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Clinical Tests: Tinels, Phalens, Finkelstein.What are they

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A proactive test in which flexion of the thumb and ulnar deviation of the wrist ... Impingement Test. Speed's Test ... Speed's Test. Yergason's Test ... – PowerPoint PPT presentation

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Title: Clinical Tests: Tinels, Phalens, Finkelstein.What are they


1
Clinical Tests Tinels, Phalens,
Finkelstein….What are they?
  • By William D. Moore, M.D.
  • Orthopedic Surgeon

2
Clinical Examination is Very Important
  • The clinical examination of a patient along with
    their history is very important in forming a
    diagnosis and treatment plan.
  • Diagnostic imaging must be correlated with
    clinical exam findings.

3
Tests for Forearm, Wrists Hands
  • Tinels Test
  • Carpal Compression Test
  • Finkelsteins Test

4
Tinels Test
  • The examiner taps over the carpal tunnel at the
    wrist. A positive test causes tingling or
    paresthesia into the thumb, index finger, and
    middle and lateral half of the ring.

5
Tinels Test
6
Carpal Compression Test
  • The examiner holds the supinated wrist in both
    hands and applies direct, even pressure over the
    median nerve in the carpal tunnel for up to 30
    seconds.

7
Carpal Compression Test
8
Finkelsteins Test
  • A proactive test in which flexion of the thumb
    and ulnar deviation of the wrist are used to
    elicit the pain of de Quervains tenosynovitis.

9
Finkelsteins Test
10
Test for the Shoulder Biceps
  • Hawkins Impingement Test
  • Neer Impingement Test
  • Empty Can Test
  • Cross-arm Adduction Impingement Test
  • Speeds Test
  • Yergasons Test

11
Hawkins Impingement Test
  • A test for rotator cuff impairment in which the
    shoulder is flexed 90 degrees and maximally
    internally rotated.

12
Hawkins Impingement Reinforcement Test
13
Neers Impingement Sign
  • The production of pain by maximal passive forward
    flexion of the shoulder, considered a sign of
    rotator cuff impingement.

14
Neers Impingement Sign
15
Empty Can
  • A resistive test for the shoulder, designed to
    isolate supraspinatus function as much as
    possible, performed with the shoulder in a
    position of 90 degrees abduction and maximal
    internal rotation in a plane 30 degrees anterior
    to the coronal plane.

16
Empty Can
17
Cross-arm Adduction Impingement Test
  • This test uses the position of cross-arm or
    horizontal adduction to produce contact between
    the rotator cuff and biceps long-head tendon and
    the coracoacromial arch.

18
Cross-arm Adduction Impingement Test
19
Speeds Test
  • A provocative test for biceps tendon pain in
    which the shoulder is flexed against resistance
    with the forearm supinated.

20
Speeds Test
21
Yergasons Test
  • A provocative test for biceps tendon pain in
    which the patient is asked to simultaneously flex
    the elbow and supinate the forearm against
    resistance.

22
Yergasons Test
23
Knee Tests
  • Apleys Test
  • McMurry Test
  • Anterior Drawer Sign
  • Lachmans Test
  • Posterior Drawer Sign
  • Posterior Sag Sign

24
Apleys Test
  • A provocative test to elicit the pain associated
    with a meniscus tear by compression and rotating
    the knee in the 90 degrees flexed position.

25
Apleys Test
26
McMurray Test
  • A provocative test to elicit pain and clicking
    associated with a torn meniscus by passively
    manipulating a hyperflexed knee.

27
McMurray Test
28
Anterior Drawer Sign
  • A manipulation test to detect abnormal anterior
    laxity of the knee in the 90 degrees flexed
    position primarily a test of anterior cruciate
    ligament (ACL) integrity.

29
Anterior Drawer Sign
Anterior Drawer in sitting in position. Examiner
feels anterior shift
Examiner watches for anterior shift.
30
Lachmans Test
  • A manipulative test for detecting abnormal
    anterior laxity in the knee performed in a
    position of mild flexion primarily a test of
    anterior cruciate ligament (ACL) integrity.

31
Lachmans Test
32
Posterior Sag Sign
  • With the knee flexed at 90 degrees, it causes the
    tibia to drop or sag back on the femur because of
    gravity, if the posterior cruciate ligament (PCL)
    is torn.

33
Posterior Sag Sign
34
Waddell Signs
  • Hoover Test
  • Straight leg raise (seated vs. supine)
  • Non-Anatomic distribution of weakness/numbness
  • Trunkal Rotation
  • Occipital Compression
  • Over reaction to light stimulus
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