Special Tests
Patient is seated or standing with elbow flexed to 90degrees and forearm fully pronated.
Palpate the biceps brachii tendon in the bicipital groove
Instruct patient to supinate arm against the therapist resistance
Resist the supination force but allow the patient to go through the motion
What is Yergason's Test
Most prevalent in people 50-54 years of age.
Insidious onset, maybe trauma related
May be from acute injury or degenerative disease
Patients main complaint is shooting pain
What is Cervical Radiculopathy
DTR- Radial nerve (C5, C6)
Brachioradialis
Initial treatment for: Right shoulder
Pain 2/10 now, 6/10 worst, 0/10 best
GH posterior hypomobile
Flexion L: 178, R:172 w pain at 115
Abd L: 176, R: 175 w pain at 105
ER L: 90, R: 75
IR L:70, R: 50
Hawkins Kennedy +
ER lag -
Crank test -
ER MMT L 5, R 4-
IR MMT L 5, R 4
Supraspinatus MMT L 5, R 4-
Mid Trap L 4+, R 3+
What is GH Posterior glides grade 3-4
Older age
History of trauma (MVA or fall)
incontinence
Gait disturbances due to hyperreflexia
What is Cervical Central Cord Lesion
Positive test: Reproduction of myelopathic symptoms during forward flexion, decrease in symptoms during anterior to posterior movement, or excess displacement during the AP movement.
What is Sharp Purser Test
Insidious onset, maybe from a sudden change in time spent in certain positions.
UE paresthesia and pain with or without symptoms into the neck and/or head.
Hand feels hot or cold, and arm may feel heavy or swollen
Observed trophic changes
What is T4 Syndrome
Description of a DTR 4+
What is "A tap elicits a repeating reflex (clonus), always abnormal"
Treatment to improve LOWER cervical mobility
What is CPA, UPA, upglides, lateral glides, cervical paraspinal STM, SNAGS
Patient has a history of diabetes and IV drug use. The patient has insidious onset of chest pain localized in the SC joint. Patient has a fever
Septic Arthritis (AC joint)
Patient seated with therapist standing
Stabilize superior portion of the patients shoulder with one hand while passively abducting their shoulder to 90 degrees and internally rotating
Add an axial compression to the humerus ad maintain compression while horizontally adducting arm.
What is Jerk Test
Mostly seen in intercollegiate sports of men's rugby, wrestling, and hockey.
Traumatic cause: FOOSH
Main complaints: pain and difficulty lying on involved side, overhead activity, and reaching across body
What is AC Joint Sprain
Crosses anterior at lateral epicondyle -> supinator muscle
What is Radial Nerve
Treatment to improve UPPER cervical mobility
What is suboccipital STM, suboccipital stretch, anterior-posterior upper cervical mobilization
Age>50
Unexplained weight loss
No relief with treatment or bed rest
Previous history of cancer
Neck pain
What is cervical neoplastic conditions
Patients is standing with radial pulse found.
Passively abduct, extend, and externally rotate the patients arm.
Patient takes a deep breath in and rotates their head to the same side.
What is Adson's Test
Main causes are overuse, pathology, and malalignment
Affects 1 in 3 adults
More stiffness in the AM
Wearing down of hyaline cartilage leads to an inflammatory response
What is Osteoarthritis
Name the nerve between C4-C5 vertebra
What is C5 nerve root
Initial Treatment: L shoulder
Pain 1/10 now, 5/10 worst, 0/10 best
ROM: WNL
MMT R 5/5
MMT L Flexion 4, Abduction 4-,Extension 4, IR 4, ER 5
Adson's +
Roos +
First Rib Spring +
Costoclavicular Test +
ULNT +
Joint rib mobility WNL
Chest, shoulder, or upper abdominal pain
Dyspnea
History of, or risk factors for developing deep vein thrombosis
What is Pulmonary Embolism
Purpose: Assess for cervical radiculopathy
Positive Test: Decrease or elimination of patients symptoms
What is Cervical Distraction Test or Cervicoscapular Unloading
Minor neck strain resulting from an unguarded or awkward movement or position.
Unilateral neck spain commonly with referred pain to scapula and shoulder.
(+) Spurlings
What is Facet Syndrome
Which ULNT?
Scapular Depression, Shoulder external rotation at 90 degrees, Wrist Extension + pronation, Shoulder abduction brining hand to ear
What is Ulnar Nerve
When would you avoid doing a manipulation
What is
-Lack of practitioner skill
-Lack of confidence
-Patient denies
-Osteopenia/porosis
Chest pain- intensified with inspiration
Difficult to ventilate/expand rib cage
Hyper resonance upon percussion
Decreased breath sounds
Recent bout of coughing or strenuous exercise or trauma.
Pneumothorax