part 4. special tests (13) biceps tendon tests (6) impingement tests (3) thoracic outlet tests...
TRANSCRIPT
Yeargason Test (LH biceps): Examiner begins by positioning the standing
pt into 90 degrees of elbow flexion with the arm at the side
Examiner uses one hand to palpate the long head of the biceps and the other at the distal arm to provide resistance
Examiner then instructs pt to attempt to first externally then internally rotate the shoulder as the examiner resists the movement
Test is positive for biceps tendon subluxation (and subsequent tenosynovitis) if pt experiences pain or the examiner notes palpable crepitus.
Gilcrest Test (LH biceps): Pt begins by grasping a 5-pound dumbbell in
each hand Pt is then instructed to externally rotate the
shoulder, supinate the wrist, and raise both arms over head
Pain or crepitus at or around the superior glenoid fossa is a positive test that is indicative of tenosynovitis of the long head of the biceps
Pain or crepitus at or around the coracoid process is a positive test that is indicative of tendinitis of the short head of the biceps
Important distinction between long head tenosynovitis and short head tendinitis lies in the fact that only the long head is protected by a tendon sheath
Speed’s Sign (LH biceps):
Examiner first palpates the tendon of the long head of the biceps (deep in the anterior deltoid)
Examiner then instructs pt to flex the elbow as the examiner resists
Pain indicates a positive sign for bicepital tenosynovitis
Lippman’s Test (LH biceps): Pt begins with the elbow
flexed to 90 degrees and the humerus resting at the side
Examiner palpates the long head of the biceps and moves 3 inches distally
Examiner then rolls the biceps tendon against the humerus
Pain indicates a positive test for long head biceps tendon subluxation
Booth & Marvel (Transv. Hum. Lig.) Test (LH biceps): Examiner passively abducts pt’s arm to 90
degrees and then passively internally and externally rotates pt’s shoulder
At the same time, the examiner maintains pressure on pt’s bicepital groove
Pain or a popping sound or sensation is indicative of a positive test for long head biceps tendon subluxation
Ludington’s Test (LH biceps): Examiner
instructs pt to clasp the hands overhead and contract the biceps isometrically
Test is positive for long head biceps tendon subluxation if pt experiences sharp pain on contraction
Neer Impingement Test (impingement): Examiner passively flexes pt’s arm
into complete flexion Pain indicates a positive test for
subacromial impingement syndrome
Hawkins-Kennedy Test (impingement): Examiner passively positions pt’s
shoulder in 90 degrees of flexion, 90 degrees of elbow flexion, and end-range shoulder internal rotation
Apprehension or sensations of pain are considered a positive test for subacromial impingement syndrome
Jam Test (impingement):
Examiner first abducts the standing pt’s arm to 90 degrees and flexes the elbow to 90 degrees
Examiner then internally rotates pt’s arm so that pt’s hand points toward the floor
Next, examiner rapidly and sharply pushes the pt’s elbow with one hand to effectively drive the greater tuberosity under the coracoacromial ligament
Examiner’s other hand should be used to stabilize the shoulder
Test is positive for subacromial impingement syndrome if pt experiences pain
Adson Test (thoracic outlet syndrome): Examiner begins by palpating pt’s
radial pulse Pt’s arm is then abducted, extended,
and externally rotated while the examiner continues to palpate the pulse
Pt is then instructed to take a deep breath and turn the head toward the arm being tested
A disappearance of the radial pulse is a positive test that indicates a compression of the subclavian artery by the medial scalene muscle
Allen Test (thoracic outlet syndrome): Pt begins from a standing position Examiner passively flexes pt’s elbow
to 90 degrees, then abducts and externally rotates pt’s shoulder
Examiner then palpates pt’s radial pulse and instructs pt to look away from the side being tested
A disappearance of the radial pulse indicates a positive test for thoracic outlet syndrome
Halstead Maneuver (thoracic outlet syndrome): The examiner first palpates pt’s
radial pulse and applies a downward traction on the pt’s arm being tested
Examiner then instructs pt to rotate the head to the opposite side and then extend the neck and look at the ceiling
A disappearance of the radial pulse indicates a positive test for thoracic outlet syndrome
Provocative Elevation (Roos) Test (thoracic outlet syndrome): Examiner instructs pt to raise both
hands overhead and rapidly pump the hands 15-30 times
Test is positive for vascular insufficiency indicating thoracic outlet syndrome if the pt experiences numbness, cramping, or tingling