and/or sciatic nerve distribution.

A patient presents with an acute sprain of the right ankle. According to the patient, this has occurred fairly frequently over the past 5 years. What clinical test should the therapist use to examine the integrity of the anterior talofibular ligament? 1. Anterior drawer test. 2. Morton's test. 3. Talar tilt. 4. Thompson's test.

1. Anterior drawer test. The anterior drawer test is specifically designed to assess the integrity of the anterior talofibular ligament

A patient complains of persistent wrist pain after painting a house 3 weeks ago. The patient demonstrates signs and symptoms consistent with de Quervain's tenosynovitis. What special test can be used to confirm the diagnosis? 1. Finkelstein's test. 2. Phalen's test. 3. Froment's sign. 4. Craig's test.

1. Finkelstein's test. Finkelstein's test is specific for reproducing the pain associated with the de Quervain's tenosynovitis of the abductor pollicis longus and extensor pollicis longus

An older patient complains of pain in the right hip region. The therapist suspects hip osteoarthritis based on the patient's subjective symptoms. What clinical test is the BEST choice to confirm this diagnosis? 1. Scouring test. 2. Thomas test. 3. Craig's test. 4. Posterior impingement test.

1. Scouring test. A positive scouring test would be a consistent finding for a patient who has osteoartrosis of the hip joint. It compresses the joint

A patient with traumatic onset (motor vehicle accident) of neck pain presents with subjective complaints of frank upper cervical spine instability. Which test would safely assist in identifying the integrity of the C1-2 articulation? 1. Transverse ligament stress test. 2. Vertebral artery test. 3. Maximum cervical compression test. 4. Hautant's test.

1. Transverse ligament stress test. The transverse ligament stress test is specifically designed to assess the integrity of the transverse ligament, which maintains the position of the dens of C2 with the anterior arch of C1

Idiopathic scoliosis is suspected in a 12-year-old girl. During the physical examination, what is the standard screening test for this condition? 1. Longsitting, forward bend test. 2. Standing, Adam's forward bend test. 3. Sitting, rotation test to the right and left. 4. Standing, backward extension test.

2. Standing, Adam's forward bend test. The Adam's forward bend test is the standard screening test for scoliosis. During the test, the child will bend forward with feet together, knees straight, and arms hanging free.

A college soccer player sustained a hyperextension knee injury when kicking the ball. The patient was taken to the emergency room of a local hospital and was diagnosed with "knee sprain." The player was sent to physical therapy the next day for rehabilitation. As part of the examination to determine the type of treatment plan to implement, the therapist conducted the test shown in the fi gure. Based on the test picture( lachman test), the therapist is examining the integrity of which structure? 1. Iliotibial band. 2. Posterior cruciate ligament. 3. Anterior cruciate ligament. 4. Medial meniscus.

3. Anterior cruciate ligament.

What is the Thompson test used to examine? 1. Anterolateral rotational instability of the knee. 2. Iliopsoas tightness. 3. Rectus femoris tightness. 4. Achilles tendon rupture.

4. Achilles tendon rupture.

A patient presents with low back pain of insidious onset. Based on the history and subjective complaints, the patient appears to have a dysfunction of a lumbar facet joint. What clinical test should be utilized to confirm this diagnosis? 1. McKenzie's side glide test. 2. Stork standing test. 3. Slump test. 4. Lumbar quadrant test.

4. Lumbar quadrant test. The motion of the lumbar quadrant test places the lumbar facet joint in its maximally closed and therefore most provocative position, so if positive it is typically indicative of a lumbar facet dysfunction

A patient presents with signs and symptoms consistent with sacroiliac dysfunction. What cluster of special tests/findings provides the highest diagnostic accuracy for sacroiliac dysfunction? 1. Thigh thrust test, Gillet's test, stork test, and Patrick's test. 2. Anterior superior iliac spine asymmetry, posterior iliac spine asymmetry, pubic symphysis pain with palpation, and sacral inferior lateral angle asymmetry. 3. Fortin finger test, torsion test, supine-to-sit test, and Gaenslen's test. 4. SI gapping, sacroiliac compression, thigh thrust test (P4), sacral thrust, and Gaenslen's test.

4. SI gapping, sacroiliac compression, thigh thrust test (P4), sacral thrust, and Gaenslen's test.

A patient is referred to physical therapy after an antero-inferior dislocation of the right shoulder. What positive examination finding is expected as a result of this dislocation? 1. Weak rhomboids. 2. Positive drop arm test. 3. Positive Neer's test. 4. Weak deltoids.

4. Weak deltoids. Because of the anatomical position of the axillary nerve, it can be damaged by an antero-inferior dislocation at the GH joint.

Hawkins-Kennedy Test

Examiner places pt's shoulder into 90* of shoulder flexion with elbow flexed to 90*. Therapist passively internally rotates the pt's arm Pain with external rotation Shoulder impingement involving supra

Finkelstein Test

For de Quervain's disease Pt in sitting or standing. Asked to make a fist with the thumb tucked inside the fingers. Therapist stabilizes the pt's forearm and ulnarly deviates the wrist. Pain over the abductor pollicis longus and extensor pollicis brevis tendons at the wrist

Quadrant Scouring Test

For degenerative joint disease of hip Pt supine with hip in 90* flexion and knee maximally flexed. Place compressive load into femur vis knee joint, thereby loading the hip joint. May reproduce pain within in the hip joint and refer pain into knee

Murphy Sign

For dislocated lunate Pt in siting or standing, asked to make a fist. Positive if third metacarpal remaining level with the second and fourth metacarpals.

Patrick's Test (FABER test)

For hip dysfunctions, mobility restriction Pt supine. Passively flex, abduct, and externally rotate test leg so that foot is resting just about knee on opposite leg. Slowly lower the leg down toward the table surface Positive when involved knee is unable to assume relaxed position and/or reproduce pain

Tripod Sign

Hamstring tightness Pt sitting with knees flexed to 90* over the edge of a table. The therapist passively extends one knee. Positive is indicated by tightness of hamstrings or extension of the trunk in order to limit the effect of the tight hamstring

90-90 Straight Leg Raise Test

Hamstring tightness Pt supine and asked to stabilize the hips in 90* flexion with the knees relaxed. Instruct pt to alternately extend each knee as much as possible while maintaining the hips in 90* flexion. Positive test indicated by knee remaining in 20* or more of flexion

FADDIR/FADIR Test (flexion, adduction, internal rotation)

Identifies anterior-superior impingement, iliopsoas tendonopathy, and anterior labral tears Pt supine, involved LE is taken into full passive hip flexion, abduction, and ER into flexed, adducted, and internally rotated position Positive if reproduction of pain with or without click

Jerk Test

Pt sitting with shoulder elevated to 90* and in medial rotation with the elbow bent. The therapist provides an axial compression force through the pt's elbow while horizontally adducting the shoulder. A sudden clunk or jerk as the humeral head subluxes posteriorly indicates the presence of posterior instability. A second clunk or jerk may be heard when the shoulder is returned to the starting position as the humeral head reduces. Complaint of pain could indicate presence of a posterior labral lesion

Drop Arm Test

Pt sitting with shoulder passively abducted to 120*. Pt instructed to slowly bring arm down to side. Guard pt arm from falling in case it gives way Pt is unable to lower arm back down to side RTC tear

Costoclavicular Test

Pt sitting. Find radial pulse of extremity being elevated. Move involved shoulder down and back. Neurological and/or vascular symptoms (disappearance of pulse) will be reproduced in UE.

Wright Test

Pt sitting. Find radial pulse of extremity being elevated. Move involved shoulder into maximal abduction and ER. Take deep breath and rotating head opposite side being tested may accentuate symptoms Neurological and/or vascular symptoms (disappearance of pulse) will be reproduced in UE

Adson Maneuver

Pt sitting. Find radial pulse of extremity. Rotate head toward extremity being tested, and then extend and externally rotate the shoulder while extending the head Neurological and/or vascular symptoms (disappearance of pulse) will be reproduced in UE.

Roos Test

Pt standing with shoulders fully externally rotation, 90* abducted, and slightly horizontally abducted. Elbows flexed to 90* and pt opens/closes hands for 3 minutes slowly. Neurological and/or vascular symptoms (disappearance of pulse) will be reproduced in UE.

Trendelenburg Test

Pt standing, asked to stand on one leg for approximately ten seconds Positive test is drop of pelvis on the unsupported side May indicate weakness of gluteus Medius on supported side

Sulcus Sign

Pt standing. Therapist positions pt's arm in 20-50* abduction. Grasp the pt's elbow and pulls the arm inferiorly. Positive if inferior instability if a Can be graded by measuring the vertical length of the depression 1+ for <1cm 2+ for 1-2 cm 3+ for >2cm

Thessaly Test

Pt stands on one leg with approximately 5* of knee flexion while therapist provides their hands to assist the pt with balance. Pt rotates the femur on the tibia laterally and medially three times. Repeated procedure with 20* of flexion. Positive if pt has joint line discomfort or catching or locking in the knee

Infraspinatus Test

Pt stands with elbow flexed to 90* and the shoulder in 45* of medial rotation. The pt then resists as the therapist applies medially directed force to the forearm Pain or weakness is positive

Supine Impingement Test

Pt supine while therapist passively moves the shoulder into flexion. The therapist then laterally rotates and adducts the shoulder so that the arm is near the pt's head. From this position, the therapist medially rotates the shoulder. Increase in pain with medial rotation

Varus Stress Test

Pt supine with knee flexed to 20-30*. Therapist places one hand on the lateral surface on knee and other hand on the medial surface of the knee. Applies varus force to the knee with distal hand Positive test indicated by excessive varus movement , LCL sprain.

Valgus Stress Test

Pt supine with knee flexed to 20-30*. Therapist places one hand on the medial surface on knee and other hand on the lateral surface of the knee. Applies valgus force to the knee with distal hand Positive test indicated by excessive valgus movement , MCL sprain.

Apprehension Test-Posterior Dislocation

Pt supine with shoulder abducted 90* (in plane of scapula) with scapula stabilized by table. Place a posterior force through shoulder via force on pt's elbow while simultaneously moving shoulder into medial rotation and horizontal adduction Pt does not allow and/or does not like shoulder to move in direction to simulate posterior dislocation

Apprehension Test-Anterior Dislocation

Pt supine with shoulder in 90* abduction. Slowly take shoulder into ER Pt does not allow and/or does not like shoulder to move in direction to simulate anterior dislocation

McMurrary Test

Pt supine with testing knee in maximal flexion. Passively internally rotate and extend the knee-tests lateral meniscus. Passively externally rotate and extend the knee -tests medial meniscus Positive if reproduction of click and pain in knee joint

Brush Test

Pt supine, therapist places on hand below the joint line on the medial surface of the patella and strokes proximally with the palm and fingers as far as the suprapatellar pouch. The other hand strokes down the lateral surface of the patella Positive test is indicated by a wave of fluid just below the medial distal border of the patella

Anterior Drawer Test

Pt supine, with knee flexed to 90* and hip flexed to 45*. Therapist stabilizes the lower leg by sitting on the forefoot. PT grasps the pt's proximal tibia with two hands, places their thumbs on tibial plateau, administers anterior directed force to the tibia on the femur Positive indicated by excessive anterior translation of tibia on the femur with diminished or absent end-point

Bounce Home Test

Pt supine. Therapist grasps the pt's heel and maximally flexes the knee. The pt's knee is extended passively. Positive test indicated by incomplete extension or rubbery end-feel

Glenoid Labrum Tear Test

Pt supine. Therapist places one hand on the posterior aspect of pt's humeral head while the other hand stabilizes the humerus proximal to the elbow. The therapist passively abducts and laterally rotates the arm over the pt's head and then proceeds to apply an anterior directed force to the humerus. Positive test by a clunk or grinding sound

Active Compression Test (O'Brien's Test)

Sitting or standing. Pt is instructed to place the shoulder into 90* of flexion and 10* of adduction. Arm is actively internally rotated so the thumb is pointing down. Inferior directed force into shoulder extension, first with the thumb pointing down and a second time with the thumb pointing up Positive for acromioclavicular lesion if localized pain in the acromioclavicular joint with the thumb pointing down and decrease in pain with the thumb pointing up Positive for labral tear if painful clicking in the joint with the thumb pointing down, which is reduced or eliminated when the patient resists the interior force with the thumb up (supinates the forearm)

Capral Compression Test (Median nerve compression test)

Therapist holds the pt's wrist with both hands and applies pressure over the median nerve in the carpal tunnel for 30 seconds. Or performed by placing the pt's wrist in 60* of flexion before applying pressure Pain or paresthesia in the median nerve distribution

Acromioclavicular Crossover Test

Therapist moves the pt's shoulder into 90* of flexion, then fully horizontally adducts the shoulder Positive if pain over the acromioclavicular joint

Thomas Test

Tightness of hip flexors Pt supine with one hip and knee maximally flexed into chest and held there. Opposite limb is kept straight on table. Observe whether hip flexion occurs on straight leg as opposite limb is flexed Does not differentiate between tightness of iliacus or psoas major Positive if straight limb's hip flexes and/or unable to remain flat on table

Ely's Test

Tightness of rectus femoris Pt prone with knee of testing limb flexed. Observe hip of testing limb Positive if hip of testing limb flexes

Ober's Test

Tightness of tensor fascia lata and/or IT band Pt sidelying with lower limb flexed at hip and knee. Passively extend and abduct testing hip with knee flexed at 90*. Slowly lower uppermost limb and observe it if goes below horizontal or reaches table -Modified starts with knee extended Positive if uppermost limb is unable to go below horizontal or rest on table

While providing sports coverage at a local high school, a physical therapist is asked to examine an athlete with a knee injury. Based on the mechanism of injury, the therapist suspects rupture of the ACL. What test should be performed immediately to identify a torn ACL? 1. McMurray's test. 2. Reverse Lachman's stress test. 3. Lachman's stress test. 4. Posterior sag test.

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What muscle length test for the tensor fascia lata is recommended in a patient with decreased muscle length of the rectus femoris? 1. Modified Ober test (knee extended). 2. FAIR (flexion, adduction, internal rotation) test. 3. Ober test (knee flexed). 4. Ely's test.

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