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145 Cards in this Set
- Front
- Back
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L and T Spine ROM techniques |
Lateral lumbar flexion w/ tape measure Lumbar flexion w/ tape measure Lumbar extension w/ tape measure Thoracolumbar flexion w/ tape measure Thoracic rotation |
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C Spine ROM techniques |
Flexion (2 inclinometers or goni) Extension (2 inclinometers or goni) Rotation (goni or supine inclinometer) Lateral flex (goni or inclinometer) |
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AO flexion ROM |
20 degrees |
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AO ext ROM |
10 degrees |
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AO lateral flexion ROM |
5 degrees |
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AA rotation ROM |
35 degrees |
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C spine flexion normal ROM |
65 degrees |
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C spine extension ROM |
40 degrees |
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C spine lateral flexion ROM |
35 degrees |
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C spine rotation ROM |
50 degrees |
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Thoracic spine flexion ROM |
35 degrees |
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thoracic spine extension ROM |
25 degrees |
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T spine lateral flexion ROM |
20 degrees |
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T spine rotation ROM |
35 degrees |
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L spine flex ROM |
50 degrees |
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L spine ext ROM |
35 degrees |
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L spine lateral flexion ROM |
20 degrees |
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L spine rotation ROM |
5 degrees |
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C + T + L spine flex ROM |
150 degrees |
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C + T + L spine ext ROM |
100 degrees |
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C + T + L spine lateral flexion ROM |
75 degrees |
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C + T + L spine rotation ROM |
90 degrees |
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Lumbar instability tests |
prone instability test |
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prone instability test |
-prone on edge of table w/ legs off table and feet touching floor -PT applies P-A pressure at lumbar spinous process -if pain, PT instructs pt to lift both LEs off ground while holding onto table -repeat PA pressure in this position -don't do if suspect spondylolisthesis (+) if pain lessens in 2nd position |
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SI special tests |
-pain provocation: gapping (distraction) test, compression test, Gaenslen's test, posterior shear test, sacral thrust test -other: FABER test * if >/= 3/5 tests + =high probability of SIJ dysfunction |
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SI Gapping (distraction) test |
-supine -palms on both ASIS -cross arms across -gradual force on and off (+) if symptoms reproduced |
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SI compression test |
-supine -opposite of compression -hands on outside on ASIS -push in + if symptoms reproduced |
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Gaenslan's test |
-supine caddywompus -1 LE off table (laying diagonally) -PT flexes other hip/knee -PT applies downward force onto extended leg and supports flexed leg -repeat downward force up to 6x -assess bilaterally + if symptoms reproduced |
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posterior shear test (aka thigh thrust) |
-supine -flex 1 hip to 90 degrees, knee flexed -PT places hand on other SI joint than knee flexed side -come from outside to avoid awkwardness -press down w/ body weight up to 6x's -aggressive thrust posterior force through femur + if sx's reproduced |
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sacral thrust test |
-prone -one hand over other and apply PA force to sacrum -up to 6x thrust -slow CPR of sacrum + if sx's reproduced |
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FABER test |
-supine -Figure 4 position -apply pressure at pt's knees and contralateral ASIS + if sx's reproduced |
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cervical ligamentous injury special tests |
sharp-purser test alar ligament test |
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cervical radiculopathy special test |
compression test distraction test spurling's test |
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cervical flexor fxn test |
deep cervical flexor endurance test cranio-cervical flexion test |
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sharp-purser test |
-seated -pt chin tucks until symptoms felt -f pt hears/feels clunk = + test -if no symptoms reproduced w/ mvmt, PT stabilizes at C2 and applies AP pressure to pt's forehead + if symptoms relieved -originally test for RA |
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alar ligament test |
-seated or supine -PT palpates, key grip C2 spinous process and/or lamina -PT rotates head 1 way then other -PT should almost immediately feel spinous process move contra laterally + if head rotates > 20-30 degrees before rotation at C2 |
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cervical compression test |
-seated -hand on top of pt -downward compression on top of head (make sure pt has good posture) + if reproduces symptoms/pain |
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cervical distraction test |
-seated -cup hands around pt's occiput -gradually applies upward distraction force + if pain reproduced or if radicular pain relieved -make sure to take out earrings! |
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spurling's test |
-seated -pt side bends to uninvolved side -if reproduces symptoms, stop -apply downward compression -repeat on involved side + if radicular symptoms reproduced |
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deep cervical flexor endurance test |
-supine/hooklying -tuck chin -pt lifts entire head 1 inch off table -pt maintains position w/o losing chin tuck -fail if quick jaw thrust and then chin tuck + if unable to maintain 38 seconds male, 30 seconds female indicates deep cervical flexor weakness |
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cranio-cervical flexion test |
-supine/hooklying -BP cuff behind neck, below occiput -inflate cuff to 20 mmHg to fill space -pt chin tucks slowly increasing pressure by 2 mmHg and maintain for 10 sec -10 sec break -pt chin tucks and increases pressure by 4 mmHg and maintain 10 sec -break -keep repeating until gets to 30 mmHg + if unable to do mvmt or increase pressure, indicates deep cervical flexor weakness |
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scapular elevation MMT |
levator scap and upper trap seated, bilateral gravity-lessened = prone |
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scap adduction MMT |
middle trap scoot to opp side gravity-lessened = chair |
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scapular adduction + depression |
middle trap, lower trap, rhomboids no gravity lessened modified grading scale (543210) |
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scapular adduction + downward rotation |
resistance at elbow rhomboids, levator can help prone elbow bent and diagonally back no gravity lessened modified grading scale 543210 |
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abduction and upward rotation scapula |
serratus anterior seated flexion and IR, thumb pointing down modified grading scale 543210 force prox to elbow, lat edge of scapula pushing down and back |
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shoulder abduction MMT |
seated supra stabilize shoulder, proximal elbow pressure supine = gravity lessened |
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scaption MMT |
no gravity lessened, modified scale |
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shoulder flex MMT |
ant delt stabilize on trap side-lying = gravity lessened |
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shoulder flex + add MMT |
90 flex, arm bent, aw shucks motion pull down and back modified scale 543210 stabilize upper trap |
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shoulder ext MMT |
prone straight arm at side teres major and lat stabilize trunk sidelying= gravity lessened |
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shoulder horizontal adduction MMT |
pec major arm across, bend pull away, stabilize shoulder seated = gravity lessened |
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shoulder IR MMT |
90 degrees ABD, 90 elbow flex subscap towel under elbow pressure pro wrist gravity lessened = prone arm hanging down |
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shoulder ER MMT |
90 ABD, 90 elbow flex infra, teres minor gravity lessened = prone arm hanging down towel under elbow |
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subacromial impingement |
-entrapment of subacromial bursa and/or supra tendon in subacromial space -occurs w/ shoulder elevation (flex, abd) and/or IR -pt presentation: lateral/anterior shoulder pain w/ OH activity and/or exhibits painful arc -tx: PT, can progress to RTC tear if untx |
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subacromial impingement tests |
neer test hawkins-kennedy test yocum test |
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neer test |
-seated -UE is IR, stabilize scapula (hold on top, push inferior a little) -passive shoulder flexion + if pain |
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hawkins kennedy test |
-seated -UE 90 flex, elbow 90 flex -UE passively moved into max IR -Support arm + if pain |
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yocum test |
-seated -affected arm on other shoulder -elevate elbow w/o elevating shoulder towards face - active test + if painful |
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rotator cuff pathology |
-generic term referring to injury/damage sustained by one or more RTC tendons, including strain, tenonopathy, tear -typically results from overuse or trauma -pt presentation: pain location varies w/ specific tendon(s) involved but typically occurs whenever tendon/muscle is stressed; if severe, pt may have ROM deficits -if torn, many need surgery |
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drop arm test |
supraspinatus passive ABD to 90 ask pt to maintain position, then slowly lower to side + if painful and unable to control descent spot their arm on way down thumb up |
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full can test |
supraspinatus standing pt elevates UEs to 90 scaption PT applies resistance at wrists downward + if painful and/or weak |
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ER lag sign |
infraspinatus 20 degrees scaption, elbow to 90 PT laterally rotates maximally (no resistance, just PROM) + if pain/unable to maintain end range ER |
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IR lag sign |
subscapularis standing PT positions IR behind back at 90 elbow flex PT extends shoulder 20 ask pt to maintain + if unable to maintain IR (whether weakness or pain) |
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hornblower's test |
teres minor standing scaption 90, elbow flex 90 PT asks pt to maintain against resistance + if can't maintain/pain |
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speed's test
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seated UE elevated to 60-90 flexion w/ elbow fully extended and forearm fully supinated maintain position against resistance palpate intertubercular groove apply resistance down + if bicipital groove pain reproduced |
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biceps tendonopathy |
-generic term referring to any injury/damage to biceps tendon (long head), including strain, inflammation, or tear -typically results from overuse or trauma -pain typically located in anterior shoulder (bicipital groove) and occurs whenever tendon/muscle is stressed |
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yergason's test |
-seated -neutral arm, elbow flexed 90 and forearm pronated -PT has pt supinate and apply resistance -support arm, use other hand to twist forearm + if bicipital groove pain reproduced |
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labral pathology |
-superior part of glenoid labrum loosely attached to adjacent glenoid rim -~50% of fibers of tendon of LH of biceps are direct extensions of superior glenoid labrum -remaining 50% arise from supraglenoid tubercle -large or repetitive forces on biceps tendon can partially detach loosely secured superior labrum from glenoid rim at 12:00 position |
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o' brien's test |
-seated -Part 1: UE 90 shoulder flex, 10 horizontal adduction w/ max IR and full elbow ext; PT applies downward resistance pro to elbow Part 2: test repeated but w/ UE in full ER + = pain/clicking reproduced w/ part 1 and is lessened w/ Part 2 |
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GH instability |
common ortho pathology ranging from small subluxations due to congenital factors to dislocation as result of trauma -may or may not involve pain; pt will often report feeling of shoulder giving way/out |
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sulcus sign |
-seated -palpate acromion -UE at pt side, distal humerus distraction force + if excessive laxity (>2 pt's fingers' width) vs. uninvolved side |
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apprehension test/relocation test |
-supine -part I apprehension procedure: UE positioned in 90 abd w/ 90 elbow flex and neutral rotation -PT gently ER shoulder, looking for sign of apprehension/pain from pt -part II: only if Part 1 positive; while pt in apprehension, PT provides post force to humeral head; + if pain/apprehension produced; part 2 + if pain/apprehension reduced |
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shoulder IR movers |
anterior deltoid subscapularis teres major latissimus dorsi pec major coracobrachialis |
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shoulder IR ROM |
0-90 |
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normal end feel shoulder IR |
firm/capsular |
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shoulder IR contractile limitation |
ERs |
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shoulder IR kinematics |
anterior roll, post glide humerus in glenoid |
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shoulder IR peripheral nerves |
axillary subscapular thoracodorsal medial pectoral lateral pectoral musculocutaneous |
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shoulder IR nerve root |
C5-C8 |
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C6 myotome |
GH IR |
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shoulder ER movers |
post delt teres minor infraspinatus |
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shoulder ER ROM |
0-90 |
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shoulder ER normal end feel |
firm/capsular |
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shoulder ER kinematics |
post roll, ant glide of humerus in glenoid |
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shoulder ER peripheral nerves |
axillary suprascapular |
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shoulder ER nerve root |
C4-C6 |
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myotome C5 |
shoulder abd, ER |
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shoulder add movers |
coracobrachialis latissimus dorsi trees major LH triceps teres minor ST: rhomboids, levator, pec minor |
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shoulder add ROM |
0 degrees |
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shoulder add normal end-feel |
soft tissue approx |
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shoulder add kinematics |
inferior roll, superior glide of humerus in glenoid |
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shoulder add peripheral nerves |
lower sub scapular n radial axillary thoracodorsal musculocutaneous |
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shoulder add nerve root |
C5-T1 |
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shoulder abduction movers |
middle delt
supraspinatus subscapularis infraspinatus ST: upper trap, serratus anterior, lower trap |
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shoulder abd ROM |
0-180 GH: 0-120 |
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shoulder abd normal end feel ROM |
firm/capsular |
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shoulder abd kinematics |
superior roll, inferior glide humerus in glenoid |
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shoulder abd peripheral nerves |
axillary suprascapular |
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shoulder abd nerve root |
C4-C7 |
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shoulder flex movers |
anterior delt
pec major biceps LH coracobrachialis |
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ST shoulder flexion movers (force couple) |
upper trap, serratus ant, lower trap |
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shoulder flex ROM |
0-180, GH 0-120 |
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shoulder flex normal end feel |
firm/capsular |
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shoulder flex kinematics |
humeral head rolls anterior, glides posterior in glenoid 0-90 humeral head rolls superior, glides inferior in glenoid 90-180 |
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shoulder flex peripheral nerves |
medial pectoral musculocutaneous axillary lateral pectoral accessory long thoracic |
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shoulder flex nerve root |
C5-T1 |
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shoulder ext movers |
post delt latissimus dorsi trees major triceps brachii- LH |
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shoulder ext ST force couple |
rhomboids levator scap pec minor |
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shoulder ext ROM |
0-50 |
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shoulder ext normal end feel |
firm/capsular |
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shoulder ext kinematics |
0-90: humeral head rolls post, anterior glide in glenoid 90-180: humeral head rolls inferior, glides superior in glenoid |
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shoulder ext peripheral nerves |
lower sub scapular thoracodorsal axillary radial |
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shoulder ext nerve root |
C5-C8 |
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shoulder horizontal abd primary movers |
post deltoid, infra, teres minor, LH triceps |
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ST horizontal add mvmt |
rhomboids, middle trap |
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shoulder horizontal ABD ROM |
0-30 deg |
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shoulder horizontal ABD end feel |
firm/capsular |
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kinematics of shoulder horizontal abduction |
post roll, anterior glide humerus on glenoid |
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peripheral nerves of shoulder horizontal ABD |
axillary, suprascapular, radial |
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nerve root of shoulder horizontal ABD |
C4-C6 |
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primary movers of shoulder horizontal ADD |
anterior delt, coracobrachialis, pec major |
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shoulder horizontal ADD normal ROM |
0-120 |
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ST joint mvmt in horizontal ABD |
serratus anterior |
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shoulder horizontal ADD end feel |
firm/capsular |
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kinematics shoulder horizontal ADD |
anterior roll, posterior glide humerus on glenoid |
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peripheral nerves of shoulder horizontal ADD |
axillary, musculocutaneous, medial pec, lateral pec |
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nerve root of shoulder horizontal ADD |
C5-T1 |
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ST mvmt of flexion |
upper trap, serratus anterior, lower trap |
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ST mvmt of abd |
upper trap, serratus anterior, lower trap |
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ST mvmt of add |
rhomboids, levator, pec minor |
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if have SCI at C5, still have shoulder motion? |
very little |
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CUT into shoulder IR = weak and painless... sources of symptoms? |
complete tear of IRs, nerve injury to C6 nerve root (impingement, tumor, bone spur) |
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CUT into shoulder IR = weak and painful |
muscle, peripheral nerve compression |
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PROM horizontal add limited to 0-90 |
tight shoulder horizontal abductors lack of posterior glide lack of ST ABD |
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what is ST doing during shoulder adduction |
downward rotation, depression, add |
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what is ST doing during shoulder ABD |
upward rotation, elevation, ABD |
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what is ST doing during shoulder flex |
ST: upward rotation, ABD, elevation |
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what is ST doing during shoulder ext |
ST: scap add, downward rotation, depression |
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what is ST doing during shoulder horizontal ABD |
ADD |
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what is ST doing during shoulder horizontal ADD |
ABD |
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weak and painless |
muscle: complete rupture nerve: serious nerve pathology |
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weak and painful |
muscle: muscle tear nerve: compression (partial) |
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strong and painful |
muscle: grade 1 strain nerve: ok |
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strong and painless |
muscle: ok nerve: ok (likely inert) |
