Thursday, September 25, 2008

MOST COMMON STRESS TESTS

ANKLE

Anterior Drawer – anterior talofibular ligament

Positive Sign – pain, laxity

Talar Tilt – calcaneofibular ligament; deltoid ligament

Positive Sign – pain, laxity

Kleiger – deltoid ligament

Positive Sign – medial and lateral pain, displaced talus

Thompson’s Test – Achilles tendon rupture

Positive Sign – no plantar flexion

Swing Test – posterior tibiotalar subluxation

Positive Sign – resistance to normal dorsiflexion

Tinel’s Sign – deep peroneal nerve; posterior tibial nerve

Positive Sign – no tingling and paraseizure

Morton’s Test – Morton’s neuroma

Positive Sign – pain between 3 rd and 4 th metatarsals

Homan’s Sign – deep vein thrombophlebitis (calf)

Positive Sign – pain in calf with passive dorsiflexion of ankle and knee

extended; pain with palpation of calf

KNEE

LIGAMENT TESTS

Valgus – lateral collateral ligament

Positive Sign – pain, laxity

Varus – medial collateral ligament

Positive Sign – pain, laxity

Posterior Drawer – posterior cruciate ligament

Positive Sign – pain, laxity

Anterior Drawer – anterior cruciate ligament

Positive Sign – pain, laxity

Lachman – anterior cruciate ligament

Positive Sign – pain, laxity

Slocum – anterior cruciate ligament

Positive Sign – pain, laxity

Hughston – posterior cruciate ligament

Positive Sign – pain, laxity

MENISCUS TESTS

Apley Compression – meniscus lesion

Positive Sign – pain,

Apley Distraction – ligament lesion

Positive Sign – pain,

Squat – medial (internal rotation); lateral (external rotation)

Positive Sign – pain,

McMurray – medial (varus/internal rotation); lateral (valgus/ external

rotation)

Positive Sign – pain,

OTHER TESTS

“Q” Angle – patella tracking; dislocation

Apprehension – patellar dislocation

Positive Sign – contraction of quadriceps muscles

Femoral Grinding

Waldron – condralmalaysia

Positive Sign – grinding of patella while extending leg

Noble Compression Test – IT band

Positive Sign – decreased pain

Wilson Test – osteochondritis dissecans

Positive Sign – decreased pain

Thigh Contusion

HIP

MORE THAN ONE AREA

Straight Leg Raise – hip joint pathology (single); SI joint pathology

(bilateral); tight hamstrings

Positive Sign

Patrick’s Test Positive

Sign

Periformis Syndrome Test – periformis tightness (periformis); sciatica

(buttock)

Positive Sign – pain in periformis or buttock

Sign Of The Buttock – lumbar, sciatic, or hamstring (negative); bursitis,

tumor, or abscess in buttock (positive)

Positive Sign – no increased flexion

Trendelenburg – gluteus medius

Positive Sign – pain in Symphysis pubis or SI joint

Flamingo – Symphysis pubis or SI

Positive Sign – pain in Symphysis pubis or SI joint

Gaenslen’s Test – ipsilateral SI joint lesion; hip; L4

Positive Sign – pain

SI JOINT

Ipsilateral Prone Kinetic Test – ilium flexion and rotation

Positive Sign – no movement

Piedallu’s Sign – hypomobile SI

Positive Sign – lower side becomes higher side

Gillet’s – hypomobile SI

Positive Sign – affected side moves little or up

HIP

Ober – IT band tightness

Positive Sign – leg doesn’t drop to the table, pain on trochanter

Trochanteric Bursitis

Positive Sign – pain on palpation, hip flexion and adduction while

weight bearing

Iliopsoas Bursitis – anterior groin pain

Positive Sign – pain on hip flexion

Thomas – rectus femoris

Positive Sign – extended leg flexes at knee;

Craig’s Test – internal/external rotation of hip

Positive Sign

Torque Test – hip capsular ligament integrity

Positive Sign

OTHERS

Leg Length Discrepancy

Torsion tibial

or femoral (cause of discrepancy)

SPINE

CERVICAL

Foraminal Compression (Spurling’s) – cervical radiculitis/nerve root

pressure

Positive Sign – pain on side head towards; pain on opposite side is

muscle spasm

Distraction Test – nerve root pressure

Positive Sign – decreased pain

Upper Limb Tension Test – brachial plexus

Positive Sign – minimal or no symptoms

Adson Maneuver – thoracic outlet syndrome

Positive Sign – disappearance of pulse

Allen Test

Positive Sign – disappearance of pulse

Halstead Maneuver

Positive Sign – disappearance of pulse

Shoulder Abduction Test – herniated disc, epidural vein, and nerve root

compression

Positive Sign – decrease or relief of symptoms

Valsalva Test – herniated disc or tumor

Positive Sign – increased pain

Romberg’s Test – upper motor neuron lesion

Positive Sign – excessive sway or loss of balance

Vertebral Artery Test (Cervical Quadrant) – vertebral artery

compression

Positive Sign – dizziness and nystagmus

LUMBAR

Straight Leg Raise – spaceoccupying

lesion

Positive Sign – radiating pain; pain on opposite side (unilateral

raise)

Prone Knee Bending – L2 or L3 nerve root lesion (posterior & lumbar);

tight quad or stretched femoral nerve (anterior thigh)

Positive Sign – pain in posterior and lumbar area; pain in anterior

thigh

Slump Test – neuromenengeal tract tension

Positive Sign – knee extends further with release of cervical,

symptoms decrease; or increase in symptoms

BrudzinskiKernig

Test – menengeal irritation

Positive Sign – neck and back discomfort

Valsalva – see cervical

Positive Sign –increased pain

Bowstring Test – sciatic nerve pressure or tension

Positive Sign – symptoms reestablished

Babinski Test – upper motor neuron lesion

Positive Sign – extension of big toe and abduction of the others

Beevor’s Sign – abdominal muscle dysfunction

Positive Sign – umbilicus not in straight line

Hoover Test

Positive Sign – patient can’t lift leg or examiner feels no pressure

from opposite leg

SHOULDER

ANTERIOR INSTABILITY

Load and Shift Test

Positive Sign – pain, laxity, reproduction of symptoms

Crank

Positive Sign – apprehension, resistance to further motion, feeling

experienced when previously dislocated

Fulcrum

Positive Sign – apprehension

Anterior Drawer

Positive Sign – clicking, apprehension

POSTERIOR INSTABILITY

Load and Shift Test

Positive Sign – pain, laxity, reproduction of symptoms

Posterior Apprehension Test

Positive Sign – apprehension, resistance to further motion,

reproduction of symptoms

PushPull

Test

Positive Sign – apprehension, greater than 50% posterior

translation

INFERIOR INSTABILITY

Sulcus Sign

Positive Sign – measurement acromion to humeral head greater

than 1 cm

Feagin Test

Positive Sign – apprehension

LABRAL LESIONS (TEARS)

Clunk Test

Positive Sign – clunk, grinding sound

Anterior Slide

Positive Sign – popping or cracking, anterosuperior pain

Compression Rotation Test – bankhart or SLAP lesion

Positive Sign – snapping or catching

SCAPULAR STABILITY

Lateral Scapular Slide Test

Positive Sign

ACROMIOCLAVICULAR SEPARATION/SPRAIN

Acromioclavicular Shear Test

Positive Sign – pain or abnormal movement of AC joint

Scratch and Pull Test

Positive Sign – pain, apprehension

MUSCLE TENDON PATHOLOGY

Speed’s Test – biceps tendon

Positive Sign – increased tenderness in the bicipital groove

(tendonitis); profound weakness (2 nd or 3 rd degree strain)

Yeargason’s Test – biceps tendon

Positive Sign – tenderness in the bicipital groove (may pop out)

Empty Can Test – supraspinatus

Positive Sign – pain, weakness

Drop Arm Test (Codman’s) – rotator cuff complex tear

Positive Sign – unable to return arms to side smoothly or slowly,

severe pain

Liftoff

Sign – subscapularis

Positive Sign – inability to lift hand away from back

IMPINGEMENT

Neer Test – supraspinatus and/or biceps tendon overuse

Positive Sign – pain

HawkinsKennedy

Test

Positive Sign – pain

Impingement Test

Positive Sign – pain in anterior or posterior shoulder or both and

indicates a grade II or III shoulder lesion

NEUROLOGICAL TESTS

Brachial Plexus Tension Test – stretch of brachial plexus

Positive Sign – minimal or no symptoms

Tinel’s Sign

Positive Sign – no tingling or paraseizure

THORACIC OUTLET SYNDROME

Roos Test

Positive Sign

Costoclavicular Syndrome Test

Positive Sign

WRIST

LIGAMENTS, CAPSULES, AND JOINT INSTABILITY

Ligamentous Instability For The Fingers – collateral ligaments

Positive Sign

Thumb Ulnar Collateral Ligament Laxity or Instability Test

Positive Sign – valgus > 35°

Murphy’s Sign – lunate dislocation; level of 3 rd metacarpal head

Positive Sign

Watson Test (Scaphoid Shift) – instability of scaphoid and lunate bones

Positive Sign – pain on radial deviation

Piano Keys Test – instability of distal radioulnar joint

Positive Sign – mobility and pain on ulnar depression

Axial Load – metacarpal or carpal fracture or joint arthrosis

Positive Sign

TENDONS AND MUSCLES

Finkelstein Test – tenosynovitis of abductor pollicis longus and extensor

pollicis brevis tendons

Positive Sign – pain over the tendons

Sweater Finger Sign – digitorum profundus tendon rupture

Positive Sign – distal phalanx of finger won’t flex

Extensor Hood Rupture

Positive Sign – inability to extend interphalangeal joint while DIP

is extending

BunnelLittler

Test – tight intrinsic muscle or contracture of joint capsule

Positive Sign

NEUROLOGICAL DYSFUNCTION

Tinel’s Sign – carpal tunnel syndrome

Positive Sign – tingling in median nerve

Phalan’s Test – carpal tunnel syndrome (median nerve)

Positive Sign – tingling in median nerve

Carpal Compression Test – carpal tunnel syndrome

Positive Sign

Forment’s Sign – ulnar nerve paralysis

Positive Sign – flexion of IP joint of thumb and/or hyperextension

of MCP joint

Weber’s TwoPoint

Discrimination Test (Moberg’s)

Positive Sign

CIRCULATION AND SWELLING

Allen Test

Positive Sign

Digital Blood Flow

Positive Sign – nail bed doesn’t return to normal color within 3

seconds

COMMON PEDIATRIC CANCERS

Common Pediatric Cancers

Children can get cancer in the same parts of the body as adults do, but cancers don't always act like or get treated like adult cancer. Childhood cancers can occur suddenly; however, they have a high rate of cure.

Some types of cancer are more common in children. The most common form of childhood cancer is leukemia. Leukemia is cancer of the blood.

In addition to leukemia, these are other common cancers found in children: